Medsider: Learn from Medtech and Healthtech Founders and CEOs - How to Get Users to Fall in Love with Your Product: Interview with SafKan Health CEO Sahil Diwan

Episode Date: December 7, 2023

In this episode of Medsider Radio, we had a spirited conversation with Sahil Diwan, CEO of SafKan Health. Sahil's company is developing the OtoSet, the first automated and FDA-cleared ear-cleaning device. With a background in computer science from the University of Oregon, Sahil's entrepreneurial journey began early. He was already coding at the age of 16 and building startups during his college years. Sahil’s venture into medical technology was inspired by his brother Aadil's struggle with impacted earwax.In this interview, we talk about consumer-driven medtech, the power of design, garnering experience from real-world data, focusing on building the business before fundraising, and how OtoSet went viral on social media. Before we dive into the discussion, I wanted to mention a few things:First, if you’re into learning from medical device and health technology founders and CEOs, and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.Second, if you want to peek behind the curtain of the world's most successful startups, you should consider a Medsider premium membership. You’ll learn the strategies and tactics that founders and CEOs use to build and grow companies like Silk Road Medical, AliveCor, Shockwave Medical, and hundreds more!We recently introduced some fantastic additions exclusively for Medsider premium members, including playbooks, which are curated collections of our top Medsider interviews on key topics like capital fundraising and risk mitigation, and a curated investor database to help you discover your next medical device or health technology investor!In addition to the entire back catalog of Medsider interviews over the past decade, premium members also get a copy of every volume of Medsider Mentors at no additional cost, including the recently launched Medsider Mentors Volume IV. If you’re interested, go to medsider.com/subscribe to learn more.Lastly, if you'd rather read than listen, here's a link to the full interview with Sahil Diwan.

You want to kind of go where the market's pulling you rather than pushing a boulder up a hill because selling to clinicians a lot of the time can feel like pushing a boulder up the hill. You want to go where you're being pulled, right? Welcome to Medsider, where you can learn from the brightest founders and CEOs in medical devices and health technology. Join tens of thousands of ambitious doers as we unpack the insights, tactics, and secrets behind the most successful life science startups in the world. Now, here's your host, Scott Nelson. Hey everyone, it's Scott.

In this episode of Medsider, I sat down with Sahil Dewan, a first-generation immigrant and fast-moving entrepreneur and the co-founder of SoftCon Health. With a background in computer science from the University of Oregon, Sahil's entrepreneurial journey began early. He was already coding at the age of 16 and building startups during his college years. Sehill's venture into medical technology was inspired by his brother ideal struggle with impacted earwax, leading to the idea for Otocet, the first automated and FDA cleared ear cleaning device. Here for you the key learnings that we covered in this conversation. First, design is about so much more than just looks. It shapes how people see your product, how they use it, and even how they feel about it.

Aim to craft something that's not just easy on the eyes, but also easy to use, avoiding complex features that could overwhelm your users. Second, facing FDA's rigorous guidelines shouldn't be considered a regulatory hoop to jump through. Getting actively involved in the process with a top-notch consultant by your side can lead to some key learnings that you may not have otherwise anticipated. Third, building a solid business foundation is often more challenging than raising capital. Managing a med tech startup involves juggling market demand, product refinement, and team building, all the while balancing day-to-day operations. When you zero in on the fundamentals, funding gets a lot easier. Before we jump into this episode, I wanted to let you know that the latest edition of MedSider

mentors is now live. Volume 4 summarizes the key learnings from the most popular Medsider interviews over the last several months with folks like Rob Ball, CEO of Shoulder Innovations. Kate Rumroll, CEO of Obelative Solutions, Dr. Christian Ramdo, CEO of Tempe Health, and other leaders of some of the hottest startups in the space. Look, it's tough to listen or read every MedSider interview that comes out, even the best ones. But there are so many valuable lessons you can glean from the founders and CEOs that join our program. So that's why we decided to create Medsider mentors. It's the easiest way for you to learn from the world's best medical device and health technology entrepreneurs in one central place.

