Infections have very dire consequences. Sometime you go from being healthy with a total knee to getting an infection, and then two months later you pass away. My wife that passed away, she died of complications of an infection from a surgery. And that was after I started the company. Personal kind of stuff has continued to fuel me to really focus on these patients.
Dr. Michael MeneghiniBut I also know it does fuel you about making this company right for patients. Today we are sitting down with Chris Hughes and Eric Stukey, two longtime orthopedics operators who built osteo remedies into one of the most dominant infection management companies in the industry. In this episode, they talk about realities of entrepreneurship and healthcare.
Eric StookeyHonestly, I hadn't focused on infection at all because most of my career was in primary hips and knees. And so my first initial reaction was, how big is this market?
Chris HughesI remember I had a conversation with a guy, and he was like, Man, you're crazy. You're gonna do spacers?
Dr. Michael MeneghiniSomeone says that to you, what is your initial instinct?
Chris HughesI was happy. I loved my anonymity. I loved it when everyone said that's a small market. I mean, yeah, don't let me stay out of it. I wanted everybody to think, forget about the infection market because I wanted to own it.
Dr. Michael MeneghiniIs that a hunch for you or did you have data?
Chris HughesIt was a hunch. I don't believe the data has proven out. And Mike Tyson said it best, right? Everyone has a plan until they get punched in the face.
This is Dr. Michael Menigini. Welcome to the Unhinged Podcast. As I routinely say, the healthcare landscape is shaking. The ground is trembling below us. There is so much change, so much controversy and chaos. And we are here on this podcast to talk about the real issues. The things that people are afraid to talk about or a little nervous or timid to talk about, maybe out in public, maybe at a large venue at a large orthopedic meeting. But here we're gonna have the difficult conversations and we're gonna have great guests who are willing to share their thoughts about the healthcare future on Unhinged. And I'm honored today to have two of my very, very close friends with me. Chris Hughes, Eric Stookie, who we're gonna talk about a lot of things in this podcast. We're gonna talk about innovation, we're gonna talk about risk and entrepreneurship, we're gonna talk about starting a business from nothing, growing it in a really niche space, which is infection, which some may have called you both crazy. And the good news is the two of them are also close. We're gonna dive into that later. In fact, they're kind of like brothers a little bit. Uh sometimes they'll finish each other's sentences, that'll be weird, but hang with us. Uh but it'll be a great time. We're gonna dive into all things. The first thing I want to talk about is tonight we're drinking Italian red wine. That seems to make our design sessions better. We'll get into that a little bit later about our design sessions. Um plenty of vintages. That's exactly right. So I'm Northern Italian, I happen to love Italian wine, that's a good theme tonight. Your parent company of Asteremedies, Dimitra, is in Italy as well. That's right. So I think the only wine we could drink tonight is Italian wine. It's much better than the $5 wine that I first uh learned to drink when I was in Connecticut 15 years ago that I bought at the gas station. So we've come a little way from that. That's right. So uh cheers. Cheers, gentlemen, thanks for being here. Thanks for having us. Thanks for being here to share your thoughts on all things orthopedics, infection, and entrepreneurship. Cheers. All right, let's get right into
it. First thing, if you don't mind for the audience, just introduce yourselves real quick. Give us your past. Chris, tell us the role at Oster Remedies, how you started it a little bit, but give us your past, even from where you're born and raised up till now, so the audience gets to know you. Well, Eric won't be surprised that the first sentence out of my mouth is I was born and raised in Ohio, diehard Ohio State Buckeye fan. Here we go. And uh went to college down in Florida. I've been in the South my whole adult life. Um was fortunate to go through an ROTC scholarship in college, spent four and a half years active duty in the Army, but my whole post-army life has been orthopedics and spine. That's really all I know. But uh it's how many years has that been? So 32 years of orthopedics and spine after four and a half in the Army. So Well, thank you for your service. Yeah, well, it was a pleasure to serve. So that's kind of what I what I kind of grew up in. Uh I've I've had a really fortunate career in that I had the opportunity to work with a couple of big companies. Yep. And then I worked with a couple of small companies, and I've worked with some private companies and some public companies, and and I've had a real pleasure the last, I guess it's uh 13 plus, it's about 17 years now working with three startups. Yeah, we're gonna get into that. I mean, Medtronic to this is like uh that's what I wanted, we would we're gonna dive into that. Yeah, so that's that's kind of that's really all I know. Orthopedics and spine and Italian. Thanks for thanks for Italian wine. Good. Thanks for being here, Chris. I appreciate it. Eric, give us your background, where you're from. We can talk a little bit about the Hoosiers. We're sitting here in my basement, uh, where some of the magic happens, as we say, in Indiana. But give us your story if you don't mind. Yeah, I was uh 1993-ish, was my I guess my real introduction to professional orthopedics. I grew up just outside of Wursaw, Indiana, so 15 minutes outside. I was a uh Wallace warrior who was the competing school lawyer. I know, I know. And I didn't, so my parents were both school teachers, so I didn't have a direct connection, but literally I was at Indiana University, which won the national championship. I don't know if Chris remembers that or not. They beat Ohio State on the Wednesday. But uh yeah, this year and no, I was sitting there. This happened again. I mean, this is a recurring theme. I was sitting in Indiana and there was a thing posted up when they used to put things on like billboards and stuff, and it was for an internship at DePew. And I was like, I think I could go do this. I went and interviewed for it, got it, started making a little money going back. It was actually a co-op program where you it was a great program. A lot of professionals that got into it went through that. But six months at school, six months at DePew, did that for uh about a two-year period back and forth, and then went to work for a couple of the guys that um that worked at DePew at the time and uh ended up following them to Wright Medical, spent twelve almost 20 years at Wright in various positions, marketing on up into sales, and ended up running the extremity biodivision at the end. But learned a ton and so many good people went through that there that went on to run companies and everything else. Unbelievable experience, and then that carried me all the way through 2014. And uh he and I, believe it or not, knew each other because he was at Wright Medical in 1996. I started in 95 and we were both junior product managers. But you did that's when you first met, was right. That's when we met and worked together at right. We met 30 years ago. So there's there are two spectacular pictures that the audience need two. One, you guys get dressed up and ready to go. You had a button that got you in trouble on it. The other one, that's fine, we won't talk about that. The other one, you guys are in more casual
clothes with your with your uh respective, it looks like you were, I know you were in an IU thing. But tell us about when you guys met, because I've I've known you guys for over a decade, and the two of you are kind of like brothers. I mean, you'll finish each other's sentences, you will barb each other, and I love it, it's a great interaction, but it's rare, I think, and I want you to comment on that, that you see people that are such good friends that work together in business. Yeah, in business that long. I've seen it tear some relationships apart if you manage to work. Walk us through your your guys' relationship together from the beginning. Yeah, I mean, I'll take a stab at it. You know, they say you should never go into business with your brother or if it gets really uncomfortable and you feel like hugging him, it's totally legal. You can do whatever you want to. Come on over there. We hug it out once in a while. I mean, you have to, uh, warm and fuzzy. Especially when you travel. Uh a lot of people have a have a work wife. I have a work wife, it's just Eric. Yeah. Okay. No, but you know, it's interesting. They always say you should never go into business with your brother or your best friend. And and it's probably good advice for the most part. But really, if you check things at the door and you respect each other for their strengths and their weaknesses, you know, my whole life um I've I've overachieved because of other people. You know, I've always covered up my weaknesses with great people. That's a good leadership. That's a good leadership tip. So, you know, I read that somewhere. I didn't come up with that. Um, but when when I had the pleasure of founding and starting Ostea Remedies, you know, I got things kind of off the ground, had an idea of where I wanted to go, but was really fortunate that Eric became available looking for his next opportunity, and I asked him to just help me think through things. And we did that for two, three months. Yeah. And then finally when you were considering starting osteous. I'd already started it. I'd probably have been about a year, year and a half in, got got the thing going, hired a bunch of distributors, started selling, and then uh when you