February 17, 2026 • 15 mins
This episode is the companion episode to "The 100 year Journey from Surgeons with Reputations to Surgical Robots". It frames the value that you can takeaway for your engineering career.
In this episode we discuss things such as:
1. Industry differentiation and the pressures that force it
2. Where values reveal themselves
3. Industry recognition vs. customer recognition
4. Who is rewarded under different paradigm
5. The right champions matter for technological adoption
6. The need for champions
The Engineering Passion Express is about growing knowledge and the passion for engineering.
If you are a conference organizer and are looking for an engineering or scientific speaker to inspire or educate in a keynote presentation, please reach out to me on LinkedIn. You can find my profile below.
Thanks for listening,
Brandon Donnelly
Please connect with me on linkedin @ linkedin.com/in/brandondonnelly
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:13):
Welcome to the Engineering Passion Express
podcast.
I am your host, BrandonDonnelly, and this is the
companion episode to our episodeon surgical robots.
I'd like to take some time andtell you a bit about why I told
this story, especially why Itold it over a hundred year
span, and go through it togetherand find out what the takeaways
(00:36):
are.
So, first of all, I told thisstory over about a hundred-year
time span because it illustrateshow industries shift over a long
time horizon.
And in those shifts, there's alot of opportunities that arise
across those times.
But because it happens so slow,often most people miss the
opportunity.
And I think this is where a lotof engineers can increase the
(01:00):
value in their career byrecognizing when an industry has
shifted enough to make a bigchange.
So medicine is a highlycompetitive industry, obviously.
Lots of schooling required, lotsof dedication.
In this story, I shared howinitially 100 years ago,
(01:25):
surgeons built their careers offof reputation.
In fact, outcomes weren'tmeasured.
There was no real database.
So because of that, it wasn'treally about your skill, it was
about maybe how media savvy youare.
Then outcome measurements camealong, and then it was all about
mortality statistics.
(01:46):
If you were better than theother guy, obviously more people
are gonna feel comfortable withyou, and you're going to get
your pick of work, maybe higherpay for that work.
And the people that will bestuck with the other guys are
the people that can't pay asmuch but need surgery
immediately, or they're gonnadie.
And so then they're stuck withsurgeons with worse mortality
(02:10):
outcomes.
But over time, those outcomesare chased, and you reach this
sort of inflection point whereyou can't really make it much
better.
There's some amount of peoplethat have such bad conditions
that no matter what you dosurgical-wise, they're probably
going to pass away during thesurgery.
(02:31):
So you kind of reach a plateauwhere your level of skill or the
quality of your hands can't goany further.
And that's when differentiationin an industry starts to begin
because it's it's hard to standout.
You have to pick some othermetric that other people either
aren't measuring or are pickinga different one.
(02:52):
And that's when values begin toshift.
I mean, you can see this in lesscompetitive industries, or I
shouldn't say less competitive,I should say you can see this in
less serious industries, likefast food versus a restaurant.
One cares about how fast we getyou your food, the other might
care about the quality.
Even within a restaurant, theremight be another one that cares
(03:14):
about the ambiance.
Those are differing values.
You could add price to that.
And that's what happens when anindustry gets very competitive.
You now have to havedifferentiation.
And those differentdifferentiations lead to
different technologicaladaptations.
(03:35):
Everything McDonald's does is tospeed up how fast we can get
your order out the window.
Where everything a high-endrestaurant might do is how can
we impart the most flavor andthe most experience onto the
customer?
And those two things lead tovery different technological
adaptations.
But something that's alwaysclear in every industry is that
(03:59):
the customer matters and whatthey value matters.
In particular, there'softentimes like the patients in
this story, where they justcared about surviving because
that was the goal to keep theirlife.
That's why they were going forcritical surgeries.
But then somebody else toldthem, not only can you keep your
(04:22):
life, but I can get you back toyour normal exercise, back to
your normal work, all of that,in a very quick time frame,
quicker than the other surgeons.
And I've been measuring this, sothat's how I know.
When nobody else has the datalike that, then you become the
expertise.
(04:44):
And sometimes what people miss,and this is what Dr.
Reginald Hawthorne missed in theepisode was that conflating
industry recognition withmetrics that a customer cares
about can be two differentthings.
(05:08):
I think if you wanted across-industry comparison here,
oftentimes movie or music awardshows, somebody gets an award,
which is like industryrecognition, but yet that song
wasn't the most popular or themovie wasn't the most widely
shared by the population.
(05:31):
And so those people are beingproud of their industry
recognition, but at the sametime, they're not being rewarded
by the customer.
And essentially, markets alwayscome back to customers.
So I think something special toalways look for in your career
is an opportunity for a valuesshift.
(05:54):
Dr.
