How Challenging Assignments and Brutally Honest Feedback Makes You Better with Dave Rosa

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Dave Rosa is CEO of NeuroOne Medical Technologies, a company that has developed high-definition, minimally invasive diagnostic and treatment devices based on a unique thin film electrode technology, with an initial focus on epilepsy and the fast-growing neurostimulation market. In this episode he shares some times when tough feedback helped him grow as a leader, why taking the stretch assignment was the better choice, structuring a marketing group, key criteria when evaluating distribution options in a start-up company, and how NeuroOne is providing technology helpful to patients and clinicians.

Links from this episode:

• Dave Rosa LinkedIn https://www.linkedin.com/in/daverosa/
• NeuroOne Medical Technologies  https://nmtc1.com/

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• LinkedIn: https://www.linkedin.com/company/mastering-medical-device
• Patrick Kothe LinkedIn: https://www.linkedin.com/in/patrick-kothe
• Patrick Kothe Twitter: https://twitter.com/patrickkothe

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Episode Transcript

Pat Kothe (00:31):
Welcome.
Growth and development come frommany different sources.
But I found that I've grown themost from painful experiences.
Failures, negative feedback,stretching into an area where
I've been really uncomfortable.
The pain actually forces me tobe better.

(00:53):
To learn from the experience.
But also to embrace the pain asnow, I know it's going to help
me in the long run.
I think you're really going toenjoy this conversation with
Dave Rosa, CEO of NeuroOneMedical Technologies, a company
that's developed highdefinition, minimally invasive
diagnostic and treatmentdevices.

(01:15):
Based on a unique, thin filmelectrotechnology.
Their initial focus is onepilepsy and the fast growing
neurostimulation market.
In his roles at CR Bard, BostonScientific and St.
Jude Medical, Dave has had somegreat mentors, and really nice

(01:35):
responsibilities.
In our conversation he sharessome times when tough feedback
helped him to grow as a leader,why taking the stretch
assignment was the betterchoice, structuring a marketing
group, key criteria whenevaluating distribution options
in a startup company, and howNeuroOne is providing technology

(02:00):
helpful to patients andclinicians.
Here's our conversation.
So Dave, you've contributed tomany companies in your career
and you came up through thesales and marketing route.
Is that a good place forsomebody who's starting out
their career in medical device?

Dave Rosa (02:19):
I think it's a great place to start.
for me in particular, it wasmore of a requirement for the
company that I was interested inworking for.
It was, Stryker Surgical at thetime.
And before you could move intoany sort of marketing or say,
senior management position, youhad to start out in sales.

(02:40):
And I think it was actually, itwas a little bit surprising to
me at first, but of course Iwas, I think, 22 years old, at
that time.

Pat Kothe (02:48):
why do you think they, they wanted you to start
off in

Dave Rosa (02:50):
sales?
Yeah.
So they explained it very well.
And, what they said was, look,before we put you in any
position of decision makingauthority, you need to
understand, the products, howthey work, what's important to
customers.
So it, they felt it was the besttraining to prepare you for a

(03:11):
senior management position.
And, uh, to be honest with you,I appreciate it.
I completely, after going intosales, completely understood
because it took me a good sixmonths to really get up to speed
to, number one, learn how tosell, number two, understand
what customers wanted, how theprocedures were done, what the

(03:32):
issues were, what problems wewere trying to solve, and it
really prepared me to move intoa position of decision making
authority.
Or what I was looking to getinto was marketing at the time.
So most of the companies, that Iwas even speaking to at the time
were not interested in hiring mefor a marketing position, which

(03:52):
is what my MBA was in.
They wanted me to start in salesand it was for that reason.

Pat Kothe (03:57):
And why medical device?
Why did you choose medicaldevice?

Dave Rosa (04:00):
Device?
I have always liked and beenfascinated by the medical device
field.
And personally, I've had so manymedical issues that I spent a
lot of time researching things.
When you're growing up, you'retrying to figure out, really
what you want to do.
And, and the things that Ialways seem to enjoy were
helping people.

(04:20):
And the second part was figuringout how to solve some of my own
medical issues.
So It was a good marriage andreally after I graduated
college, I spent a little bit oftime outside the medical
industry, but then really foughtto get into it because, it was
really my passion.
So you

Pat Kothe (04:37):
moved, from sales into marketing and then into
management.
Did you have a, a grand visionfor your career?
early on, or were justopportunities presented to you?

Dave Rosa (04:49):
I had a grand vision, but never, the vision never
included me running a privatecompany at some point or a
public company at some point.
I knew I liked the, thestrategic part of working in a
company.
I liked coming up with.
determining, a strategy to growa business, or, to really

(05:10):
develop, technology.
But I wouldn't say I everthought, gosh, you know, by this
age, I wanted to be in thisrole.
I wanted to be in the seniormanagement at some point, but
not necessarily a CEO.
Your question of, didopportunities just present
themselves?
The answer is yes, but what I'lltell you is, I always focused,

(05:31):
on the difficult businesses, uh,to get involved in, as opposed
to the successful businesses.
And really the reason why I didthat was, I had a mentor of mine
telling me that you're going tolearn a lot more from solving
problems than you are takingover businesses that are
successful.

Pat Kothe (05:52):
yeah.
And early in my sales careertoo, people would say you either
want to follow the best salesrep or the worst sales rep, that
middle of the road one is notwhere you want to go in.
And the turnarounds are a lot offun, a lot of work though.

Dave Rosa (06:07):
Yep.
But, but it's where I think, youknow, you, you really learn, how
to solve problems and how todevelop, a capability of, really
making decisions and how to goabout making decisions.
it's great to see, technologiesor companies, become successful
and try to duplicate that model.
Every company's different,challenges are different, and I

(06:30):
think it's in the, really, inthe, jobs that you have that,
you know, face, really severechallenges that you really grow
as an individual, and, and Ithink your contributions, can be
a lot greater through justdealing with issues, whether
you're successful at resolvingthem or not.

Pat Kothe (06:49):
So I'm going to ask you about two transitions.
One transition is when you wentfrom sales into marketing.
And the other one was when youtransitioned out of marketing
into general management.
What was that first transitionlike moving into marketing?
Was it, you said you, got anMBA.
That was your area of interest.
Was it what you expected it tobe?