know Eric was president of Wright Medical and he was deciding, okay, it's time for another opportunity, he started looking, he had great opportunities. So I kind of stole him for a little bit, you know, like I I as my friend and as a colleague and as someone I really trusted in the orthopedic total joint space, because I was in the spine space for 15 years before I started Osteoremedies. And so Eric helped me think through a lot of things. And really in the three or four months where he was really kind of consulting as a friend, you know, I just kind of asked him one day, I said, why don't we just do this? Let's just do it, let's check our friendship at the door, check our titles at the door, and let's be partners and let's do this. And 13 years later, in in our case, 11 years later. So I think that's an important point. You said, let's check certain things at the door. What did you check? I mean, what did you say leave leave there? Because it's probably not gonna be a friendship. You're still friends. I mean, right? Yeah. What was that point? The point was, okay, I'm the founder, I'm the president, I'm the CEO, and that's on my business card. Eric's coming in as our COO, he's gonna do all the hard work and he's done it all for the last decade. He's gonna make the I can vote for that. He's gonna make all the good decisions and he's done that for the thing. I mean, Hughes comes in with the wine, he'll come in making with the food. He's like, you know what? But that's what CEOs do. The point of it is I think in order for our friendship to work in a business setting, yeah, is is we don't have that hierarchy, you know. Right. We're we're we're partners in this. We make and we decided this together. You know, early on, we kind of looked at the org chart that we had, which was like three people, and we said, well, someday we'll have 50 people and and let's divide it. You know, okay, I'll be in charge of these five things, and you're in charge of these five things. If we ever have a tie. And you had this conversation directly with one of the people. We absolutely did. Yeah, and I will say one thing to add to that too, is I think it would have been different if we both had taken the same paths for the you know 20 years before that. It was different. But we were together as you know, young product managers at Wright, like I mentioned. For just a couple years. For a couple years, and then it was over. Then he went and did a you know completely different path. I stayed at right for 19 years. Before you formed off the case. Before we formed. So my own. Okay, so there was a little bit of exactly. And so like we didn't come in, even though we'd remain friends, we didn't come in like-minded and say this is gonna be a groupthink thing. Like, we've had plenty of experiences where we've like called each other out and said, you know, we I think it should go this way. No, it should go that way. And we come up with what we think is the best decision out of it. But it's not just a bunch of the best way to come to a consensus is to hammer it out. And that's what I mean by checking it at the door is don't worry about titles, don't worry about who's in charge, don't worry about all those things they teach you to do in business school or in the military. Right. But let's truly go through this as partners and and build this thing with the patient in mind first. And that's why I started Ostea Remedies is you know, it was an unmet need that I thought patients were suffering in uh in a miserable way, and and so we're I'm proud of what we've done. So is that the way he describes it? Similar perspective? For sure. Yeah, when you guys had to go were there times, I'm sure, when you had to go at each other a little bit. You can't run a successful growth business. Well, I mean, I I'm about ready to ask you, I'm about ready to ask you what's the worst thing you've called each other. And because I mean brothers can get after it. I mean, I've got three boys, and sometimes we I have to separate the two of them. So let's I mean, have you had to go at it for a little bit? We're both we're both like at this point, maybe more we were both more fired up in our younger years. But yeah, I will say we've we've calmed a little bit, but there's been times when we like we can tell when each other when we've reached the limit. And we're like, That's fair enough. If I go another step beyond this, this is gonna get a little get a little awkward. But that's what I'll be honest, that's rarely happened. Yeah, it doesn't mean we agree on everything, but we're usually able to talk it out. And and the other good thing is keep in mind, we're talking about you know, 10, 11 years ago. Yeah, now we've got an unbelievable group of people that we work with, and that's right. We've relinquished so many things to the team that you know they're the ones that are making a lot of the big decisions. It's been fun to watch, it's been fun to be a part of. I want and that's I think it's important for people who hear this to understand because you're right, people will tell you, don't do this. But you all have done that. I think you should do it if it makes sense. I think people want to feel purpose and value in their job. And the one of the things that we know, it's it even when I was at IU, you would always see in the reviews when people, when they're asking people, how are you doing in your work, they would always love the team they work with, and then they thought the executives were you know horrible. It didn't matter when they took that over my 10 years, always the same. People want the people they work with to value each other. And you guys have done it in a way I've been admirable because I mean a lot of their companies you you know, there's a lot of churn, there's an executive moves on, but you guys have been together for a long period of time, and I think it's important for people to understand it's possible. But you got to work at it too. I'm sure you had there were times where you did have to check, check your ego at the door, right? I think you asked about bad names. I mean, most of the bad names we've called each other were on the golf course or you're in Ohio State, Indiana football or basketball games. And that's probably fair game. On the business, on the business side, you know, I think we're both able to compartmentalize well. I think both of us are aggressive, we're both competitive, but when we need to get things done that are important for the business, the the good thing is we're talking about people, we've made every hiring decision together. And and you know, it's not like he's hiring people and I'm hiring people. We've purposefully interviewed everybody we've hired, the two of us plus other managers, because the most important thing to us from the beginning was culture. It wasn't always and this doesn't mean we haven't hired the best people because we have, but it wasn't always let's hire the best of these five people. It's let's hire the person that's going to be the best fit for us in this role. And that served us well in the last 13 years. I mean, most we've we've had a really good track record of long-term employees and the couple that haven't been that way of being been because they didn't fit into the culture and we probably missed a little bit. But I mean that's a that's been a small number. When you're a growth and you're trying to get employees, you're gonna hire and fire a little bit, but if you can retain the majority of the side of a healthy company. How many give us a perspective? Uh you started the company what year? So officially started in July of 2013. 2013. So we're gonna be able to do that. That's when I founded the founded the business. So just you, 13. And take it today, how many people are in the company? So we've got 34 people in our W-2 world today. We've got 21 in our Memphis office, and then the rest of them are scattered out in the field. We've got a handful of uh remote employees that do that do uh corporate work, and then we've been blessed in the last uh two and a half years to pick up we've gone from zero to uh nine regional sales directors that I believe have now set us for the next phase of our uh of our build, you know, to really hone in on really hone in on being able to take our good distributors that have helped build the business and and help them succeed. Right. So when he when you guys when you were advising him, I assume that was for free. Is that right? You were helping. Yeah, at the beginning. So I didn't have any money. It was fair. It was friendship. And you probably couldn't even afford a nice wine back then, I'm sure. All right, so what convinced you when he made the pitch? What convinced you to join him? I'm I'm looking forward to this answer because I've never asked anybody. I asked, I had to ask, and then I'm gonna have a sip of wine while he while Eric's I uh it's interesting because I had just come off, you know, what I described a little bit of uh what I didn't get into is that you know, at right over the last three or four years, lots of acquisitions, lots of change, lots of leadership stuff and everything else. And so it was starting to become you know bigger and bigger. And with that comes sometimes bureaucracy. It's not a bad thing, it's just like it's a fact of transition of business, right? And so, in part, the part that excited me the most was, you know, I I went and we talked about what was he doing. He's like, Well, I'm I'm doing everything. I, you know, earlier today I shipped out some product and you know, I I looked at a exactly I looked at a booth and you know, I'm probably gonna have to go set that up next week at a meeting. And I was like, honestly, that that along with an opportunity to work with somebody that I knew, for better or worse, we knew all the good and the bad, right? You knew I knew exactly, you know, what we were going to get into, and I felt really good about it. So there was a