John Wickham representedsomebody who both saw an
opportunity to shift values andwas successful in campaigning
them, thinking about the changein keeping someone alive to
maximizing their recovery andmaking sure that they have as
much capability after thesurgery as they did before.
(06:17):
That's a shift in where you'relooking and the result that
you're gonna get.
In this value shift range, Ithink we overlook a lot of times
that those are who are rewardedfrom the old values will resist
the new values.
And you can't really outlogicit, you can't really help them
(06:41):
see it because they've been sorewarded that they almost don't
want to see it.
And the speech that thecharacter Dr.
Reginald Hawthorne made here wasto share a bit of an old man's
wisdom on that fact.
Within this story, Hawthorne andother surgeons resisted Wickham
(07:04):
and Mull's contributions to themedical field because
recognizing them might possiblyreorder the hierarchy, which is
always a threat, even as mostpeople don't recognize it
themselves.
But sometimes you just need tospeak a different language or
(07:25):
find a different champion ofyour idea.
In this case, Fred Moleeventually spoke to hospital
administrators and quit tryingto convince surgeons who already
felt like they were at the topof their game and didn't want to
be replaced with robots.
Instead, he made a business caseto the hospital administrators
(07:46):
about why their patients wouldlike it, how they would get a
boost to the business, morepatients, more throughput,
better quality, less lawsuits,all kinds of things that are
very, very beneficial.
And now today, these robots areeverywhere because once they
realize the benefits, once thecustomer was happy with the
(08:09):
results, it's hard to go back,no matter how resistant the
industry was at the beginning.
And oftentimes these valueshifts require entirely new
methods and tools.
So in our story, John Wickhamdidn't yet have surgical robots.
His values were for minimallyinvasive surgery.
(08:33):
So what he first did was refinetechniques that under the old
methods and the old tools.
He didn't revolutionize thetechnology, he revolutionized
the techniques that were usedthat fit his values.
And oftentimes these valuesshift that do require a champion
(08:54):
because they don't changeovernight and they don't change
without somebody fighting forthem.
And when you fight for a longtime for something better,
you're gonna both feel worn out,but at the end of a years-long
or decades-long campaign, you'retypically rewarded, which is
(09:16):
what Wickham saw, and it's whatMole saw.
But I guarantee for both ofthese gentlemen, there was a
huge amount of self-doubt.
Am I really the authority here?
As they got pushback, theyprobably wondered, is there
(09:37):
someone else that can take thison?
This seems like a heavy burden.
And in the early days, it's allburden and no payoff.
And the longer you go, thehigher the stakes become.
Will this ever pay off?
Or will I have just acceptedsort of a beating from the world
(10:00):
without anything to show for it?
So where you can look foropportunities is look for
shifting values, look forcustomer values, and look for
values that can be strengthened.
And then ask yourself what arethe tools, what are the methods,
what are the techniques that Icould use that we're not using
(10:20):
today to better serve all ofthose values?
I think it's important to sharea little bit of the inspiration
for this episode.
I made this because a recentexperience brought me into
contact with these robots andtheir usefulness.
Engineers often can't see theshifts in values that follow an
industry until the end of theircareers.
(10:42):
You have to sometimes be in itfor 20, 30, 40 years to realize,
wow, we were moving the wholetime.
When you join an industry, itseems like it's always been that
way and is always going to bethat way.
And so it feels much morestatic.
But further towards the end ofyour career, it feels like
(11:03):
things have been dynamic.
And I think if engineers can seethat maybe five, ten years
sooner, then we can have anexplosion of innovation, of
creative ideas.
But I think there's a lot ofroom for industries to improve,
(11:23):
but yet there aren't enoughchampions out there.
So the first step to creatingmore champions is to create more
people that see.
And I hope that that's what theepisode accomplished.
Anyway, I enjoy the fact thatyou're listening to this short
companion episode.
I'm gonna try to make these fromnow on for each story episode,
(11:46):
because the story episodes takea month or so to decide on the
story, do some research, scriptit out, and it's a lot of
effort.
And I know that it feels like along time between episodes.
So, what I'm planning on doing,do one of those a month, do one
of these where we kind of gothrough the story, and then I
(12:10):
would like to do one interviewstyle format for something
that's useful to engineers withactionable items once a month.
It would boost us up to threeepisodes a month, give you more
consistent items to listen toand help build value in your
career and help you see theworld and understand where you
(12:33):
can maximize your value.
Thank you for listening to TheEngineering Passion Express.
As I mentioned before, my nameis Brandon Donnelly, and I'm
enjoying the work that I'm doingwith this.
I hope you are too.
I would really appreciate it ifthere's anyone that you can send
the podcast to to say check itout.
As we got going here, there aresome episodes that I feel are
(12:56):
much higher quality than others.