Dave Rosa (07:08):
Um, well, that's, that's a good question.
No, it wasn't what I expected itto be, but I'm not sure that my
expectations were right to beginwith.
I thought when you got intomarketing that, you would go
out, talk to the customer, findout what they wanted, work with
R& D, to develop the product.

(07:29):
But I always thought, that themost important thing was, to
develop, the perfect product.
We had to keep refining theproduct, until it met all the
needs, solved all thechallenges.
And that's probably a little bitof my technical background
interfering with the, thebusiness, learning.
So I was surprised when, youknow, there was a lot of

(07:51):
pressure to, every three to sixmonths get, get a new product
out the door.
and why that was so important tothe business other than, we want
to get a new product out thedoor.
But, there were a lot ofreasons, and one was to
maintain, if it was acompetitive space, uh, or
landscape, to really maintain orgrow your ASP, because if you're

(08:12):
working in an area that hascompetitors like most of us do,
we're constantly, beingchallenged by companies reducing
their price, or, leveragingother technologies to undercut,
your pricing, So it's reallyimportant, which was not
something I could appreciate itat the time.
You want to have a product thatmeets all the needs, but it's

(08:33):
not realistic.
So you have to make a decisionof this is good enough as it is,
and we'll iterate from that toimprove upon the technology to
offer more features and use thatas a, again, a strategy to help
maintain your your margins, yourpricing, or even grow them.

(08:53):
So

Pat Kothe (08:53):
some companies have a product manager who's
responsible for the upstreammarketing or that product
definition and moving a productthrough an R and D process, and
then pass it off to thedownstream people who do the
product support and the sales,support and promotion with the
product.
Some people have one person whodoes all of that.

(09:13):
Other companies have downstreammarketing people and upstream
marketing people.
What was your experience like?

Dave Rosa (09:18):
so it included both, but I can tell you that, when I
joined and you were a productmanager, you were responsible
for everything upstream,downstream, and, uh, even in, in
one of the companies that I wasat, C.
R.
Bard, a large company.
We were even responsible formarketing communications, so
developing the strategy, comingup with the brochure, the

(09:39):
concept.
We might bring in a graphicdesigner, but we did everything.
And then, uh, when I got toSciMed, and then it was acquired
by Boston Scientific, it was thefirst time I had ever heard of
anything, called upstreammarketing, downstream marketing.
and really...
That was back in 1997, I think,when, when I first heard that

(10:01):
term, and now you, you hear itall the time.
I'm not a big fan of it.
I understand why companiesgravitated to that.
But there were also issues that,that came out of splitting that.
So, you know, my philosophyis...
Is that, I need to understandwhat's important to the
customer.
what, challenges the fieldsales, people are, are

(10:24):
experiencing so, so I can, help,develop the best product with R&
D that, that we can offer themarket.
I, you know, I always felt thatif one person was just involved
on the development side and theother one, uh, was, um, uh,
strictly on the, um, promotionalside, that there isn't always

(10:46):
great communication in betweenthose two groups.
And at times, you know,everyone, you know, has their
own little island that they wantto protect, that the upstream,
marketing people were not, infront of the customer or the
salespeople as much as theyneeded to be.
And it's because the, you know,the downstream, marketing people
felt that was, more their role.

(11:08):
And then there was also issues,when we were trying to
incorporate this early on atBoston Scientific with, really,
a lack of enthusiasm from theupstream marketing group.
Because they felt, gosh, we didall the work to get this product
out the door.
And now, like, where's my,where's my congratulations?

(11:30):
I'm, I'm kind of handing it offto the person who now gets to go
on stage and, and more or less,get, get a lot of the credit
for, the technology.
So there, there were issues withthat.
how do you reward the upstream,marketing person?
How do you give them, accolades,for the work they did?
There was always like this, I'llcall it, um, well, I'll call it

(11:53):
what it was, it was tension inbetween the two groups.
Uh, so personally, you know, I,I want the person.
Who presents it to the salesforce, being the person who went
through, two years of findingout why the technology needed to
be developed that way.
Why, we didn't go a differentdirection than someone who was

(12:16):
kind of, you know, hand it offthe project when it was done.
So, you know, again, just my ownphilosophy.
And in small companies, youdon't really see that.
You've got to be a jack of alltrades for obvious reasons.
Look, a lot of big companieshave been successful, separating
the two.

Pat Kothe (12:37):
Like you, I've came up through the sales and
marketing side and run marketingdepartments and I've done it
both ways and I've split it outupstream, downstream, then I've
recombined it.
We see so much, change withinlarge companies where they've
got a lot of different divisionsand they roll them up and, the
sales organization is under,different product groups that

(12:59):
are under one salesorganization.
Then they split them back outand then they come back.
Bottom line is there's nooptimal way of doing this
because if you're askingsomebody to be an expert at
upstream and downstream, that'sall, that's a big ask.
And the other thing is when youare focused on the product
development, the sales team isgoing, Hey, what about me?

(13:21):
We're out here selling thisstuff.
We need more support than whatwe're getting.
And when you're, focusing on thefield and supporting a field,
the R and D teams feel in thesame way, where's my love here.
So it is a really difficultthing when you get to be a
larger company to have bothresponsibilities and have the
right people in place and haveenough time to devote to both.

(13:45):
So it's like I said, is there aright answer?
Depends on where you are andwhere, what's your individual
company needs.
Ideally, you'd like to havesomebody who has both skillsets,
so you can emphasize one or theother, but it's a

Dave Rosa (13:58):
difficult thing to ask.
I, I agree with that.
What big companies were doing atthe time is they would take, a
business segment, this is in thedays when, one person was doing
upstream and downstream, andthey would start, cutting up the
business segment saying you'llhandle all the products that fit
under this category, right?
Upstream, downstream.

(14:19):
So I'll use angioplasty balloonsas an example.
You're handling everything thatpertains to over the wire
angioplasty balloons.
And you over here are going todo everything that involves
rapid exchange, ballooncatheters.
You know, products that are usedin the same procedures, but
sometimes based on preference orthe procedure itself.