friendship and a trust thing there, of course. But beyond that, like taking a step back and going really small was super exciting to me and doing it from the ground up. He was a year and a half in or whatever it was, really less than a year of fully launching. Correct. And it was a chance to go do all the stuff that I've loved through this experience. Like I know we'll probably get into some of it, but just you know, developing good surgeon teams and the things that I really wanted to go do without all of the, you know, there wasn't all the rules and regulations at the beginning because we could go set the rules. And that's the part that was most compelling for me was to get back and do those things that I love doing. Yeah, and we're gonna dive in a little bit, and I hope you understand the authenticity that we're in my basement, and while you're talking on a serious moment, my four kids apparently seem to be running uh in through the kitchen, which is directly above us. So my apologies if the creepy. Which is what I love about coming here, by the way. Well, we've been in here for we're gonna talk about it many years. Podcasts are supposed to be real life. There's nothing wrong with it. Real life, all right. Because I just wrote it. I just was I literally, if I could have pulled my phone out and said, Stop running your like across the top of our podcast. Anyway, yes, I have six children and I love them dearly. Four of them are young and upstairs running around. My wife's at a uh funeral visitation right now, so it's a little bit chaotic. Well, that's life, right? Now here we are at the podcast. All right, so
let's talk. We talked a lot about you know that journey between the two of you. Now I want to talk to you about the leap. So one of the things I like to, you know, in this part of my career, and you you all know I recently did that as well, one of the things I like to ask people about is that entrepreneurship leap. It's not for everybody. Some people think it is, some people are like, no, I can do it, I want to do it. But man, when you get out there and you first do it, sometimes it's really lonely. Sometimes it is also like, what the hell did I just do? Chris, did we talk us about talk us through the leap to do that? And then did you have some moments early on where you're like, shit, I think I may have gotten out over my skis a little bit. And it's okay. Have a drink of wine if you need to figure it out. Yeah, it's a good idea, actually. Yeah, I'm going back. I had some of those moments early on. I had the same moment two days ago. Those moments never go away. Um, the interesting thing. Two days ago. Jeez. You know, the interesting thing is with osteoremedies, when I founded it, what I'm proud of is I was literally able to draw it out on a napkin and take it to the You came up with the name, you did everything, you said, here it is, and you can For better or worse, did it all, right? Early on. I like the name. I I got lucky. It was available and I hired a trademark attorney, and he said, You can have that name. I said, I want it. And then he told me how much it was to pay for that, and I was like, I don't have any money yet. We're gonna start selling soon. But um, but prior to Osteoremedies, I had the fortune, you know, I left a big company. We talked about that. I was at Medtronic for 10 years, and I never thought about money. I never thought about cash, I never thought about expenses. You know, we just we had a lot of it. And then I went to a startup company that had already begun, but they hired me as president. So I had a chance to build a company. That was a good but I didn't start it. Good transition. Yeah, so I learned a lot, made a lot of mistakes. And how long are you there? Four years. Four years. Four years, oh yeah. Four years. Started a spine company with an amazing group of people in New York City, and then exited out of that, started a distribution company for a couple years to sit out a non-compete, and that's when I reacquainted myself with my Italian friends, and uh, you know, we dreamt up Ostea Remedy. So Italians can be very interesting. So this is my third startup. First one I started from the napkin, but a a lot of the lessons learned were from the first two. But yes, I had a lot of those aha moments. Did you remember? Would you remember do you remember one in particular that was memorable for you? When I'm like, oh, what I might have gotten too far early on. With Ostea Remedies? Yeah, was there a time? Absolutely. It was shortly after Eric joined us. I think I know what he's gonna say. And we were shipping out all our executive in the hunt. We were shipping out all our sets and implants, and we're doing a lot of cases, and we're growing because there's not a lot of competition at the time. That's true. And then Eric and I started going through our instrument trials. And and he pulls out my instrument sets, and they're there's these stainless steel knee, hip and shoulder trials. I don't know if we ever showed them to you. It's a boat anchor. You literally could put an anchor to that boat right out there, no problem. I'll show them to you one day. But but I had one of those aha moments where it was like, man, yeah, I guess I made some decisions early on that maybe maybe maybe weren't perfect, but then we we changed to Ray Dell and the rest is history. That's one, but there's there's plenty of it. I thought I thought what you were gonna say as we showed up at the I can't remember if it was current concepts or what it was, and somebody we shed ship this booth in. And it was like the first moment, you know. I said earlier I was excited about going and doing that stuff, and it was, but I wasn't excited at the moment when the booth ship. Yes. That was the MSIS. MSIS, that's right. That's what it was. And it was It had a thousand parts to it. It took us hours to step up. The two of us putting up. Did you get a picture of that? Probably somewhere out there. We were sweating the death. Like he had to take his shirt off and go change because he was sweating so much. And I was like, We were walking around to other booths. We were borrowing scissors. We were borrowing tape. Then we started 16. Maybe 15. It might have been late 15. I started working with you guys. In full disclosure. It had to be 15. For the audience, I am a consultant with Authority. We'll get into that for full disclosure. But I started working with you guys in 16, right? The beginning of 16. So it was before that. It was before that. It was probably right. Chris is right, it was right before that. Because we we launched the company started July of 13. I launched product in March of 14. Eric joined us in February of 15. That was August. It's always in August. It was so it was the fall of the R. See, that is the stuff that people need to hear, in my opinion. Yeah. Because you don't you see the big company now, you see it successful, you see your booths, you're not putting them up anymore. But I think I deal with that even with young with young surgeons sometimes who are like, well, I see your practice, I want that. Well, you don't see the things that happened early on when I'm going to every chicken dinner, I'm answering every phone call. They don't see that. And I think entrepreneurship has a level of risk and sweat equity early on. Yeah. And today you can reminisce and have good wine about the all the thousand pieces it was in. But at the time, you're like, what the is going on? If he had to go change shirts, he's sweating. We might have used some choice words at each other that that that 15-minute booth assembly took us about three and a half hours, and we never finished it. We end we ended up just giving up. It was close. Because it was pretty much the good thing is you had no competition in the infection space anyway. The air conditioning would have been blowing hard, the thing would have fallen over. I'm telling you. We got through that. And then we that was the lap first and last time we used that booth. Yeah. The good news is I won't tell you what we called that booth, but we had a name for it. Was it foul? It was it was inappropriate, that's all I'll say. They can probably delete it out. Look, the good news is you're not putting up your own booth now, and I can only imagine how people were making fun of you and watching you two try and put that thing together. Well, that was the interesting thing, is a lot of people in our industry knew Eric as president of Wright Medical. They knew me as someone that started a couple companies and did well at Medtronics. I know, but I don't want to elevate it more than it is. But it was it was a great gig. I was very fortunate. I like your humanity. And then all of a sudden he was with me sweating, putting up a so a lot of people we'd run into, we'd run into all our friends at Zimmer and Biomet and Stryker, and they'd be like, What are you two idiots do? I will I will say though, like I we to it to a point on the culture that we were talking about before. Like we still like when we go to the academies and the AUCAS and whatever else, like yes, now we've grown to the part where really good people have other, you know, we we uh hire a lot of that stuff out and all, but we still love setting things up. He and I are still the first ones at the booth and we're the last one. Yeah, but that's another good leadership point, right? I talk about that all the time. Uh the leaders set the tone for the rest of the company. Yeah. If the if the you know, I always pride myself in being the last one of the last cars in the parking lot and not the last park, depending. We've got a good culture now where I'm not. Certainly not the first one there, because I'm not an early riser, but I'm I'm usually the last, but not always, which I love. But your point is correct. You're not willing to roll your sleeves up and get down in it. Now there's a fine, I think there's a there's a fine line between micromanaging.