If you're interested in learning more, head over to Medsider Radio.com forward slash mentors. premium members get free access to all past and future volumes. And if you're not a premium member yet, you should definitely consider signing up. In addition to every volume of MedSider mentors, you'll get full access to the entire library of interviews dating back to 2010. You'll also be able to see all of our playbooks, which are handpicked collections of the most insightful interviews with the brightest founders and CEOs. Whether you're looking to master capital fundraising, navigate early stage development, tackle regulatory challenges, understand reimbursement, or position your venture for a meaningful exit. it, Medsider Playbooks have you covered. And last, considering that fundraising can be one of the most daunting tasks for any startup, we created a meticulous database of investors right at your

fingertips. Explore a wealth of VC funds, private equity firms, angel groups, and more, all eager to invest in medical device and health technology startups. Access to this database is a premium member exclusive, so don't miss out. Learn more about Medsider mentors and our premium memberships by visiting Medsiderradiotcom forward slash mentors. Again, that's Medsiderradio.com forward slash mentors. All right, without further ado, let's jump right into the interview. All right, Sahil, welcome to Medsider Radio. Appreciate you coming on, man. Yeah, thanks for having me, Scott. And based on the pre-interview conversation, I think this is going to be a fun one. Got to have fun, right? That's right. That's right. And that tech can be sometimes a little bit stale

unnecessarily. But the weird thing about that that I've always felt is like, we're all working on like very meaningful products, right? And so alongside that should come with some, maybe a little bit more energy, right? Yeah. I mean, that med device just doesn't need to be boring. I mean, we're working on cool stuff that people, you either, you know, that it's being used on people every day in a very, very meaningful way. I mean, it's literally their health care. So it's an exciting space to be in. Yeah, definitely doesn't have to be boring or stodgy. I'm sure we'll kind of touch on that as the kind of conversation unfolds. But let's start at the top. I recorded a brief, a very brief bio at the outside of this interview. I would like to hear it kind of from the horse's mouth, so to speak. So give us a

sense for kind of what you've been doing before founding softcon health and working on the Otis device. Yeah. So I probably don't have a ton to say here because I'm pretty early on in my career, but I'm happy to share the stories so far. My parents are immigrants. So I'm first generation here in the US. One thing I like to say is that being first generation, you have some of the immigrant mentality, but you really have this concept of return and investment just hardwired into you. So, you know, a lot of pressure from Asian parents and whatnot in a focus on doing something meaningful with all the sacrifice that they made, you know, to put you in the position. So when I was younger, it's kind of where this itch for entrepreneurship started is I taught myself to code when I was 16. I then went to college and studied computer science in undergrad, honestly not really knowing what I wanted to do, but, you know, wanted to be, you know, wanted to start some kind of business at some point.

So really, I started off just building websites for small businesses. That's how I made money when I was younger, launched a bunch of apps with friends. Some of them did pretty well and had hundreds of thousands of users. So that was my first kind of start into startups. I loved our LLC name at the time. It was called Lunch Money LLC. So our goal was enough money to be able to go out and have cool lunches with our friends. And then I graduated college in 2014.

and while I was still in college, me and one of my friends, a guy named Casey, we started a company that used algorithms to match actors to audition. So we had this cool kind of B2B SaaS startup right out of college. It failed miserably, but I learned a ton. So I kind of called that my MBA was that first startup that I did right out of college. I think where the story gets pretty interesting is with my brother. So a couple of years after I was out of college, and we, ended up shutting that company down. My brother who was, who was a couple years younger than me,

was still in undergrad studying biomedical engineering. And he was the one that came up with the idea for Otocet. So Otisat being the first and only FDA cleared ear cleaning device. And I'll tell you the story of why he developed and how he came up with it. But I would sleep in his, so he had a college apartment with a bunch of roommates. I had a little cot in the closet. and I was sleep in the closet when I was visiting him down in college and we'd 3D print prototypes with our small team of engineers. And that's how this started. So that was back in, you know, mid-2016 is when we were first kind of tinkering around

with the idea for the product. Yeah, we talked a little bit about trends, right, before I hit the record better for this interview. But it seems like that that's something that always surfaces with like, with entrepreneurs, is that you can always tell, like there's just things that they were involved with, like even middle school, high school that you could tell they just had this itch to either build or try things. And I'm such a big believer that like in this like the acronym LBD, like learn by doing. That's the best way to learn from my perspective.

And you just, you just need reps. You need swings at the plate. You need reps. And it sounds like that that I'm seeing that right from your kind of early story of like, you know, you were in a cot doing three-d printing. I mean, most people are like, no, you need to go study and learn how to do three-d-d-printing. You're like, no, we're just going to do it. You know? He's going to do it.