(14:41):
So then what happens is you havemultiple marketing people
dealing with...
salespeople for really the samecategory of products.
And that also, annoys thesalespeople and, they want to
deal with one person, right?
and,

Pat Kothe (14:55):
and, and we didn't, we're not even talking about the
physicians who want to deal withone person too, because you're
developing an over the wiresystem and a rapid exchange
system is basically talking tothe same docs, right?

Dave Rosa (15:05):
Absolutely.
Uh, uh, agree completely.

Pat Kothe (15:09):
Let's kind of, um, move to that other transition we
were talking about, you movedout of marketing, you learned a
tremendous amount, through that,and then you moved into, a
general management or VP levelposition.
Tell me about that transition.

Dave Rosa (15:24):
Yeah, that was, um, tough, although I didn't think
it was tough.
So managing people, is probably,I would say, the greatest
challenge.
For me, learning a technologyhas always been, you know, I'm
fascinated by science.
But managing people, who maybe,approach things a different way,
than you do was eye opening tome.

(15:45):
So I'll tell you a quick story,that made me, that really
changed, at least myperspective.
I was at, Boston Scientific.
I think it was actually stillScimed at the time.
And, I found out that I had anopportunity to move up, into
management.
Actually before I moved intomanagement, One day, this

(16:05):
consultant showed up and, so thepresident of the division had
hired this guy, unbeknownst tothe people he was working with,
he was really there to assesstalent that was not in
management yet.
And, what we were told was, he'sgoing to help you, you know,
become better at what you do,make better decisions.

(16:26):
But really what he was doing,because the company was growing
so fast, was...
he was going back to thepresident saying, look, out of
these 20 people, that you haveme working with, these three
people are people that I thinkcould quickly step into a
leadership role because theywere growing so fast.
They didn't want to hire fromthe outside, but they had to,

(16:48):
more quickly develop, their,people internally.
For the,
for

Pat Kothe (16:51):
the listeners, Scimed was an extremely successful
company in the angioplasty areain the early days and developing
some great technology for, theangioplasty procedure.
Very aggressive group, but avery talented group of people
and a lot of great, greatmedical device people, spent

(17:13):
time at Scimed.

Dave Rosa (17:14):
Yeah.
it's, it really spawned ageneration of people that have
gone out and either takenleadership roles and private
companies, public companies.
really an amazing company.
and I really.
And that's where I learned mostof the things that I've applied
really since then.
But in this case, I, so I workedwith, this consultant.

(17:37):
It was probably for between sixand nine months.
And he came up to me one dayand, he said to me, he said,
Rosa, I think you're a smartguy.
I like the way you assessthings.
I would tend to do what yourecommend to do in the business.
But the problem is, is that youleave a lot of dead bodies along

(17:57):
the way.
Wow.
And, uh, you know, I'm a guyfrom Philadelphia.
Like, what are you talkingabout?
I leave a lot of dead bodies,right?
I'm very direct.
That's the way people on theEast Coast are in the Northeast.
And if you're screwing up, Itell you, you're screwing up,
but you're, but you're a job.
That's what you should be doing,but you're in

Pat Kothe (18:19):
Minneapolis and the Minnesota nice culture is a
little bit different than the

Dave Rosa (18:23):
East coast.
So, I mean, in my world, it was,and even, prior to that, when I
was at a Stryker, even thoughthey were based out of
Kalamazoo, that was the mostaggressive company that I ever
worked for.
Just the way they did things, itwas at a whole different level,
so a personality like mine fit,fit very well, really into their

(18:46):
portfolio of, let's just sayemployees, and what they were
looking for.
So, you know, when he said that,I was like, what are you talking
about?
He's like, you know.
Um, you know, it's good that youhave an opinion and, that you
have a good understanding of thebusiness and where it needs to
go, but it's a painful process,Dave, and you will never be

(19:08):
successful, if this is, youknow, the way you do things.
and he said something to methat, people have said to me, or
just in passing have said, isthere's a lot of different ways
to get to the finish line,right?
There's your way.
Which, if you were like me backthen was kind of like, this is
the only way, right.
The way I'm doing it is theright way.

(19:30):
but, you know, the, the, thecomment was, let people take a
different way if it gets them tothe same destination.
That, that you're, you want toget to, how old were you?

Pat Kothe (19:41):
How old were you at the time?
Where were you

Dave Rosa (19:44):
in your career?
Okay, so that was 1997, and Iwas born in 64, so I was 33
years old.

Pat Kothe (19:52):
And you knew everything at 33.
I know.
I knew everything at 33

Dave Rosa (19:56):
now I knew everything at 20 Uh, so so yeah, I mean.
You know, it was, honestly, itwas probably so clear to
everyone else.
But the only person it wasn'tclear to, was me.
So, you know, I kind of thoughtabout that, and I still thought,
you know, look, um, you know, myformula works, so, uh, but, you

(20:21):
know, as, as time went by, Ithink early on, the reputation,
my reputation was, he's this,hard nosed guy, and, very
demanding, and...
Uh, and I think, you know, Istill am that way, but I don't,
I don't approach things the wayI did back then, which is it has
to be my way.
Everybody's got a differentstyle and again, if we can,

(20:42):
achieve the same goal, and it'sa different way, you know, who
cares?
And I, and I think that comesmore.
with maturity and age and, backthen it was a complete shock.
So that was one of the bigthings that, shocked me, in
terms of moving into, a seniorleadership position that you
need to change the way youapproach people or, you're going

(21:04):
to be working by yourself andprobably somewhere else.
What's

Pat Kothe (21:08):
interesting to me about that is you'd been in
companies for 10 years at thatpoint, 23 to 33, you've been,
you've had several managers dothat and it took an outside
consultant to come in and giveyou that feedback.
All of your managers could havegiven you that feedback

(21:29):
throughout that and they didn't.
Why?

Dave Rosa (21:32):
Well, um, when I was at C.
R.
Bard, my manager was exactlylike that.
I would sit down with him andtake him through a, a product
launch and the strategy and hewould sit there, and this is a
true story, he would look at mybrochure, right?
and I'm more of like, thestrategy is what's important
here.
It's, you know, the brochure iskind of like along for the ride,

(21:55):
but he always wanted to changesomething because it was never,
what anyone did was neverperfect or the way it should be
done.
So he would, he would look at mybrochure and he would say, what
Pantone color is the backgroundon that?
And I would say, I don't knowwhat Pantone color is.
Uh, I think, I think you need tochange that to a lighter shade.