No doubt. Right? And how do you I mean, how have you managed to do that now? You both stay really involved, but yet I assume, because you've got good employee retention, you don't micromanage. How have you managed to do that? I'm still figuring it out. You know, I figure it out every day. I was thinking about it. We a fact we talked about that a little bit on the way up because I had some calls and um it's hard when you've built it together. You're you're putting up the stuff, and now all of a sudden you've got to let go and let people, but you gotta groom the next leaders, right? You have to let people assume it, right? I mean, so it's hard. No doubt. You know, you like you've met a lot of the people that have gone through, and we've had some unbelievable people, unbelievable people in austere imities, but we have like we've hired people at a you know increasing level over the years, and they've grown a lot. You know, you think about think about like people like you met Rachel when she first started, who runs RD. Absolutely and you know, been in our coming out as an in as a young engineer and growing to be. Look what she's done through the organization. So it's like it's not it's not something I have to think about now to you know uh uh give her the autonomy she needs because she's like better at it than I ever would be. You know what I mean? So some of it's happened naturally without so do you ever have a moment when you were like, oh shit, I made the wrong decision. We're we're we're in a place that's not gonna be good, or have you always had the confidence like yeah, this is you mean about the business overall? When you made the leap to jump into the no I joke I I joked about some of that stuff early on, but you all you felt Yeah, I felt it. It's it's been it's been home from the day that I got here. I knew it was the right thing. I had a no shit moment. I'm gonna let you know right now. You did? You know when it was? When I when I got my rear end up at the hotel in Washington, DC to go advocate for you guys for the FDA. Well, that's a good one. And we were coached and coached and coached in the FDA is completely nonsensical, right? And you go in there and no one really warned me that the FDA has no rational thought process whatsoever. And we're like, what? Like, how hard could it be to say that hips and knees and antibiotics are exactly the same? And they're like, No. And the fact that we showed up, they were like, Oh, you guys are here, and they put a hundred people randomly with chairs in a room. Crazy. It was unfortunately tells a lot about our government. But I was like, Are you kidding me? Yeah, this is we gotta prepped, God right now. I remember that. Like we it was showtime, yeah, we had Sultan preparing us, and then you go to present to a bunch of people who look like they could give a shit. I was like, what on God's green? That was the hardest part to do it. It was disappointing about our country, in all fairness about the FDA, really, that they can't even get their act together. But I guess we were so low on the totem pole. You know, we're in Indiana, you like Lily could probably call a meeting tomorrow on the beat there going. I mean, oh my gosh, that was obsessed that was obscene. At that point, I was like, what have I gotten myself into now? Interesting. Fortunately, you haven't invited me back to the FDA since then, and I appreciate that. Well, we've been lucky to have mostly straightforward 510K stuff, other than you know, other than that one dog. A few battles that we had, but uh we learned a lot from those. You know, you you brought up something interesting. One of the words that I used a lot early in my career and that I don't like anymore is micromanaging. And I try to be a micro leader. You know, I try to I try to use that term even micro leadership instead of micromanagement. To me, it means removing obstacles for your people so they can get their job done best. So it I view myself as a as a leader of my team, and my goal, my number one priority is to remove their obstacles. When they have a problem with FDA or they have a problem with a distributor, they have a problem with our partners and overseas, I try to remove those obstacles so they can get their job done. I don't tell them what to do. I don't like to micromanage. I like to micro lead. I love that perspective. What is the hardest thing that you have to remove for your team? Distractions. Inside the business or or inside the business, I'm sorry. Keeping people laser focused. Yeah, and it's the distractions that they don't bring up themselves. It's the distractions coming in that they get just from the fact that you know we're a victim of our success in a way, right? We're no longer a small startup. We're a pretty decent sized company trying to get bigger. We now have really good global partners that make our organization even bigger, and so consequently, there's just a lot more communication going on amongst all the companies, and sometimes that can be distracting to our people from what they need to do for OSTI Remedy. So I try my best to get in there and remove those things and and and help them from that standpoint. Let's talk about let's talk about we'll get into it, let's talk about the space that you're in.
So you didn't you didn't form a company and say we're gonna go into orthopedic. You didn't inform a company we're gonna spine, which was we which was your wheelhouse. You came into the infection space, which is a unique space we can spend some time on. Yeah. Eric, when when you heard Ozzy Remedies was going infection, did something attract you to the infection space? I'm gonna ask Chris in a minute about what it is. A little bit. I will say two two things hit me at the moment at the first when we first started talking about one was is it is it big enough? You know, you think about Well, that's how much infection is there, right? Exactly. Like, and honestly, I hadn't spent that much time in it just because most of my career was in primary hips and knees, revision hips and knees, and then foot and ankle and bio extremity. Yep. And so I hadn't we really hadn't focused, I can tell you right, we didn't focus on infection at all. And so my first initial reaction was, and I remember even we talked about that early on, is like, how big is this market? And Chris was like, Well, I went to the MSIS meeting and I think it's a lot bigger than people give it credit for. And so we talked we started talking. It was a hunch. So I would make you feel better knowing you did the whole thing on a hunch. Well, it came from him, so it didn't make me feel that much about it. But I mean it was uh it was fair. You go home and tell your wife, you're not gonna believe what the hell I just learned. You did the whole thing on a hunch. Yeah, right. But well, you go and then I'm gonna say one thing about that. No, but it it's true. You know, before I officially said, okay, I want to do this, I went to the MSIS in Philadelphia, the the consensus meeting in 2013. And I just registered as an independent person. I didn't even have the name Ostia Remedies. What made you do that? Just because you're like, I weren't interested in it. Because I was talking with my partners in TechRas, and they were interested in me doing this. And I thought I need to really do some diligence on what this market's about. You had the relationship with Tech Ris through before. I met them, believe it or not, in 1996, same time because I'm I was the product manager at Wright Medical that got stuck with bone cement. Nobody wants that as a product manager. I got it. And so I established a relationship with TechRas in 1996, so 30 years, even though I started this company only 13 years ago. But the point of that was it was kind of a hunch, is that you know, I heard about this meeting and I thought, well, I'm gonna go there because everybody who knows anything about infections is gonna be there. And I listened to all the talks. I specifically went and talked to a bunch of surgeons I knew, a bunch of PhDs I knew, and I started asking them questions, and they kept looking at me like, what are you doing here? Aren't you still with you know Paradigm Spine or aren't you still with Medtronic? And I was like, Well, I'm thinking about doing something specific to infection only. And I remember I had a conversation with a guy named Tiger Buford who writes a writes a really great blog called Orthostreams.com. Yeah, I get it every day. Yeah, and he writes a lot. He's been doing that for a long time. That's kind of and I talked to him about it, and he was like, Man, you're crazy. You're gonna do spacers? And then about two years later, after I joined it. If someone says that to you, what what is your initial instinct? I was happy. I loved my anonymity. I wanted showing Zimmer and the pew and Anovis. I wanted everybody to think, forget about the infection market because I wanted to own it. And I looked at and that's the reason that's the reason I started the company is I looked at it as an unmet need in a problem that was getting worse. And the the real problem with the infection market, it's unlike a dislocation or osteolysis or something like that. Infections sometimes you go from being healthy with a total need to getting an infection, and then two months later you pass away. That's a bad outcome. Infections have very dire consequences, and not just for the patient, it's for the family, it's for the business that that patient works for. I mean, there's an ecosystem of people that are affected when someone gets a PJI. And and I wanted to really focus on that and be 24-7 infection because no one else was. Everyone was dabbling in infection, but no one was 24-7 on it. So I just kind of loved my anonymity. Loved I loved it when everyone said that's a small market. I mean, yeah, don't yeah, stay out of it. And and that allowed us to kind of build it up well before everyone else jumped in there. You feel the same. Yeah, in fact, so here was that was what the first part was was it big enough that we were talking like we were talking about before. The second part was what hit me when Chris