So if you can send them some ofthe ones that you really liked
as their hook in, that would begreatly appreciated.
In the future, I will also lookto start to organize these
episodes into common themes thatcan help illustrate different
(13:16):
kinds of topics that you maywant to learn as your career
progresses.
Thank you again for being alistener.
And if you haven't, subscribe,and we'll see you on the next
episode of the EngineeringPassion Express.
Welcome to the Engineering Passion Express
podcast.
I am your host, BrandonDonnelly, and this is the
companion episode to our episodeon surgical robots.
I'd like to take some time andtell you a bit about why I told
this story, especially why Itold it over a hundred year
span, and go through it togetherand find out what the takeaways
(00:36):
are.
So, first of all, I told thisstory over about a hundred-year
time span because it illustrateshow industries shift over a long
time horizon.
And in those shifts, there's alot of opportunities that arise
across those times.
But because it happens so slow,often most people miss the
opportunity.
And I think this is where a lotof engineers can increase the
(01:00):
value in their career byrecognizing when an industry has
shifted enough to make a bigchange.
So medicine is a highlycompetitive industry, obviously.
Lots of schooling required, lotsof dedication.
In this story, I shared howinitially 100 years ago,
(01:25):
surgeons built their careers offof reputation.
In fact, outcomes weren'tmeasured.
There was no real database.
So because of that, it wasn'treally about your skill, it was
about maybe how media savvy youare.
Then outcome measurements camealong, and then it was all about
mortality statistics.
(01:46):
If you were better than theother guy, obviously more people
are gonna feel comfortable withyou, and you're going to get
your pick of work, maybe higherpay for that work.
And the people that will bestuck with the other guys are
the people that can't pay asmuch but need surgery
immediately, or they're gonnadie.
And so then they're stuck withsurgeons with worse mortality
(02:10):
outcomes.
But over time, those outcomesare chased, and you reach this
sort of inflection point whereyou can't really make it much
better.
There's some amount of peoplethat have such bad conditions
that no matter what you dosurgical-wise, they're probably
going to pass away during thesurgery.
(02:31):
So you kind of reach a plateauwhere your level of skill or the
quality of your hands can't goany further.
And that's when differentiationin an industry starts to begin
because it's it's hard to standout.
You have to pick some othermetric that other people either
aren't measuring or are pickinga different one.
(02:52):
And that's when values begin toshift.
I mean, you can see this in lesscompetitive industries, or I
shouldn't say less competitive,I should say you can see this in
less serious industries, likefast food versus a restaurant.
One cares about how fast we getyou your food, the other might
care about the quality.
Even within a restaurant, theremight be another one that cares
(03:14):
about the ambiance.
Those are differing values.
You could add price to that.
And that's what happens when anindustry gets very competitive.
You now have to havedifferentiation.
And those differentdifferentiations lead to
different technologicaladaptations.
(03:35):
Everything McDonald's does is tospeed up how fast we can get
your order out the window.
Where everything a high-endrestaurant might do is how can
we impart the most flavor andthe most experience onto the
customer?
And those two things lead tovery different technological
adaptations.
But something that's alwaysclear in every industry is that
(03:59):
the customer matters and whatthey value matters.
In particular, there'softentimes like the patients in
this story, where they justcared about surviving because
that was the goal to keep theirlife.
That's why they were going forcritical surgeries.
But then somebody else toldthem, not only can you keep your
(04:22):
life, but I can get you back toyour normal exercise, back to
your normal work, all of that,in a very quick time frame,
quicker than the other surgeons.
And I've been measuring this, sothat's how I know.
When nobody else has the datalike that, then you become the
expertise.
(04:44):
And sometimes what people miss,and this is what Dr.
Reginald Hawthorne missed in theepisode was that conflating
industry recognition withmetrics that a customer cares
about can be two differentthings.
(05:08):
I think if you wanted across-industry comparison here,
oftentimes movie or music awardshows, somebody gets an award,
which is like industryrecognition, but yet that song
wasn't the most popular or themovie wasn't the most widely
shared by the population.
(05:31):
And so those people are beingproud of their industry
recognition, but at the sametime, they're not being rewarded
by the customer.
And essentially, markets alwayscome back to customers.
So I think something special toalways look for in your career
is an opportunity for a valuesshift.
(05:54):
Dr.
John Wickham representedsomebody who both saw an
opportunity to shift values andwas successful in campaigning
them, thinking about the changein keeping someone alive to
maximizing their recovery andmaking sure that they have as
much capability after thesurgery as they did before.
(06:17):
That's a shift in where you'relooking and the result that
you're gonna get.
In this value shift range, Ithink we overlook a lot of times
that those are who are rewardedfrom the old values will resist
the new values.