(22:16):
Bring the, uh, Pantone colorchart here and let me take a
look at it.
So he was always tweakingsomething, and it was so
annoying, and I was doing thesame thing, when I went into
management, but I didn't thinkit was annoying, to the point
where I started putting in thelaunch documents, or the
brochures, misspelled words.

(22:37):
And I'm very anal about spellingand, proper spelling and
grammar.
and he would be excited becausehe would find a mistake, but he
caught on one day.
He's like, you did this onpurpose.
You're gaming the system.
But I had worked in theNortheast, um, cause I, you
know, being from Philadelphia,that's where my early jobs were.

(23:00):
And my bosses were the same way.
So I had never seen any otherway other than they tell you
exactly what you think.
It's usually painful and itdoesn't bother you because,
that's more the culture there.
It's when I got out of that,that environment that, you know,
that I, met people, like yousaid, Minnesota nice, a whole
different culture that was verydifferent from where I first

(23:24):
started.

Pat Kothe (23:25):
So that's one of the major lessons I take it that,
that you learned is you've gotto be a little bit more open,
forgiving to other people'sstyles.
Were there, Were there someother lessons that you learned,
through that growing up period,so to speak, and development
period that, that really became.

(23:48):
foundations of how you managetoday.

Dave Rosa (23:51):
Yeah.
I would say the biggest one thatwas more, I would say from a
managing people's standpoint.
and this one also, influencedthat as well.
Uh, so it's a story again atBoston Scientific.
I always felt that one of mystrengths where is, we're having
good instincts.
now it doesn't mean that, Ididn't ask anybody their

(24:14):
opinion, but my instincts havealways been very good and
ultimately.
you're going to grab data andthe data could swing you one way
or another most of the time.
I mean, sometimes it's clearcut.
Uh, and you're going to have tomake a decision, and in those
cases, I rely on my instincts,and I'm right more than I'm
wrong.

(24:34):
So, I was running theintravascular ultrasound
business, which was a disasterat Boston Scientific.
Salespeople didn't want to sellit.
The company, after they boughtit, really didn't even want the
technology.
The guy they brought in to runthe business lasted two months,
and they got rid of him.
It was losing money.
They were being sued by the FTC.

(24:57):
Hewlett Packard was suing them.
You know, they were losingmoney, in terms of sales.
And I had an opportunity to workin the stent business, which was
booming.
It's one of those businesseswhere, you know, without me, um,
it might've done better, um, or,or the ultrasound business.
And I sat down with thepresident at the time, Mike

(25:19):
Berman, smartest man, um, I'veever met, uh, and Mike said to
me, listen, and by the way, hewas from New York, division
president in Minnesota.
His story was he was so rougharound the edges when he was a
product manager in the company,that his boss, uh, that they had

(25:40):
put him on a plan, they weregoing to fire him because, he
was just rubbing people thewrong way, but I connected with
him because he was from the samepart of the world as I was.
So he said to me, here's thedeal.
This business has a lot ofproblems.
It's never going to be a billiondollar business.
What I want out of this is Iwant to get it profitable, I

(26:00):
want to clean up all theproblems, and that's what I
want.
That, that we will consider, tobe successful.
and he said, look, if things getworse, then you'll get fired.
But that's, and he said it justthat way.
So I said, okay, and it's one ofthose jobs that, I thought, my
friends thought I was crazy, butI thought, I've never been

(26:22):
involved, and had to go througha lawsuit by the FTC or, any
company, all these problems,salespeople don't want it, it
was a disaster, but I thought,Um, I'm going to learn a lot
from this and the bar is so lowhere that I don't know that it
can get much worse really thanit is.
So I, I, I took the job and, youknow, the business started

(26:46):
getting better, after about ninemonths to a year.
and then it got to a pointwhere, you know, we hit this low
again in terms of sales.
I won't go into all the details,but what we would do every
quarter is we would have abusiness review, at the division
where the products weremanufactured.
And it was the divisionpresident, so Mike was there,

(27:08):
the heads of sales, marketing,manufacturing, all the
respective, departments.
And you would get up there, Iwould get up there in this role,
because I was responsible forUltrasound, the business, and I
would give an overview.
Where sales are, what'shappening, why, what we're doing
to address some of the issues.

(27:29):
So I got up there one day, andum, Mike said to me, you know,
I'm looking at these numbers,they're flat, um, to declining,
and I think, uh, you know, thatpeople are using it less.
And I said to him, I don't thinkthat at all.
I think the, uh, the, because,uh, the company made a change in

(27:55):
how the products were sold, whatthey did was, they said, because
ultrasound involved capitalequipment, we're going to hire,
uh, well first we had our ownseparate group selling it, and
then there was a decision madeto combine, to have the sales
rep sell everything.
Now if you're a disposable salesrep, who's used to selling a

(28:17):
product, and getting a saleminutes after they, get done
their presentation and thenhaving to sell capital equipment
for a product that gets usedsparingly.
That's not exciting.
And I was very against itbecause I thought nobody's going
to sell my product.
They're going to make all theirmoney in stents.
And to be honest with you, Iwouldn't have if I was them
either.
So I said, the people, you know,our top 20 customers are using

(28:42):
the product just as much, if notmore.
It's everyone else who relies ona sales rep, a dedicated sales
rep, to come in, set up theequipment, show them how to use
it.
Because it's not used regularly,and there weren't these
ultrasound specialists.
The reps were, in essence,filling that void.
And now that you've taken thataway, and there's no

(29:03):
specialists, the people that,that aren't real believers, but
occasional users, are not goingto use the product.
Takes too long to set up.
They don't know what they'relooking at.
and, I'll never forget this.
He said to me, Oh, really?
He said, that's not what Ithink, so show me your data.
And at that point, I kind oflike froze, like, what do you

(29:24):
mean, show me, you know, yourdata?
And I remember looking down, itwas a U shaped room, and to the
far right, closest to me, was mydirect, uh, boss.
And I remember looking at him,he had this little mustache, and
he was, he was twirling thismustache, he was sweating, and
when I saw that, I'm like, youknow, I...