started talking through this, and we started talking through this, was there was a parallel with what I had just been through at right. You know the history, a little bit of that, right? Dow Corney Wright with breast, you know, breast implants and all that stuff. Then the problems, then Leo Whitesite comes in, uh, you know, Vanim knee and all that, and it becomes a knee company, cementless knee company, well ahead of its time. Yeah, ultimately became you know the medial pivot, which was one of my first or one of my early projects. By the way, yes, very innovative that'll come back around to be mainstays and it'll be there. But back back then, niche. Correct. And so, but the challenge for right was in the hip and knee world, tiny, tiny piece of it. Even with all that, they were such a small piece of it. All of a sudden, you know, some really smart people discover foot and ankle, and for a long time it's like that market's too small, it's undeveloped, there's nothing there. Look at it now, don't waste your time, look at it now. It's what ultimately unlocked the value for right and why they got acquired by a really nice multiple by Stryker, right? That's why it happened. If they would have remained, you know, a you know, just sort of a hip and knee company, I don't think they ever would have gotten there. There was a ton of parallels with that that Chris had already already identified it, right? But for me, like you talk about building the confidence and all, I was thinking about, oh my gosh, this can be another foot and ankle type scenario. We can go shine a big old light on this at the right time. You know, stay with the anonymity while you can, but eventually put a big light on this saying, and we spin, when we wake up, this is what we think about every single day. Yeah, we're gonna innovate in a way that others that are doing it part-time just can't and won't. Yeah, yeah. So that's what really connected with me. All right, let's get into the next topic, which I really want to dive into.
This is something special. We're in uh my basement and we've had a unique history uh together where we do a lot of design meetings, and especially in the early days. Eric, you and I were in my old house in the basement. There's a picture that uh is one of my favorites, which is Mario, who was the eight-year-old I just got went upstairs and yelled at, and swaddled, swaddled. And I and I I I uh Tim Broker took that picture, but it I was crazy. Yeah, I was um typing on my laptop, I had a cell phone right there, cheese that Broker would always bring, a glass of wine, and Mario swaddled, uh, who I can swaddle like nobody's business. I remember when I think this is so funny because Mark Zuckerberg for a period of time was like saying he could change a diaper than everybody. I would tell you right now, I would I would race Mark Zuckerberg in two seconds, I would destroy him. I mean, I have six kids. Zuckerberg's probably got eight nannies taking care of his babies. Oh boy. I can change and swaddle a baby. You're also a surgeon. You're used to kind of used to surgical, there's a surgical technique that I've got to be able to do. Oh, yeah, I cannot change a diaper yet that I'm aware of. Okay. So let's let's get into those basement sessions. It was special for me because I appreciated the fact that as a busy uh surgeon with a family, you would come and we'd get in the basement and then we'd just start mapping stuff out. We'd have a nice glass of wine, but that really frees things to not be in a rigid environment. What I mean that was unconventional. You spent time at uh Wright Medical, those basement sessions, I think they were special. They were amazing. And I can remember the first time like when we started talking, and then Tim said, Hey, we're gonna go to Dr. Menagini's you know basement and stuff, and I was like, what are you talking about? Like I've we do design meetings at hotels and at you know company events and whatever, and it was so unorthodox. But um it was it was unbelievable because for the reasons you said one, you were able to do the things that I've really admired about you over the years, which is you were able to balance the family side with the unbelievable stuff. It helped me because I didn't have to travel. Exactly. I could I could go up and sleep in my own bed uh and be with my kids later, and I could be with the kids before it, like I did tonight. Right, exactly. Yeah, it just is a human standpoint. I always respect that. And I appreciated that you were willing you guys were willing to do that. For sure. But but you know, I would say in addition to that, just like the amount of conversation that we had and the efficiency that we worked through it. But, you know, uh I we have countless, countless books of you know, all of the drawings that you made, and you grab the book from me and you start drawing out a hip stem or a knee stem, and and probably one of the most rewarding things is going back and looking at that now and seeing those drawings that started back in 16, and all of a sudden then we see the products that we eventually launched and the patients that they benefit from that. And I know you've lived that in previous lives and with you know bigger companies. But at least you brought the proper uh the book you had had nice, it was the proper squares. It wasn't like some you brought a mead like fourth grade book to the meeting, so that's good. Yeah, you you did bring the right stuff, which is good. And those that you're right. The books, I love looking back at it because literally we were just sketching stuff out in the basement. Yeah, that's and those things turned into not just products, but they turned into patentable ideas and things that you know we've been able to protect and offer up. So yeah, it's it's unbelievable going back and looking at that stuff, but it's a testament to you know, you think about what do you want to work with with a surgeon, and that's one of the things I did learn from my earlier part of my my career. You know, I always wanted somebody that uh I shouldn't say I, but we always talked about we wanted surgeons that, you know, for one, could think beyond their own OR OR, think beyond their own practice. Like, can they see what the market needs beyond what works for them? And so finding somebody like you and some of the other great surgeons we worked with was you know, was really representative of that. The other thing is finding somebody that you know could uh disrupt, that could, you know, not just develop and design and think about status quo, but how do you go do something, you know, that could disrupt the market? And not in a way that people don't want to buy it either, right? People can come up with some really crazy ideas that nobody's ever gonna use, but coming up with ideas of things that that meet a real need and that we can convince others and are willing to stand up at the podium and ask the tough questions and make the big statements and things like that. Well, part of it was part of it for me, in all fairness, in the infection space is because I treated so much infection, and I'm like, oh my gosh, there's a company that I can actually innovate with in infection, that was great. I didn't know at the time, and so part of it, yes, I'm I'm not afraid to disrupt, as you know, and I'm willing to get up at the podium and say things not a lot of people will. That's fine, that's one thing. I was also ignorant because I didn't realize a huge chunk of my colleagues were in some infect in some fund around infection. Right. So I didn't understand why some of the attacks were almost personal. Well, I didn't know. No one told me that half some of my colleagues were to my left and my right were all in a fund competing against us. I didn't know that. I was blind to it, right? They didn't ever, it was never really disclosed. I'd be up there, I'm a I'm a consultant for Oster Remedies, and we're getting hit. I'm like, Jesus Christ, what is happening, right? Well, I didn't know, but now I know. Now I know when I get up there and I'm gonna talk about some infection, I bring my Caribber vest and I get up there and we get after it. But it's a different sign. No, no, but those those were but that's where real innovation happens, right? That you sit down with people you like. I think for me, you open up a glass of red wine, you sit there and you start talking, let free flowing happen, you get a pen, you start sketching stuff out, and I think it's been great. I appreciate that. I would that's been a very rewarding experience for me, even me personally and professionally to be able to do that. For sure. To do that with you. And I will I will thank you. And it's same obviously the same for me, but I will say that the third component is the other thing you just said, which is, you know, when you're gonna find somebody that you're gonna work with in these situations where we're spending a lot of time at meetings and in basement sessions and whatever, find somebody that you want to you want to spend time with, right? That's right. We used to talk about like, you know, go go uh find a surgeon consultant that you'd go have a beer with or enjoy a dinner with or whatever. And I think that's critical because you do spend so much time together. And if you don't have some of that, what's the point? You're gonna be away from your family, right? You want it, and I think you sort of self-select anyway, right? People gravitate towards that, I think. Yeah, but that I those early basement sessions were awesome, right? The writing stuff down. Now, our I think in full disclosure, our basement sessions have evolved, right? So now we do the same old design. You bring your book. I love your book uh with all the design sketches there, it's a different book. But Chris, we talk a lot about now. We're doing more, we talk about some strategy things. So, right? So you bring an update with how the business is doing, we talk strategy. You're a different company now than you were back then. Tell us tell us about the next evolution of I would say the basement sessions and things that are important to the company.