What were, uh, what were some of your things when you were younger? a lot of similar stories, right? Like just trying to find different ways to make money, you know, as an example. Like instead of like, I never liked this idea, like working like an hourly rate, like an hourly rate. I'd be like, I don't want to go work for a landscaping company when I'm in a freshman or sophomore in high school. I want to go actually do, I want to run the business, right? It's going to be my landscaping company. I'm going to make more money more and lawn.

So, you know, just things like that, you know, and I don't know if that's like hardwired, you know, into us. I mean, you mentioned kind of like the, you know, being a first generation immigrant, you know, you, you, uh, you, uh, you, uh, you're around around that. Or maybe it's just kind of innate to your, your, your, your character. But, um, definitely, definitely a trend that I see a lot of with, you know, other, other entrepreneurs, um, that that come on the, on the, on the program. Uh, you know, little light. moment. I still remember it. I had a part-time job at Hollister. And you were making like, I don't know what the minimum wage was at that time. But I'd make like at that young, I was under 18, so I couldn't work a full day. So I was only making like $30 in a day. And I was charging people thousands of dollars for a website. And it just didn't make sense to spend that time doing that job. So that was my kind of lightblood moment of if you take like a normal job, you're pretty much

capped. And if you decide to go down the entrepreneurial route, it's, you know, the world is yours kind of thing, right? It's really about how much effort and where you want to go with it. Right, right. And I think, I think one of the things that, obviously, we'll get to the substance of kind of like the normal med-seater interview here in a bit. But I, one thing I've realized, too, though, is like, even though I would never trade, you know, sort of the entrepreneurial world for a traditional job, if I, as long as I have kind of that choice or can do that, the one thing that I've realized that it's it is it is hard I mean it it is hard this is not this is not for the faint of heart right building building companies it's definitely something that you know you've got

you've got to just love to play the game you know in order to persist through all of the ups and downs and that's probably something that like looking back over the past you know 10 15 plus years it's like i have a new found kind of appreciation for that you know versus maybe a decade ago when I was like oh the startup world is so sexy and cool I want to I want to do that stuff uh yeah I mean and it is it's very, very fun and rewarding, but it's also very, very hard for sure. You have to want to do this, right? I think people who burn out of it think it's cool, think it's sexy. And then when you get into it, you realize that it's really not, right? Being on a podcast is cool, but all the work that you're doing otherwise is, it's hard. You know, you really got to get hands dirty. And you really

want to, you have to have to want this lifestyle. I think that's a big part of it. That's what I learned. Yeah, no doubt. I was listening to this podcast yesterday. My First Million. I'm not sure if you, if you, if you listen to that one. It's one of my favorites these days. But not not life science, men's tech oriented. It's just more business tech stuff. But Jesse Isler was on the show. And he's the, are you familiar with him? He started, his story is incredible. Like he, a lot of people have maybe read the book, Living with the Seal. And that seal, although wasn't mentioned was David Goggins at the time. So he's got this really eclectic background, total entrepreneur. at heart. And, you know, he mentioned that on a podcast yesterday. He was like, you know, the best entrepreneurs, they love playing the game. So yeah, I'm right there. I'm right there with you. But yeah, that's why I like hanging out with people like you. Because so, yeah, so after you graduated in 2017, that's kind of where this actually started. So I'll tell you a little bit about that and then I'll go into why, because the story is great. It's like this really personal story. So he graduated in 2017. Pretty quickly after that, we were accepted into this accelerator called

Dream at Health Tech. If you've heard about it. it. And then we closed our seed round in 2018 after going through that program, which was phenomenal for us. And then that gave us the capital that we needed to go actually pursue our 510K. Because before that, we didn't have any money. I mean, we were in our early 20s just trying to figure this thing out. And with the seed capital, that's how we got to our FDA 510K clearance at the end of 2020, which is also like probably one of the worst times in history to start a soft launch medical device, right? Because you just couldn't get in to any of the physician offices. So anyway, the whole thing to kind of sum this up, I think, is starting this company,

which I feel like is my first real startup, has given me the focus on creating the need for creating greater access to care in healthcare. And then one thing we're really interested in here at the company is doing a lot in the clinical space, but also digging in deeper into the consumerization of healthcare and how people want to, in a post-COVID, world deal with problems like this in their home. I'm a good segue to my brother. Sorry, go ahead. You were going to say something.