And you can't really outlogicit, you can't really help them
(06:41):
see it because they've been sorewarded that they almost don't
want to see it.
And the speech that thecharacter Dr.
Reginald Hawthorne made here wasto share a bit of an old man's
wisdom on that fact.
Within this story, Hawthorne andother surgeons resisted Wickham
(07:04):
and Mull's contributions to themedical field because
recognizing them might possiblyreorder the hierarchy, which is
always a threat, even as mostpeople don't recognize it
themselves.
But sometimes you just need tospeak a different language or
(07:25):
find a different champion ofyour idea.
In this case, Fred Moleeventually spoke to hospital
administrators and quit tryingto convince surgeons who already
felt like they were at the topof their game and didn't want to
be replaced with robots.
Instead, he made a business caseto the hospital administrators
(07:46):
about why their patients wouldlike it, how they would get a
boost to the business, morepatients, more throughput,
better quality, less lawsuits,all kinds of things that are
very, very beneficial.
And now today, these robots areeverywhere because once they
realize the benefits, once thecustomer was happy with the
(08:09):
results, it's hard to go back,no matter how resistant the
industry was at the beginning.
And oftentimes these valueshifts require entirely new
methods and tools.
So in our story, John Wickhamdidn't yet have surgical robots.
His values were for minimallyinvasive surgery.
(08:33):
So what he first did was refinetechniques that under the old
methods and the old tools.
He didn't revolutionize thetechnology, he revolutionized
the techniques that were usedthat fit his values.
And oftentimes these valuesshift that do require a champion
(08:54):
because they don't changeovernight and they don't change
without somebody fighting forthem.
And when you fight for a longtime for something better,
you're gonna both feel worn out,but at the end of a years-long
or decades-long campaign, you'retypically rewarded, which is
(09:16):
what Wickham saw, and it's whatMole saw.
But I guarantee for both ofthese gentlemen, there was a
huge amount of self-doubt.
Am I really the authority here?
As they got pushback, theyprobably wondered, is there
(09:37):
someone else that can take thison?
This seems like a heavy burden.
And in the early days, it's allburden and no payoff.
And the longer you go, thehigher the stakes become.
Will this ever pay off?
Or will I have just acceptedsort of a beating from the world
(10:00):
without anything to show for it?
So where you can look foropportunities is look for
shifting values, look forcustomer values, and look for
values that can be strengthened.
And then ask yourself what arethe tools, what are the methods,
what are the techniques that Icould use that we're not using
(10:20):
today to better serve all ofthose values?
I think it's important to sharea little bit of the inspiration
for this episode.
I made this because a recentexperience brought me into
contact with these robots andtheir usefulness.
Engineers often can't see theshifts in values that follow an
industry until the end of theircareers.
(10:42):
You have to sometimes be in itfor 20, 30, 40 years to realize,
wow, we were moving the wholetime.
When you join an industry, itseems like it's always been that
way and is always going to bethat way.
And so it feels much morestatic.
But further towards the end ofyour career, it feels like
(11:03):
things have been dynamic.
And I think if engineers can seethat maybe five, ten years
sooner, then we can have anexplosion of innovation, of
creative ideas.
But I think there's a lot ofroom for industries to improve,
(11:23):
but yet there aren't enoughchampions out there.
So the first step to creatingmore champions is to create more
people that see.
And I hope that that's what theepisode accomplished.
Anyway, I enjoy the fact thatyou're listening to this short
companion episode.
I'm gonna try to make these fromnow on for each story episode,
(11:46):
because the story episodes takea month or so to decide on the
story, do some research, scriptit out, and it's a lot of
effort.
And I know that it feels like along time between episodes.
So, what I'm planning on doing,do one of those a month, do one
of these where we kind of gothrough the story, and then I
(12:10):
would like to do one interviewstyle format for something
that's useful to engineers withactionable items once a month.
It would boost us up to threeepisodes a month, give you more
consistent items to listen toand help build value in your
career and help you see theworld and understand where you
(12:33):
can maximize your value.
Thank you for listening to TheEngineering Passion Express.
As I mentioned before, my nameis Brandon Donnelly, and I'm
enjoying the work that I'm doingwith this.
I hope you are too.
I would really appreciate it ifthere's anyone that you can send
the podcast to to say check itout.
As we got going here, there aresome episodes that I feel are
(12:56):
much higher quality than others.
So if you can send them some ofthe ones that you really liked
as their hook in, that would begreatly appreciated.
In the future, I will also lookto start to organize these
episodes into common themes thatcan help illustrate different
(13:16):
kinds of topics that you maywant to learn as your career
progresses.
Thank you again for being alistener.
And if you haven't, subscribe,and we'll see you on the next
episode of the EngineeringPassion Express.
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