Well, I think the basement sessions have gone at the right cadence, right? When we first started, it was all about RD because we didn't have a business to talk about. You know, we were designing products so that we could enter a business. Your payments reflected that, by the way. Dominate a business. And you know, when we got, I love to, Eric hates it when I say it, but I love to say it, but when we got to 81% market share in spacers, we were like, okay, now what do we do? So that's when we decided we can't just be a spacer company. Yeah. We have to be an inner company. What year was that even? When do you think that would happen? I uh there were two phases of that. You know, in 2013, we were in it, we were a spacer company. In 2016, we started to really think about infection management because we said, let's get beads in there. Surgeons want more opportunity to get more products into these cases, right? And then we evolved with instrumentation for debreedment, and then of course we've made a couple acquisitions and our recent acquisition of Next Science getting into the whole biowash and experience thing. You know, we we can't be a spacer company and and and sit around and I I also there that is probably a fixed pie. I mean, we have 50,000 patients a year that get infection. But there's millions of patients that need infection prevention, infection management products. So we that's why I used to laugh at It's okay. It's a friendly podcast. You can air it out. I know what you're doing. It's okay. They'll cut it if they need it. I mean, I always say when you're on camera, make sure you know that your mom might see this. And I gotta be careful about it. I've been proud of anything I'd say about from my mom would be like, yep. No, I mean the all the people that kind of made fun of me when I started an infection company, I laugh at now. Not and I don't do it in a braggadocious way. I mean, I just do it because you're like, okay, I justified that they may they were making fun of me, but I know I was on the right track. Because I would be lying if I told you who we are today was on my napkin when I had a vision of the company. Yeah, but isn't that awesome? That's great. My vision was to get spacers out there, find a few distributors, find some surgeons to help me generate the next evolution of products, and gee, I hope it's successful. We had some success. And now it's at the point where I really want the rest of the team to take it to that next level. And that's what that's why working with a friend and a business partner is so important to me is that we've got a team now of people that are constantly thinking of what's next. You know, we're not a spacer company anymore. We sell spacers, but we're an infection management company. And and and and that that need is not uh is not met yet. You know my personal experience with with uh my former my wife that passed away, she died of complications of an infection from a surgery. And that was after I started the company. Talk about ironically, and I think that's and and that personal kind of stuff has continued to fuel me to really focus on these patients. That I mean, some of these outcomes are they're life-altering. You know, I yeah, no doubt about that. And you know how sorry I'm about what happened to your wife, but I also know it does fuel you about making this company um right for patients, not just about um not just about the bottom line. You don't you're not um you know you're not publicly traded, you can focus on patient experience. You do have a a parent, you know, who you work with. But the good news is that we're gonna be able to do that. Yeah, we've been able to do things we wouldn't have done otherwise. Right, sure. Finding that partnership, as we know in the healthcare space, um in the orthopedic space, in particular over the last few years, private equity has come in, and finding that partner that can help you grow is critical. And you guys have found a really good partner in Demetra, which is great. Not not every private equity firm is great to work with. I think we're fortunate. The founder of the business that I started, um the Faccioli family in Italy, they they had a great vision, right? They wanted to build a company that thought about patience. That's what attracted me to work with them. When they brought in Astorg, it really changed our potential trajectory. It gave us the ability because of the funding. It gave us unlimited resources to help us look at our our business metrics and our KPIs, and and consequently, we've made two very significant acquisitions in the last four years because of that. We wouldn't have made that without them. So yeah, there's there's pros and cons of getting more more seats at the table. Yeah. And uh not everybody wants a lot of direction, not everybody wants a lot of help, but help is needed sometimes. And and certainly from the financial standpoint um and the ability to run the business the way that we thought was best is has been a great partnership. Yeah, that's great. When you said that when you said the Faccioli family, I couldn't help but think about the fact that you guys have never taken I we've had a lot of basement sessions, but you've never taken me to Italy for a design session. And I'm a little bit a little bit bothered by it. But any excuse, any excuse I can go to Italy is what I need to work on. We've got to work with it. That keeps us taking you there. Yeah, no shit. We'll piggyback next time you go over there on someone else's dime. No, I think that's right. We well, you know that we've talked about it. And we and and you know the good. I'm not saying I'm blown by it, but it is a real it is a real deal. This is a good time to bring this up. You know, we've been successful in the United States, osteoaremed, right? But we're not just osteoaremed, we're Demetra now. We're global, we're worldwide, and we're taking these products that we've developed, you've helped, you've spearheaded the development of in this basement that has led to be market share leader in the United States. And we're now gonna we're putting plans together. I'm running a uh a project with our whole global team right now to take all of our osteo remedies products and launch them globally. Right. That's very important. So there's going to be opportunities for the work that has been done in this basement with our Fab 4, as I call it, the best KOL team in the business. I appreciate that. And uh one of them, I appreciate that. And take these out to all the other markets out there that uh that need these products. So your first invite. Let's uh pivot back here to um spacers.
And it's kind of been your core business. You are an infection management company now.
Dr. Michael MeneghiniYeah.