Oh, no. You mentioned the consumerization of health care. And we can maybe chat about that a little bit, a little bit further down, further end of this conversation. But I'm right there with you. I, when I started, I've always had this fundamental belief that if, if people, like, people are so used on the paste up if they work at a corporation, right? They just see it like the, what they pay for health care is just automatically and

taken out, right? And they don't really get, they don't really feel that, right? Healthcare was almost entirely cash pay. People would be a lot more responsible and proactive about and it would look a lot different. You know what I mean? And so I think we're, I mean, we're kind of slowly getting there, right? Because most medical insurances, like, it almost becomes a cash pay environment anyway, unless it's like a catastrophic, catastrophic event, because deductibles are so high. You have to pay so much out of pocket anyway, you know, and it's almost like we're, we're slowly, slowly kind of getting into this environment, right? And And I think the end result of that is people are getting used to operating and with more consumer-like behavior, you know, when it comes to health care.

Like $5,000, then yeah, you're going to look for alternatives to treat whatever issue, simple issue that you have at home, right? And that's where my brother's story comes in. So growing up, we just thought he was this weird, give it too much earwax, which turned out to not be the truth. It affects a lot of people. but he would have to go to his primary care physician every few months for an ear cleaning. So he'd wake up to a point where he couldn't hear out of one of those ears. So impacted earwax, which is the leading cause of conductive hearing loss, is a problem that affects one in 10 children, one in 20 healthy adults,

and one in three people over the age of 65. So that translates to about 35 million people in the U.S. and over 800 million people around the world. So a pretty crazy amount of issues coming from. from this one pretty simple issue. And the other symptoms are like pain, infection, tinnitus, vertigo. And then particularly for hearing aid users, wax is the number one reason why their hearing aids are damaged and sent in for repair.

So talking about paying out of pocket, your hearing aids can cost you thousands of dollars, right? And you're typically paying out of pocket for those. So it's something you want to take care of and need to take care of so you can just have basic necessity of being able to hear, right? I think probably the most interesting thing is how the procedure is done today. And the story is pretty cool. So back in the 1820s, an otologist decided to use a bladder syringe.

So it's literally, I wish I had one with me right now. I could show you what it's like. But it's this metal kind of medieval looking metal syringe. And it has like a splash guard on the end of it, which is why it's a bladder syringe. And it was repurposed by this otologist to use it for cleaning ears. right? So that's where your syringing started back about 200 years ago. And that standard of care, either using a syringe or a spray bottle or something like a water pick. Like they're clinicians who literally use water picks to clean patients' ears out today because the syringe or the spray bottle is so labor

intensive. So that's the procedure my brother was going in for every few months growing up to our primary care physician who's actually an advisor to the company today. It was kind of cool. but when he became a biomedical engineer, he thought to himself, why not combine the two most popular methods, which is irrigation, using water to clean the ear, along with microsection,

which is typically done by the E&T specialist, into a pair of headphones, which number one looks cool, but mostly so that you can clean both ears at the same time. And that was the idea, and that's where it all started. And I think how we like to describe the company and our goal is that we want to do for ears,

companies like Sonic hair and oral B did for teeth. The difference is that we're starting with a solution that's in the clinic and then a version for home afterwards. Got it. That's a super helpful analogy. And for those listening, we'll definitely link to the website in the full write-up on MedSider. But if you don't get there, it's otoset.com. So O-T-O-S-E-T-com. And as the Hill mentioned, yeah, it looks like it like beats by Dre, right? Almost kind of kind of look and feel to the product. but really really super cool looking device but also clearly it meets a huge need i had no idea the prevalence was that that high but it's otoset.com otoset.com but you mentioned so you at you 5tk clearance i want to set the stage kind of for where you're at with it with the company so 5tK clearance by the end of

2020 which is incredibly fast um but like we're what do you guys now are you actively commercializing the kind of the the in clinic uh device then that's correct yeah so since 28 we've raised about 13 million in venture capital. We've done a number of clinical trials. We actually finished one up recently with the large healthcare system partner. We've done a bunch of patents and we got FDA 510K clearance. We're the only 510K cleared, or were the only FDA cleared ear cleaning device in the world, which is pretty cool.