(29:46):
I think I'm in trouble here.
So I said to him, like, I don'thave any data, but again, you
know, I thought my instincts,you know, were dead on.
Uh, I said, but you know, thisis what I think.
And he said, okay, um, uh, hegoes, what, what time is it?
It's 11 o'clock.
You have one hour to go back.

(30:06):
Um, and he said, you said thetop 20 customers, right?
And I didn't know where this wasgoing at the time.
And I said, yeah, the top 20customers.
And he said, well, uh, is itfair to say that you think the
business could be even growingthere?
I said, yeah, top 20 customers.
I do.
Give me a number, you know, 10%,20%.

(30:27):
Now, if I was smart, I wouldhave said, yeah, the lowest
number that he gave.
But I said, no, I think they'reup at least 15 percent in the
top 20 customers.
And he said, okay, you got onehour, call, call back at the
home office and get ahold offinance.
I want to see the top 20customers with, uh, you know,

(30:48):
where they were a year ago,where they are today.
You can sit down now.
That's when I started to sweat.
and I'll, I'll preface this bysaying, up to that point, all my
presentations, over the courseof the first year plus had gone
very well because things, wereimproving.
So I get on the phone, I'll fastforward, we get the data, and

(31:10):
I'm literally sitting there witha calculator, you know, what,
you know, what, what are wedoing here?
What are we doing there?
ultimately.
the business, I think it waslike 27 point something percent
growth in the top 20 accounts.
and it was probably even the top30 accounts, but after that it
was just a nosedive.

(31:31):
So now, I'm a sore winner,right?
And Mike Berman's the smartestman on the planet, you know, in
my opinion.
And I'm right, and he's wrong.
So, um, it's 12 o'clock, andI'm, by the way, my chair is
right next to his.
So, um, and he's not evenacknowledging me.
And I have sweat pouring down myface.

(31:51):
And so at 12 o'clock, he says,okay, we're, we're going to take
a break.
Uh, so what's the results, Davesaid, you know, business is up
27, you know, point whateverpercent he goes, okay, you know,
now we're going to take a break.
And, and, you know, this was mymoment of glory and this is what
I get.
I don't get a.
You're right, uh, you know,congratulations, nothing.

(32:14):
It's like, let's go to lunch.
So at the end of the day, I'msitting in the room, and I'm
really mentally exhausted fromthat whole exercise.
And, uh, the door, I hear thedoors open behind me, and, you
know, this person puts a hand onmy shoulder, and I turn, and
it's Mike Berman.
And he said to me, Dave, I wantto talk to you about something.

(32:37):
And I said, okay.
He said, listen, I think you'rea talented guy.
I think you have a good head onyour shoulders, he said, but,
don't ever come to me and tellme what you think, because I
don't care what you think.
if I have to approve something,that's based on your opinion
versus my opinion, I'm going topick my opinion over your
opinion 100 percent of the time.

(33:00):
If you've got data to show me,to make your argument, to
convince me of what you want todo, I'm going to go with what
you want to do, because I dohave confidence in you.
But he said, never come to meand tell me what you think
without having, done thehomework.
That was a turning point for mebecause then I said to myself,
yeah, I'm not that smart where,um, you know, I can kind of

(33:23):
ignore, uh, you know, what, uh,the exercise of going out there
and finding what the real answeris before I develop an opinion.
I skipped a step is what I did.
Now, my argument was, I've beenout there working with customers
and this is what they weretelling me, which was true, but
I never checked the numbers tosee if it supported that.

(33:44):
So that, that taught me a lessonof like, I can't just go in
there, you know, and, and saylike, yeah, my, my gut tells me
this and that's what we're doingwithout at least going through
the exercise of having somethingto support that.

Pat Kothe (34:00):
Fascinating story.
And, and really, you know, whata lesson I've, I've got a, I've
got a Berman story myself.
So, so, so for, again, for thelisteners that don't know, don't
know Mike Berman, Mike, youknow, he really made a
tremendous name for himself atSciMed and, and when Boston
Scientific bought, ended up tobe, you know, be a CEO of, of

(34:22):
Boston Scientific from what Iunderstand now, Mike is, is
involved on, on, on theinvestment side of things and,
and, and doing things with, uh,uh, investing in, in, in
different companies.
Thank I was, uh, in marketing,uh, marketing diagnostic, uh,
catheters in, in the cath labfor, for Mallinckrodt Medical.
And I got a call from somebody,Hey, you know, Scimed's looking

(34:45):
for, you know, somebody lookingto build a diagnostic, uh, uh,
catheter, uh, uh, company incardiology?
You want to go talk to'em?
So I did.
I went up, I went up toMinneapolis and talked to, you
know, Danny Sullivan and, and,and, and the, and the group up
there.
and I, yeah.
And the other people inmarketing and, and, uh, uh,
sitting across from, fromBerman, it was a Saturday

(35:05):
morning, a ton of snow on theground up there, January,
February, whatever inMinneapolis.
And, and Mike asked me aquestion.
he said, okay, if, if you showedup here on Monday, your first
day on the job and there wasnobody here to greet you,
everyone was.
Kind of tied up, you, you're onyour own.

(35:27):
What do you do?
What do you do those firstcouple of days?
And I had been living in thediagnostic Cardiology catheter
market for a while.
So to me, I knew well like you Ihad these instincts and I said
I, I would go down to R& D andI'd start talking to the R& D

(35:49):
folks, about capabilities andwhat to do.
And I saw on Berman's face, youkind of went kind of blank.
And at that point I knew what Ihad done.
Um, but I didn't, I didn'tbacktrack, you know, the correct

(36:09):
answer to that question is I'mgoing to go out and do it with
the customers.
I'm gonna go talk to thecustomers.
Same thing.
Data.
I need to have data in here andthe place you get data is from
your customers, but because ofmy own ego or, curse of
knowledge or whatever you wantto call it, I knew.
And he taught me basically thesame lesson that he taught you.

(36:31):
mine was in an interview, whichwas a little, you know, less,
uh, stressful than you with ajob on the line.

