Ep. 45 - The Academy Series: Leadership, Strategy, and the Future of Orthopedic Innovation with Katherine Truppi

Speaker A: Transforming Healthcare with Dr. Will Barsoum and Dr. Michael Meneghini.

Speaker B: Thank you very much for joining us today on Transforming Healthcare Unfiltered. I'm, um, the Transforming Healthcare. He's the unfiltered. Um, today we have an awesome guest with us, Kathy, uh, Truppy. Kathy, uh, has been with Stryker for. How many years have you been with? 23 years. And has held all kinds of different roles. She started an endoscopy, uh, eventually actually went to Europe and ran the joint replacement business for nine countries. Uh, did an amazing job, came back stateside to the United States, uh, just a few years ago, where she took over the hip business and did an amazing job with hips. And, uh, just about a year and a half ago, became the, uh, president of Stryker, uh, Orthopedics, uh, and all of the joint replacement, uh, business, which is today a $4 billion book of business. Uh, an absolutely incredible person who's been in the trenches, who understands orthopedic surgeons, understands sales, uh, understands what it takes to really move a product line. Uh, an incredible friend and somebody that I really enjoy having great conversations with about, you know, where healthcare is going, where it is today and where it's going. So, Kathy, thank you so much for being with us. I know you're super busy.

Speaker A: Thank you for having me.

Speaker C: How can you go wrong with that? Kind of a lead in intro.

Speaker B: No, it's awesome. Really is great having you with us. So I tried to touch a little bit on your history with Stryker and starting in the endoscopy division and kind of working your way up, but even go a little further upstream than that. Tell us about what got you interested in healthcare to begin with and kind of in your leadership journey.

Speaker A: Yeah, thanks. It's exciting to be here. So thank you guys for having me. Um, uh, pretty early, I kind of really leaned into science, and it was the thing I liked when I was a kid. And, um, my mom was an X ray tech and I got exposure to healthcare really through her. So, um, a lot of different things. They were still developing film back then, so very different to our world today. Um, but she take your kid to work day, take your daughter to work day was very cool. She got me into a brain surgery. I think I was, I don't know how old I was. 12, 10. Um, but it was something that I kind of always leaned towards and was excited to be in health care. I think I thought I would really take my career through school into following in the footsteps of folks like you and being, um, going to medical school. But I started to wonder. I started to question things. And, um, honestly, I took a year to work, and I spent that year at Stryker, and I've kind of never looked back. So, um. So it was early, early days. Um. And, yeah, as I came into Endo, what was really cool and still one of my favorite jobs I've ever had was that I was based in the or. And I loved that. I loved being like, I had my role. I loved being part of the team that was helping throughout the day, doing everything I could to support the surgeon and their staff, and was just really fascinated with that. So as I started with Stryker and left that position and got into orthopedics, it just felt. I think the thing I've always thought about is how am m. I staying close to surgeons and how I'm m staying close to their staff and the care they're trying to deliver for patients.

Speaker B: Yeah, uh, that's.

Speaker C: You miss being in the or?

Speaker A: Sometimes I do. It's a real treat when I get to go in the or, and I would love to spend more time doing it. And I.

Speaker C: It's hard when you run a $4 billion business.

Speaker A: It's super interesting. You don't. I think you can spend a lot of time through a project and through a product being developed and in. In labs developing it. But until you get in the OR and you see it in the flow of things and how it's actually working, and are we delivering on the reasons we're innovating in the first place? Um, you don't know until you're in there, right?

Speaker B: Seeing your baby for the first time, right? You've been working on this thing. It's been percolating along, and then all of a sudden, boom, there it is

Speaker A: in the operating room being used and being able to be honest about it and going, hey, we didn't get this right? Or it's not hitting this mark, or it's not driving in efficiency. We want to see. We need to. We need to go back. Um, is, you know, it's not always the most popular decision with the team, but it's has to happen.

Speaker B: So, look, I think there's nothing better than voice of the customer, right? And I think one of the things that makes you unique as a, you know, as a president at Stryker. Uh, I shouldn't even say unique at Stryker, but unique in the health care world is you came from being in the field every day, right? Being in the operating room, working with surgeons, hearing what they had to say, bringing, you know, a lot of that information back to the engineers, to the marketing folks. Uh, and then now being in the position to kind of green light things or say, hey, guys, this is not the direction we want to go.

Speaker A: Those are the hard decisions. Right. I think that's. We've talked about my role and what I'm here to do, and I think that's part of it. And how do you allow the team to really think really big and broad, um, is something that I'm excited about. Right. And how we deliver for surgeons by really opening constraints.

Speaker C: Yeah. Kathy, how many people are, um, in the way, uh, your division is structured? How many people are under you? How many people report to you?

Speaker A: 4000 ish.

Speaker C: And how do you, how do you separate that? How many people direct report to you that have other people? Like, I assume you have a team that you meet with on a, ah, weekly or.

Speaker A: Oh, yes.

Speaker C: Monthly basis. Right.

Speaker A: 4,000. Right. Correct.

Speaker C: Right.

Speaker A: Yeah. Yeah.

Speaker C: So how do you. We've been talking a lot about leadership and teams.

Speaker A: Yeah.

Speaker C: How do you. How do you see in your role putting together a successful team that supports you?

Speaker A: Yeah.

Speaker C: Is leading that $4 billion business. What characteristics you look for, what things you do with your team members?