Chris HughesUm and it's it's great you mentioned the the Fab 4, if you will. Uh James Brown, Brian Springer, and Matt Abdell, of course, good friends of mine. And it's that's another thing. It's like you guys, it's it's great for those. They're my they're my three closest friends in orthopedics, and it's great to be able to uh work with them in this capacity. It's been uh been a blast. Uh, but let's talk about spacers and let's talk about the what the threats are to spacers. Right now, the biggest thing coming, and it was just out in JBJS a couple um a couple of weeks ago, is Tom Faring's, you know, everybody's been talking about his one versus two stage, and it it appears at least in that one data set that one stage is comparable to two-stage. So tell us about how a spacer company is looking at this keen interest on single stage, because it would threaten the entire business. I mean, uh, you know, I I am certainly, and I have my conflicts and bias, I disclose those all the time, but I just I still, you know, I wouldn't work with you if I didn't think it was the right thing to do anyway. I believe, I believe in many, I think, I believe in many patients need spacers. Maybe some need a one stage, that's fine. How are you gonna navigate the one stage? Talk to us about that because it's coming fast and furious. There's no, you know, it's like other things in orthopedics. Some trends are not unstoppable. I think this is unstoppable relatively. Yeah. Tell us about navigating that. You know, for me, I tell you what, we uh we started as a spacer company. I'm proud that we're an infection management company now. And if I were to defend the spacer only, I think I'd be doing my company and patients a disservice. I think that's right. If the market moves away from spacers and moves into other things, the bad news is there's still going to be patients that get infections. So the good news for our business, when we look at is it a threat? It might be a threat to one of our products, but we're not a spacer company. We're an infection management company. So if if if everything switched from two stage to one stage, osteooremedies would still be there for the patients, the surgeons, and the distributors today. And that's why we got beads, and that's why we got the wash products, that's why we have the Debreedman instrumentation. You and the Fab 4 helped us design. And it doesn't really matter to us what is used in the surgery as long as the patient gets right care. We're going to continue to provide simple solutions to complex disorders for infections of total joints. That's what we do. It's not just spacer. It's almost like a little, I mean it's like a mission statement, right? That's our vision. That's our vision on the wall in our office, and uh and we think about it every day. We say no to products because it doesn't fit our vision. You know, we could probably have other revenue products, but it doesn't fit who we are, and then it changes our distribution changes. Do you think that the market sees you as just a spacer company, or do you think you've been successful in transitioning to an infection management company? I think it's I think it's evolving right now. I do. You think we're in the middle of it. Yeah, we are. We are in keeping the market sees you as. Well, and the mar and the market's perception in some ways is you know, what do they see in the meeting, what do you see in the ad, but it's also with the you know, Chris talked about the sales managers that we have now. We've got so many more people in the field that are going and spreading the word on the internet. And that's been new. That's been the last how we a year-ish ago we had to first or yeah, a year and a half, I guess. It's 18 months. So we're not really I mean it takes a good year to see the effect of that, right? For a long time. Can you tell my board that? Well, it's if they tune into the podcast, they're gonna hear it. I always say it's not a Harvard business case. You can't just or the PX. You can't just add marketing and grow sales like you do in the Harvard business case model in your MBA. I mean, it takes time for these things to mature. Well, especially with sales cycles. We're starting to see it. It was a couple at the beginning. Now we're up to a much larger about 10 people in the field. We've got a great person leading sales, we've got three PhDs that go support the efforts in the field. Yeah. That is so different than where you started, even as recent as two or three years ago. For sure. That is so different. So you've really made the pivot, which is I think also a good sign of an entrepreneurial growth company, is you'll pivot with the market, which it seems like you're doing. But but even if, like, I mean, beyond the products and and the people we put out there, at the end of the day, you take single stage, like you talked about before. If the data proves out, and I'm not talking about in specialized centers that you know present their data, but if it worked for the masses, like Chris said, not only do we have a product for portfolio that can, you know, can um manage and and adapt to that, but we've also got a larger group of, you know, if you look at our overall group, we're not just you know US only. We're not just spacer only. We've got a lot of things going at it. And we want what's going to work for the patients at the end of the day. I don't mean that in some altruistic way, but at the end of the day, like, why are we doing this if we're not doing it for the right reasons? I just personally, my own bias, I don't believe that believe the data has proven out. And there's a lot of things going on between single stage and the one and a half destination, all that other stuff. And I think the gold standard's still two-stage, and I think we have an unbelievable. You gotta we gotta let the, I mean, look, I would say stay the course. Uh, my advice, you know, and I give it to you all the time. There's gonna be a lot of uh one-stages. It's been everything, even in the last just 12 months, from a five-hour case, the way Faring described it, just got reported JBJS, to at the latest meeting I debated it at a at the podium. They're like, oh, I do it in two hours. Well, one, the data says is equal at five hours, and the other one says, Oh, now I do it at two hours, which means you're taking shortcuts. So I hold, I would say hold tight. It reminds me of the dive bombers. I watched this movie not that long ago where in the World War II, the dive bombers would have to, when they were getting ready to drop a bomb on the on the boat, right? They would have to hold, hold, hold, and bullets are flying around them, and they had to hold tight until the end, and then they would release and they would, you know, go, I can't remember what movie. They didn't have smart bombs back then. Right? So I think a lot of what we're doing in healthcare right now, it's crazy. Is you sometimes you just have to hold because there's a lot of chaos. There's a lot of chaos right now. A lot of people looking for shortcuts, a lot of people giving input who aren't still doing surgery.
Dr. Michael MeneghiniYeah.
Chris HughesLike they're not some of the people giving input up there. I'm like, when's the last time you've had a scalpel? Like you haven't done or held, like I mean, I know I can't necessarily call that all the time. I'm not gonna name names, but they know who they are. But like, get off the podium. It's not your like the day I stop holding a scalpel, you're gonna find me here yelling at my kids. They'll be like, 23, the older grandkids or whatever. But I'm not gonna be hanging out at the podium. So I think that's the uh you guys hold tight. There's gonna be a role for spacers, I think, uh foreseeable future, and we've got to see some of these things. Some single stages fail. Yeah. And when they have revision implants in, it's catastrophic. That's right. The next thing you might have to look at is like tumor spacers for because these are these are gonna be a mess when they fail, right? Because they're gonna go right to putting revision implants. And you talk about patients that need the kitchen sink, so to speak. You know, that's you know, we're we're blessed to be in Memphis. We work with surgeons at St. Jude, and they treat some of these kids that have cancer. They treat them with our spacers, our bone cement, our products, our beads, our wash. Yeah, and you know you you don't cut corners when you have a child with cancer. And and I wish that we didn't cut corners with the little old lady who has a bad knee either. You know, you know, it's disappointing at times when you think about the fact that some people are they get their care chosen based on economics. Yeah. You know, I mean, and when it's your mom, when it's your grandma, when it's your aunt, your brother that's getting surgery, what do you do? You find him the best surgeon you know. You don't tell all your other surgeon friends that you pick someone right. And and and you find the best. You find the best product for that family member. Sometimes it's not your own, it's a competitor. And and you just want the best for and we should think that way about every patient. I'm that's one of the things that Eric and I, from the very beginning, we talked about in 2014 when we first started talking together about this business is patients are first, absolutely first. We've got to do things that help these patients stay alive, avoidations, and get back to playing golf, playing tennis, hanging with their grandchildren, whatever they want to do. I got a guy right now, just had to redo his spacer. He was uh uh Vietnam vet, uh got got hit with shrapnel, and um when a child he was part of a chopper that went down, hit with shrapnel. He had a draining sinus for 50 years in his in his tibia and then his knee got arthritic. Super nice guy, otherwise healthy. So I did a spacer, what tried to keep keep him more ambulatory with a with a poly and um PMMA uh femur, but you know, suit is he had pseudomonas in his proximal tibial bone, right? Yeah, sometimes that takes more than one washout. Right. I mean just that these are these are tried true principles infection we all know. And so he couldn't clear it all and his even and we had to do a rotational gas rock flap and and uh we that got infected. So me and the tumor surgeon have been have been working with him together. He did the flap. And I just took I just uh took him back this week and decided I'm not I'm going back to old school cement on cement. And I told him it's gonna be a little creaky, but when you walk, we know it's gonna loot out some antibiotics, but just know that that's it, and we got to give it everything we can. We hit him with higher dose antibiotic, the flap looks great. He's gonna he's gonna save and he's like, I appreciate you. But he said, uh God bless you for trying to save my life. And that that goes right back to the the premise of what we're of what we're doing here. Now we I want to I want to leave on talking a couple things.