And then we brought a totally novel ear cleaning device to market. And that's where I think all the real learning is, is like trying to figure out how to continuously iterate on a. device that clinicians will then use every single day on patients, which is really crazy to think about that we started in a dorm, you know, basically in a closet, 3D printing these things, and now clinicians are using these on patients every single day. So yeah, we're in early commercialization. We sell into primary care. We sell into urgent care. And then we also sell into audiology because wax is a huge problem for hearing aids, not just maintaining the hearing aids, but just simply

cleaning their ears so you can sell them a hearing aid in the first place. So we have investment from clinicians and even from some of our customers, which is pretty cool. We investment from healthcare systems. We have a number of the large hearing aid companies as partners. And as of today, we have hundreds of clinicians treating thousands of patients across the U.S. with Oda-S. Very, very cool. Incredible, incredible amount of progress, right, in a short amount of time, especially in comparison

to how most med-tech companies kind of get out of the starting block. And then you mentioned, I'm not sure how much you can share, but we're recording this in kind of Q4 of 2023 just to help people that are listening after the fact, kind of get an idea of the timeline. But you mentioned the in-home kind of consumer device. I presume that's still that's actively being worked on. Do you have kind of a timetable for when that might be available? Timetable, yeah. But it's for exciting.

One thing that's probably pretty unique about us is that we've garnered over 150 million views on social media now. And we haven't spent a single dollar on consumer marketing. This is just organic from people picking it up and it can pretty viral on social media. Even clinicians who use our product, post about the product and get millions of views on social media. So that's something special. And what we're doing right now is we have thousands of patients every single day on our website looking for a place to go who their ears clean without a set.

So these are people who are willing to switch their clinician to go somewhere else. to get their ears clean because of this product. So that's what we're really focused on right now is driving those thousands of patients that we're getting every single day to sites that are using OTASET. Yeah, that's cool. I'm not sure how much,

and it's probably segues into kind of key learnings coming out of the early stage development of the device. But that's one of the things that we thought a lot about early on with Juve, which is a company I started back in 2016, is a lower barrier to entry, I think, in terms of design and development than what you built with Otisat. But we did think about that, right? Like, you know, what, as an example, like for those that aren't familiar,

Jube is it's an in-home. We initially positioned them as in-home photobiomodulation devices to the person knows it as red light therapy. We kind of created this category, this in-home kind of category before there was one. Now it's quite popular. But one of the things with infrared light, infrared light wavelengths are one of the wavelengths that we used, but they're invisible to the naked eye, right? So if you, if you do an all infrared device, it does not have near the virality, right, that it would on social. And there's obviously,

there's other inputs here, right? We mean, we're designing a device just so it could go viral on social media. But we definitely, it's definitely something that I think most people underappreciate is, are there little things that you can't incorporate into your product that hopefully will have clinical benefits, right? But maybe give you a layer up in terms of, you know, raising awareness for, for the device and helping it to kind of spread. Because at the end of the day, most people might think of like what I'm describing as like some sort of marketing hack. But the reality is that if you don't get the traction commercially, your company and your

product is never, I mean, may not ever kind of amount to much of anything, right? And if you're working on something that could be very meaningful, have a meaningful clinical impact, right? You've got to marry those two together. You know what I mean? So, yeah. Be hard. I think probably that's one of the most difficult things that I had to learn.

and coming from the software world and being a software engineer coming into med tech is how hard it is to really validate opportunities, right? Because you have to do any your clinical trials under IRB, typically with a, you know, CRO. And it's hard to get a lot of real world experience until you have 510K clearance, right? Right. Right. I mentioned, I feel like most of the real learnings come post 510K clearance, not before it. And then also the consumerization of healthcare can't be ignored.

So I think products like what you have at Juve is important. And again, you can make them look good. Like that product looks good. I would have one in my house, right? Like that cool product to have. And people are going to ask about it when they come over. And it's important. So yeah, I think people are looking for ways to solve their issues, simpler issues,

at home where they can. Yeah, yeah, cool. So let's spend the next maybe 25 minutes or so talking about kind of the, the functional areas of, you know, a traditional kind of life science medical device startup, right? And I'd love to kind of get your take on some of the, maybe the key learnings, things that you thought you did really good, things that maybe you do differently if you had to kind of restart the clock. But let's start on this on the same topic, right, design and development. Because I'm sure, you know, the Otiset device that I'm seeing online, you've got

some beautiful lifestyle imagery. It probably looks different than, you know, what it did back in the the 3D printing days out of your dorm. So talk to us a little bit about maybe some of the key thing, the key learning is coming out of those two, three years of development. You know, maybe frame that up for how either you do it differently now or maybe for other entrepreneurs that are kind of early on

in this design kind of alpha, alpha beta stage and trying to work through some of these challenges. Yeah. Well, I think coming into this and doing this for the first time, in our experience, design is everything and it's never ending. It's one of those things that just consistently need to be iterated on. And also, I think medical devices, again, don't need to be boring. They can look good.