Dave Rosa (36:40):
Yeah.
I, I, you know, I have so manystories like that with, with
him.
We could do a whole interviewjust, based on that, but, I have
to say that, And I've told himthis personally, I'm like, the
only reason why I feel like Igot to where I did, in terms of
role, is because of a lot of thethings that he taught me, either
directly or indirectly, justfrom being around him, and, he's

(37:03):
not the only one, but hecertainly, at a younger age,
when I was at a younger age, hecertainly, changed my way, my
approach, my way of doingthings, and thinking about
things, that I had never reallyconsidered before.
And I think, part of that is, asthe business was getting better,
I was gaining more confidence inmyself.

(37:23):
And I think that's a dangerousthing.
Because, I think when you startfeeling like, Oh, I got this
figured out.
I know what I'm doing.
people are telling me I'm doingwell.
You feel like, maybe I don'tneed to do that because I know
what's going on.
everything's going fine.
and Mike, again, that's probablysomething I would have done, to
someone in a group before thisconsultant talked to me, but

(37:46):
that was Mike, and I reallyresponded better, I think, to
people who kind of slapped mehard and said, hey, Mike, thank
you.
Shut up, listen, and, uh, youknow, uh, don't, don't do what
you did before.

Pat Kothe (37:59):
There's a difference between the, the person who
says, you know, slaps you andsaid, shut up, listen, and then
they take it out on you, versususing it as a teaching

Dave Rosa (38:09):
opportunity.
Yeah.
And Mike always, he wasn't thereto try to embarrass anybody.
But boy, he would teach you sometough lessons.
I saw him do it many times.

Pat Kothe (38:19):
Great learning lessons.
Thanks for sharing some of thesethings because, as we grow in
our careers, in my estimation,the most valuable things that
happen to us are when somebodysits us down and says, what
you're doing is wrong.
You need to change.
there's something about, aboutyou that, no one, if no one's

(38:40):
ever told you this before, shameon them.
But I'm telling you this becausein order for you to grow and
build your career, you need toknow this.
And there's so many people whojust go along to get along and
don't have those hardconversations because they're,
they're thinking maybe they'regoing to tick somebody off.
I don't want to have thatposition open, we'll just sweep

(39:03):
that under the rug because 90percent of what that person does
is good.
And there's 10 percent thatisn't, let me just take the 90
percent and put the 10 percentin the closet when that 10
percent could hold that personback from, promotions from a
career, because that 10 percentis so toxic to the next job.

(39:26):
So let's move, move from thatinto what you're doing right
now, because you, as you said,you built a tremendous amount
of.
of knowledge on how to growcompanies.
And you went from big companiesinto small companies.
So let's talk about NeuroOneMedical Technologies and what
you're doing there.
what's the problem that you're,that you're solving?

(39:47):
what is the clinical situation,that NeuroOne is tackling?

Dave Rosa (39:52):
NeuroOne's a company that, that's developed and
commercialized what I'll call aplatform.
Everybody likes talking abouttheir technologies as a
platform.
And, I really feel that this isa platform.
The problem when I wasinvestigating this area, which I
didn't have, it's actually oneof the things that attracted me

(40:12):
to this space because I hadnever worked in it before.
So I knew I would definitelylearn, a lot from it and I have.
But the issues were...
Initially, very invasive, morbidtype procedures, you know,
removing the top part of aperson's skull, and then
removing, brain tissue that wascausing issues, think of it like

(40:33):
atrial fibrillation where you'vegot, heart tissue that's
causing, complications for apatient.
This is just, different organ inthe brain doing the same thing.
I remember talking to a doctorat the Mayo Clinic saying, oh,
do you use a catheter to destroythat or, cryotherapy?
And he said to me, what are youtalking about?
We use a scalpel.
Um, and I thought, wow, this issuch a barbaric space.

(40:57):
You know, the brain, you know,fascinating organ.
And, I kind of, uh, expectedthat, technology would be where
it was.
It would be comparable to thecardiovascular industry.
Because.
I really saw a correlationbetween what we had done in the
cardiovascular side withcompanies I had been with to, to

(41:17):
what needed to be done in thebrain.
What I saw in NeuroOne was atechnology that could be used to
perform, multiple, notprocedures, but multiple
applications.
And what I mean by that isthere's a diagnostic aspect.
like trying to find theproblematic area in the brain.
So there were surgeriesdedicated to just doing that.

(41:38):
And then a patient would getsent home.
They would have to come back andget scheduled for another
surgical procedure where theyhad to go back into the brain
and then, remove the tissue.
and there weren't very good waysto really identify if the
procedure was successful,because if you're dealing in
epilepsy, it's is the patienthaving a seizure, and then,

(41:59):
there are other procedures wherethey place devices in the brain
or even other parts of the bodyto stimulate tissue
therapeutically, but all theserequired additional procedures.
And what I saw was spawned outof, the Mayo Clinic and the
University of Wisconsin was.
The device that had thecapabilities of being placed

(42:20):
less invasively because of howthin it was, but also being able
to perform both the diagnosticand therapeutic function.
As a patient, less invasive,minimally invasive, non
invasive, that's what everyonewants.
But also, no one wants to go infor multiple surgeries to begin
with.
But if there was a way tocombine the diagnostic and

(42:44):
therapeutic, part into oneprocedure, not only could we
reduce the number ofcomplications, just based on
reducing the number ofsurgeries, but people should,
should only have to, uh, gothrough a hospital stay once
instead of twice or maybe threetimes.
And there's also a cost elementthere.
The ability to save thehealthcare system some dollars

(43:07):
as well.
So I looked at it as, thepatient wins, the hospital
doesn't have to eat up eighthours, for a diagnostic
procedure, another eight hours,they could do more procedures,
because capacity is not verygood in, in these neurosurgical
procedures, just because of howlong they take.
And I saw an opportunity thereand, you know, so my vision was,

(43:31):
to take this one platform andexpand it not just for
diagnostic purposes, but also toaddress the therapeutic side
using the same device.
And, uh, that's kind of the paththat we've taken, and mine was a
stepped approach.
So let's develop the diagnosticpiece first, and then the
combination piece for, ablation,meaning destroying the tissue as

(43:55):
well as being able to, monitorthe area or find the problematic
area.
And then, stimulation being, thenext piece upon that.
and really, that's where we aretoday.
We've got two, approved productfamilies, that are being sold by
Zimmer Biomet, who's, ourdistribution partner.
And our first combinationdiagnostic therapeutic device is

(44:17):
sitting at the FDA right now.
We've already had an initial setof questions.
We're going to be responding tothose shortly.
And I envision that sometime in,late Q1 next year, we'll be in a
position to launch that.
and, there's always curveballsthat get thrown along the way.
Things that, again, that couldlead you down a different path,

(44:39):
have you change your strategythat you didn't see coming.
And one of the things that weare excited about is, the
ability to use this sametechnology to not only deliver
drugs into the brain, But also,evaluate the, effectiveness, of
those gene therapies or drugs inthe brain as, as we're
delivering them.