Number one, the future. Yeah. Five years from now. Sure. Five years from now. Eric, where is Austromity's five year from now in your viewpoint? I think uh a big part of it is they're no longer, you know, the products and the and the patients that we serve and the and the and the surgeons that we work with were way beyond just the US, which is exciting. So you know, we talk about those other markets. You know, one of the things that the other markets don't have access to is they don't always have access to the same modalities and technologies and things that we have in the States, and and that's a shame, right? When we talk about patient care. So totally agree. I think outside the U.S., it's a whole different picture, thankfully. Working, you know, with at a group level with Demetra and all, we've got you know channels that we can as a group go out to in a in a whole different way than we have to this point. So to me, that's exciting. Um, I think hopefully we've figured out ways that we're we're treating a lot less infection and we're preventing a lot more infection. I feel really good about the products that we have today, but as you know, we've got things in the pipeline that we think are gonna you know, hopefully prevent at another level. So I hope we're I hope we're sitting here going infection rates are down because we've helped to put some of those products through the great surgeons and the distributors that help and you know promote our products. I hope we I hope we're preventing a lot more five years from now than we are today. Those are probably two things. And beyond that, I mean just I would say from the same things that we've wanted for the culture, I hope the people that we have in this business are, you know, they meet all the objectives that they want. They feel you know, they feel fulfilled, they um are able to grow their career and their experience and they're better people for it. Like if we could do those three things, I'd feel really good about the outcome of the story. You know, something you mentioned I want to touch on, I forgot to talk about this because I had it in my mind to talk about it, was the pipeline. One of the things we've talked about, and I learned this from I learned this from Brady Shirley, who, as you know, I had a great uh have a great relationship with and was um president and COO and even CEO of Don Joy Danovis. He talked about, always talked about the cadence of innovation of a growth company. And when the cadence of innovation stops, the market begins to look for your innovation. And if it you if you stumble on that cadence and there's a gap, the market may respond by looking away a little bit. Have we seen that in osteemedies at times in the experience? Because we did have some gaps, we had some struggles. That's fair. Do you think that has happened? Yeah, and we we look at it all the time because you know my favorite chart is our sales chart from 2014 to today, because it it it goes in the right direction. You know, every year we've grown. And above the growth lines, we've always put pictures of the products we launched each year. Yeah, and there were some and then we went three years with zeros. And that's when I was getting edgy. You know, is that I was I was I was always like Yeah. And I'm not gonna blame I'm not gonna blame anybody, but we talked we talked a little bit, we talked a little bit about the FDA, and I'm not gonna blame the FDA. No, that was a big punch in the gut. That's no doubt. But the disappointing thing for me when I look at that slide and I see that those blanks above those three years, uh uh 18, 19, and 20. Yeah. When I look at those three years where we didn't truly launch anything new, it was not because we weren't thinking about it, we weren't innovating. But we went a period, the first four or five, five, ten K's, they all got cleared. And then we hit a wall. Yeah. We even got our, as you know, we got our G V hip cleared, but they said no to the knee. You were trying to innovate, but there were so we couldn't do the shoulder. Yeah. And then we started working on a foot and ankle, and then we started working, and and and so the goalposts changed a little bit, and then that's not unfair to say. So, and again, I'm not blaming anyone because we didn't get these products cleared and we didn't get these things new to the market. What it taught us though is that you can't grow your business solely organically. But at the time we didn't have any money to grow it inorganically. So at that same time when Astorg and Demetra came and took over the ownership of our business, all of a sudden we had resources. And so that's where you if you look back, organically grew well. And we went from zero to equity coming in. That's the benefit of a company, a corporate capitalization, right? You can do it. No doubt about it. I think that's where and so now we look back and and our innovations aren't just what we can design in the basement and have our engineering get through the FDA. It's it's what we can acquire. That's a great perspective. Yeah. So quickly, your five-year outlook. Where do you see Osprombies in five years? Similar? My answer is always the same in this question. I have two ideas. I have a strategic plan, and then I have a playbook. A strategic plan is in the perfect world, here's what we're gonna do the next five years. The playbook is all the contingencies when the bullets start firing. You learn in the army, you learn in the in business that everything and and Mike Tyson said it best, right? Everyone has a plan until they get punched in the face. And if you don't have contingency plans for upside and downside, you're hosed. That's the playbook. And so that's the playbook. You know, that's what the that's what the NFL head coach has. And you know, he there isn't a play for third and eighty-one, right? Yeah, you know, but there's a play for third and thirty. Yep. And it's in the playbook somewhere. So there's a there's a there's something in there. So we think about Eric and I and our board, and and okay, we want to do this product, we want to buy this product, we want to develop this product, we want to hire these people. But I'll tell you in two years what our five-year plan from today is. Yeah. Because if you plan five years out, it it's a it's smart. Especially in healthcare. But it's not gonna happen. Because a lot's gonna happen in years two, three, and four that are gonna change that fifth-year health care. Healthcare is so chaotic right now. You gotta your playbook probably overs overshadows your strategic plan all day. No doubt about that. That's really insightful. Thanks for sharing that. So, uh, Chris, Eric, I just want to thank you guys. This has been an amazing time reminiscing about some of the awesome times we've had together, but also getting your perspective on austerimities as a company. It's fun. Infection in the space, and appreciate you being honest and transparent. We've said a few things that might need to be edited out, but that's fine. The team will take care of that. But uh cheers and salute to you being here. Thank you so much for uh spending time with you. Well, I have to go out of my way to thank you because you know when Eric and I started this thing, you know, we said, hey, we can't, even with the best engineers in the world, you can't be successful in this market without surgeon input. No doubt. Because in engineers design everything perfect, but sometimes they don't have the experience to understand the anatomy. They don't have the experience to understand what it's really like to do a total knee in 30 minutes instead of two hours. And and we have always, Eric and I have always said we can't innovate without surgeons. And so we've been fortunate to find you early on. We had a distributor of ours that introduced us and we're grateful for that. And then you brought in the Stableford and I call it the Fab Four, you know, you and Dr. Brown and Dr. Springer and and Dr. Abdel. And I'm telling you that sometimes, as the small company guy, when I go to the academy, a lot of the big company guys that know me, they're like, How'd you get those four guys to work with you? You guys are like a little company. And I'm like, Yeah, we're a little company, forget about us, and I walk away. I like that fun. That's why. Proud of that fun. So I want to say kudos to you and uh it's been my honor that we've got. You've helped us uh get where we are. Well said. Thank you. All right, I want to thank the audience again. This is Dr. Michael Menigini Unhinged on the podcast. I want to appreciate everyone tuning in for the hard conversations. We're going to continue to ask tough questions, challenge our guests on issues that are important to patients, providers, and all the stakeholders in healthcare where the ground is shaking. So thanks again for tuning in.