They can feel intuitive. And if your medical device isn't intuitive or easy to use, that means that your training has to be hands-on or hours long, right? Good luck trying to get clinicians who are incredibly busy to learn your new product, especially if it's a novel product and get them to complete training on their own. So that's just a difficult thing. And I don't blame them. They're super busy.

They already have something that they're using to try and solve the problem, even if it's not the best solution. And it's our job to design something that makes their lives easier, not make it harder. And I think some of this is like obvious to kind of more consumer-oriented products, of course, right? But I think it's so applicable to like, I mean, your device is a great example because it's being used by clinicians right now,

but it has a more consumer aesthetic. But it's so crucial to kind of, for, all of us that are in this world to put ourselves in the shoes of the clinician and realize that they do not have the patients, the time, you're not going to get mind shared, you're not going to get them to adopt your product if it's complex to use. I don't care how cool it is, how novel it is, what it can do. If it's hard to use, that's going to be a very, very significant, you know, challenge. And so designing something, even if it's like a peer play, you know, physician preference device, designing it where it's so easy to use and simple, like that is imperative. You know what I mean?

Yeah, and I'm not saying that medical devices should have no training. Most of them, almost all of them are going to have some training to some level. It just needs to feel like it's not, you know, they shouldn't be scared of like, I get this thing and, and now it's going to take me years to figure out how to learn to use it, right? It can't feel like it's such a big hill to climb for people who are treating patients every day, you know, like they got other things to do. And yes, they're buying your product with intentions of using it and providing better patient care, but putting yourself in their shoes and just being there, like literally going to their clinic, sitting in the back room and watching how they're using this thing

on patients, you'll find all the little details that you need to continuously improve the design of the product. And like I said, I don't think that ever stops. I mean, we still spend a crazy amount of time doing that. We even have an MA here on staff at our office, just in the door, in the room next door. There's a patient in right now. We bring in patients. all day, every day to our office and an offer for year cleanings. So, you know, we're learning a lot all the time on how you can make small changes that make a big difference in the workflow of how a product is used. Oh, that's really clever.

It reminds me of, and this is, this is a bit of several years now, so I'm not sure if Cala Health is still doing it, but Renee Ryan is the CEO of Cala. She mentioned that they had like a Cala Health clinic in their office where they did, I'm not sure exactly, I mean, don't quote me on this. I'd have to go back and listen to the. the interview again, but they had some sort of, they had a, they had like a something similar to what you, what, what you're, what you mentioned where they, they invited, you know, patients to come in, right, and to be able to use their devices, see how they interacted with the devices. And obviously,

it's helpful because, you know, they're getting care, you know, free, free care as well. And it's extremely helpful for you because you're getting, you know, almost instantaneous feedback. Yeah. Well, I mean, in your experience, what are, what are some good ways, you know, once you get a product, clinical trials are one thing, right? How do you typically run clinical trials? Are you running them with the CRO? Are you running them with a surgeon in their normal setting? Like, how do you typically do it? And then how are you also figuring out that bridge between the clinical trial

and how it might be used by someone who's just purchasing your product off the shelf and going through it like a normal, like a normal customer? Right. No, that's a great question. So, like, obviously it depends on the device and kind of the subspecialty. but you know from my for my perspective um CRO versus like maintaining sort of control in house I tend to prefer the latter especially with sort of customer or physician facing activities so like as an example when you think about like everything that's involved in a

in running a clinical trial there's probably back in things that you potentially could hand off to a you know to to a CRO but ideally you're you're controlling sort of the customer facing aspect of of a lot of that activity, not just, not just to help more efficiently manage the trial. Also, because you're getting, you know, you're getting that much more feedback, right, that can, you can potentially ladder up to, you know, potential, you know, device optimizations, device, you know, design changes, etc. So that's, you're going to lose out on a lot of it, if it's completely outsourced, right? If you've got a bunch of, you know, 1099s at a CRO, there are kind of behind a curtain,

and you don't really get, you lose out on that, you know, that interaction, which I think is, is crucial, you know. Hey there, it's Scott, and thanks for listening in so far. The rest of this conversation is only available via our private podcast for MedSider Premium members. If you're not a premium member yet, you should definitely consider signing up. You'll get full access to the entire library of interviews dating back to 2010. This includes conversations with experts like Renee Ryan, CEO of Cala Health, Nadid Miarid,

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