(44:59):
We're having discussions with,biotech, biopharma companies, to
use, a device like ours in theirclinical trials as a way of
developing objective performancecriteria to demonstrate to FDA
the efficacy of the therapy.
So it's a little bit of a, adifferent, application, but, the
beauty of it is that today.

(45:21):
what we're doing to resolveissues, especially with
epilepsy, is to burn tissue,destroy tissue in the brain.
And I think the future will beto put a device like ours into
the brain into one or two spots,and without destroying any brain
tissue, delivering gene therapy,to address these conditions.
So I think we're, we're wellpositioned today, but we also

(45:43):
have a platform that, canreally, be the next frontier.
in terms of, treating theseconditions using gene therapy.

Pat Kothe (45:52):
Can you describe the device, the size, how it gets
placed?
what the procedure is, whetherit's permanent or temporary?

Dave Rosa (46:02):
Sure.
It really varies since we'reinvolved in a number of
different applications.
But we have, I said two productfamilies that are cleared for
diagnostics.
One is, film, based technology.
So think of, a piece of paper,something that's as thin as
that, that you can roll up, andone of our platforms is for

(46:22):
spinal cord stimulation.
And our goal is to deliver itthrough a needle that doctors
use today, to deliver paininjections in the patients.
So instead of having to make anykind of incision, we can put a
larger device in, because of howflexible it is, just through the
center of a needle.
Obviously that's percutaneous,which would be, phenomenal if we

(46:45):
could do that in, in all theseapplications.
Some of them, though, requirethe device to be placed in a
focal point or a specific point,in the brain or somewhere else
in the body.
So different devices, that looklike thin wires.
They're about 8 millimeters indiameter.

(47:05):
So they get placed directly,much deeper into the brain.
but they're used to do the samething.
and that is record what'shappening in the area.
So those, are placed using,typically using a robot.
This is why Zimmer Biomet, ourdistributor, was interested in
us.
They have a robotic platformthat will drill the hole into

(47:26):
the skull and, those holes are,the depth, the trajectory of the
electrode are all pre programmedin based on where the,
neurologist and neurosurgeon,want to place the device.
So they'll predetermine a rougharea of where they think the
problems are and then thedevices will get placed to a

(47:48):
very specific depth and angle,so that they get to the area
they need.
So the less invasive platformis, a millimeter hole in the
skull.
The more invasive platform isyou remove a piece of bone from
the skull, to place the device.
Most of the procedures today arebeing done, with, drilling tiny

(48:09):
holes, into the brain.
So that's the way they're placedin the spine.
It'll be percutaneously througha needle.
So depending upon theapplication, it'll really
determine the method ofinsertion, but we have a clear
advantage because our technologyis so thin and so flexible that
we can put it in, advance itthrough small holes, as opposed

(48:31):
to having to, for example,remove the entire top part of
the skull.

Pat Kothe (48:36):
So you've got different products, different
applications.
You've, partnered with, ZimmerBiomet on, on one application.
What does your go to marketstrategy look like in general?
Is it, partner with othercompanies?
Is it, go direct?
What does it look like in

Dave Rosa (48:51):
general?
Yeah, that's an excellentquestion.
And it's, it really depends, onthe company that I've run and
what the situation is.
In this particular case, my goalwas for the diagnostic only
products was to find a partner,a strategic partner.
And the reason for that is themarket was relatively small for

(49:12):
that.
Where the market becomes muchlarger is in these combination
devices that are not justdiagnosing problem areas, but
then providing the therapy.
That's where the revenue is muchgreater and the businesses get
much more interesting.
So my plan was find a partnerthat has an existing sales force

(49:34):
where there's some synergies,which was Zimmer Biomet.
Utilize their sales forcebecause all of our competitors
for the diagnostic onlyapplication are small private
companies.
And Zimmer obviously sells a lotmore devices than just this
robot and these procedures.
Even if the devices were equal,and we had no advantage, Zimmer

(49:57):
would have an advantage in termsof sheer number of people in the
field, as well as the ability toleverage other technologies to
get the electrode business.
But my plan, beyond that was...
to go direct, where the marketsare much larger.
The other benefit of, of havinga strategic partner, especially

(50:19):
when you're just starting, andyou're a, I don't care really if
you're a public or privatecompany, is really validation of
what you're doing.
I think most people think ofearly stage companies as well,
these companies they don't havethe resources.
They don't have the know howthat larger companies have.
The risk is greater, right?

(50:39):
Will they ever get clearance oftheir device?
Did they do developmentproperly?
So there's all these,stereotypes, I think, of smaller
companies.
And if you're able, to get, aninvestment or an agreement.
successfully with a largestrategic, it validates what
you're doing in a sense to theinvestor and in his mind, maybe

(51:01):
reduces the risk associated withmaking an investment in you.
So that reason, as well as themarket being small and me not
believing that, financially, itmade sense to add all that
overhead for such a smallermarket is the reason why, I
developed a partnership or waslucky to get a partnership with
Zimmer.

(51:21):
As time goes by, again, I said,sometimes you think you're going
to go left and you go right.
what we're doing has become alot more synergistic with, some
other strategic companies andZimmer is one of them.
So it's not just them kind ofevaluating the company based on
this diagnostic technology.
They're seeing us make progressin the therapeutic area and

(51:43):
other areas like drug delivery,deep brain stimulation.
So then, you get to a pointwhere the market today, the
financial markets today, arejust a disaster compared to
where they were, when I started.
So then you have to startthinking about, maybe, uh,
should partner with them aswell, given the cost of capital,

(52:05):
and what's happening in themarkets.
So right now we're going down aparallel path of having
discussions with strategicsabout our, combination, this
first combination diagnostictherapeutic device versus doing
it, ourselves throughdistributors and direct
salespeople.
The advantage we have in this isthat there's not many hospitals

(52:27):
that do these procedures.
So a lot of companies will have,100, 100 plus reps.
there's 30, 40 centers that dothe bulk of these procedures.
So if you just focused on that,it wouldn't be out of the
question to, to do this and, tryto handle this directly.
Ultimately, what we'll decide inthe upcoming months is what

(52:47):
makes more sense.
Does it make more sense to forman additional relationship,
whether it's with Zimmer orsomeone else, or do it alone?
A year ago, people thought thatthings would be easing up in the
financial markets.
I think they're actually stillgetting worse, and I don't know
that any of us can predict whenthings are going to settle down.

(53:07):
You know, You have to take awayall those, because they're all
important factors.

Pat Kothe (53:11):
Given our earlier discussion about having the data
to support making the decisions,I'm sure you and your team have
got the data, and going to usethat to help drive these
strategic decisions.
So good luck on this company,you're already in the
marketplace.
There's other products that arecoming.
good luck as you start to reallyget, get this thing rolling.
I do have one, one finalquestion for you.

(53:32):
And it comes back to our earlierdiscussion on careers and I'm
sure you get a lot of peoplecome to you and say, Hey, you've
been really successful inbuilding a great.
medical device career.
What should I be doing?
What should I be doing so thatI've got a full career, set out
ahead of me?

(53:53):
What are a couple of things thatyou talk to people about that
are asking for

Dave Rosa (53:56):
advice?
Again, I'll steal a little bitfrom what I did.
My attitude was look for a rolewhere, you can learn.
And it doesn't mean that youcan't learn in successful
businesses, but, what you needto learn is to be able to make
decisions, for things that are,going to be tough decisions that
you have to make.
And you learn those by movinginto roles that, have

(54:19):
challenges, obvious challenges.
So my thing is learn as much asyou can and do not shy away,
look for the jobs that arechallenging because you're going
to learn a lot more.
The second is to learn as muchas you can outside of your area
of expertise.
Um, so if, you know, If mybackground's marketing, and I

(54:40):
want to get into, uh,management, senior management,
spend time with people andfinance in the company that
you're with.
Spend time with, people in R& D.
Learn as much as you can aboutwhat's important to them, how
they approach things, so thatyou can at least be competent in
having a discussion, and inunderstanding how they approach

(55:02):
it.
Ultimately, you're going to wantto surround yourself with people
that are experts in areas thatyou're not.
But learn as much as you can.
Very early in my career, I hada, a head of R& D come up to me
in this company, and he said,Dave, explain to me, I don't
understand, why my R& D guysreally like working with you.

(55:25):
You're, you know, in the evilempire of marketing.
Like, what, what are you doingdifferent?
And I wasn't doing anythingdifferent, but I had an
engineering background, and Icould understand what they were
talking about.
I could understand what theirissues were.
I was no expert in it.
But the bottom line was theywere able to communicate me on

(55:46):
their wavelength as opposed tome talking to them from a
marketing only perspective.
And I think that's importantbecause it gains credibility
with people in other departmentsthat you're going to be working
with.
And I think that also, helpsyour career because, again, in
that situation, I didn't evenknow that these R& D or this R&

(56:09):
D group.
had a positive, vibe for me andmy interaction.
So, you know, if your goal is tomove higher up into senior
levels, try to learn as much asyou can, develop relationships
as best as you can, with peoplein other areas, not because
human nature is if you're inmarketing, you talk to the

(56:29):
marketing guys and you'refriends with the marketing guys,
you socialize with the marketingguys.
And, that's important too, but Ithink it's important to also,
spread yourself, into otherareas as well.
The other thing, and I tell thisto my, children all the time,
don't listen to all the noisearound you.
There's going to be more peoplein your life that are going to

(56:51):
tell you you're not smartenough.
You're not good enough.
It could be out of jealousy.
It could be because they reallybelieve that, but if you're
going to be successful, you gotto believe in yourself, and you
got to block out all the noisebecause there's going to be a
lot of it.
And if you let that influenceyou.
You'll never be successful.

(57:11):
and then the last thing is,don't give up if your dream is
to, to work in R& D the rest ofyour life at, at a senior level,
middle level, whatever.
keep pursuing it, keep learningand don't quit.
There's going to be roadblocksall along the way.
and you can't let that get inthe way of, you accomplishing
what you set out to accomplish.

Pat Kothe (57:33):
I'm drawn to people who are open about their
experiences.
Good and bad.
And willing to share becausethey know it's going to help
others.
Dave's one of those people.
And I hope you enjoyed theconversation as much as I did.
A few of my takeaways.
First.

(57:54):
Brutal feedback.
If you're on the younger end ofthe spectrum and no one's given
you any, seek it out.
You're not perfect.
That feedback's going to helpyou get better.
Surround yourself with people,who aren't afraid to tell it
like it is and tell it, likethey see it.

(58:15):
if you're a little further inyour career, remember you're not
all that.
Make sure that you're open tolistening for that feedback.
And if you see someone.
And you think that feedback canhelp them find a way to do it.
Step out there, give somebody a,uh, basically a hand.
And how they can be better.

(58:37):
The second thing was marketingdepartment roles.
And I enjoyed the conversationof upstream downstream combo
roles because I've lived throughit.
But whether you're in marketingor any other department be
deliberate about how you designyour department, because there
are things that you need.
But then there's also internalex external customers.

(58:58):
And what do they need?
And then what are the talents ofyour people and where are their
interests?
And it kind of leads into thelast point and that's stretch
assignments.
Dave could have taken theeasier, more successful product
lines.
But he chose harder ones.
He chose opportunities where hecould grow.

(59:20):
And in those, thoseopportunities you end up with
high risk, high reward.
He talked about, you know, Uh,how it could have been high
risk, high reward, but he'sbeing viewed by the people as a
problem solver.
We've got a real issue here.
Can someone step up and take iton.
Not only can help the company,but help you use stretch and

(59:40):
grow.
Thank you for listening.
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Medical Device podcast whereveryou get your podcasts.
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to the Mastering Medical Devicepodcast.
As interviews like today's canhelp you become a more effective
medical device leader.

(01:00:02):
Work hard.
Be kind.