Speaker A: Yeah, it is a great question. And we're. And we're kind of, um. As I came into the role, there were a lot of changes around the table. Um, so we've got a fantastic team, and I think we're in this phase of getting closer and closer together. Everybody has their role, but I think that the remit that we have is how are we leading joint replacement? So it's. How are we coming together and having that perspective? And so, I mean, I look for one, I want brutal honesty, so I want to make sure that that's part of what people are bringing to the table.

Speaker C: That's rare.

Speaker A: Um, two, um, I really think, um, we need people to be able to have their kind of functional or business unit hat, plus the JR wide kind of. Plus the striker wide one. So we're kind of constantly changing the landscape. But I think if we have that brutal honesty and you have people, um, that are all in it for this continuous improvement, and how are we actually making things better, whether that's for our surgeons, their patients, or the lives of our teams, um, that's what we're kind of centered on. Um, and I appreciate the diversity of thought around the table. We have some different makeup. The different leaders have different things they bring. And I think that's super important, that different perspective that we need to hear. We certainly don't need to be an echo chamber.

Speaker C: Well, I think that brutal honesty is so important in leadership these days, I. That I'd love to hear you say that. Kudos to you, because I just don't think that I had someone, uh, someone who used, um, to write. He covers health care a lot. He's a reporter, covers healthcare. He talks about corporate cowardice, the fact that people are afraid to say anything, whether it's political or otherwise. And so then it causes paralysis, and you can't move forward if you're not. If you're afraid to have brutal honesty. So I applaud that. That's great. I'm sure your team probably finds it refreshing because it gives them a safe space to say what they need to say to make things better.

Speaker A: But I think it's a bit of a journey so that people actually know that they can be safe.

Speaker C: It's probably true.

Speaker A: You know, not used to. It's a little bit of a journey, but it's been really good. It's a really strong team. They've come together a lot.

Speaker B: Well, I think that kind of leadership philosophy breeds raising more leaders. Right? I mean, yeah, you know, if you genuinely want folks to be brutally honest, it means that you're confident in yourself, you're confident in what you see, and, uh, you're confident in your people. And I think that's. That's a real differentiating factor. And very candidly, I mean, I think we'd all love to say and believe that all great leaders think that way, but I'm not sure that they do. Uh, I think there are a lot of leaders out there that want to surround themselves with folks that just kind of nod their head and they want to be the one that essentially makes every decision and, uh, don't really want to tolerate folks that have an alternative view. And, you know, I think coming from the field, I think you probably have a real, um, appreciation for folks that are in the field and getting direct feedback every day.

Speaker A: Yeah, for sure. But I think in healthcare, I don't know how you can afford to not want to hear what. What's happening or, you know, sometimes you have to make a hard call, say, no, this isn't ready, or gun down or down a place that we have a result we didn't anticipate. But there's patients at the end of the day that are, as far as in. In our small sliver of striker, are walking away with our implant. That's. That's a big responsibility. Right. And, um, and. And we. I don't know, it's just necessary.

Speaker B: Yeah. So together with our customers, we are driven to make healthcare better.

Speaker C: Right.

Speaker B: The purpose of Stryker, the mission of Stryker.

Speaker C: Right.

Speaker B: Um, you guys start every meeting with that slide.

Speaker A: We do.

Speaker B: Yeah. So talk a little bit about that. Talk about what that does for the corporate culture. Talk about the values of Stryker. I mean, look, you guys are now number one globally, right? For hip and knee sales, Is that right? U.S. for U.S. sales, yes.

Speaker A: And a number of markets around them.

Speaker B: Right. And then a bunch of markets outside of the US but number one in the US and clearly the fastest growing.

Speaker C: And it's been that way for a while.

Speaker B: Right, but number one in the US Is new. Right. I mean, so, um, you're doing something really right at Stryker. Right. I mean, you know, how does that, that, that mission statement and the values help kind of drive this sense of, yes, you work for Joint Replacement, but you are part of a larger organization and that organization has a mission. How does that all come together?

Speaker A: Yeah, and kudos to, uh, Kevin and the leadership team was 11 maybe years ago that, um, they came up with this and I think very carefully selected every word. And we start our internal meetings, but also our external meetings. So with anybody outside of Stryker with this slide. And, um, at least the thing I feel, and I think all of my team feels, is very connected to that is it describes what we're here to do. Um, we've kind of taken that, um, and brought it to joint replacement and said, if this is our mission, what's our purpose? And this is where we've come with this. Like, we move lives, how are we getting patients back to what they love? Um, that we feel really passionate about, given the remit that we have. But I mean, people wake up every day and I think it's, it is what they are here for. They truly live it and embody it. So it's, um, an easy thing, I think, for people to remember. Um, and I think it's a question we ask ourselves. There's a lot of energy and time we could put into many initiatives. But if you come back to what are we here to do, how are we actually improving healthcare? Um, whether that's the surgeon's experience, the staff's experience, the patient cost into the healthcare system. Like, these are the things that we're thinking about as we're innovating and making sure that the innovation is meaningful, it's doing something for one of those audiences continue to grow.

Speaker C: And Even with the 10 years I was a striker growing like a rocket ship, still Are still are. How, as you scale and get bigger and bigger, do you preserve that culture? I mean, it almost. The bigger you get, the more focus it takes, in my opinion, to preserve that culture. What do you. What are you doing on your team?

Speaker A: I love that you said that because it's been. I think my team might be, um, tired of hearing me say focus at this point, saying that in the best way. It's, uh, the horse's dust almost at this point, as I've talked about it so much. But I think that's where the road meets m. Where it's really hard. Where are you choosing to very intentionally spend your time and energy? And how are we doing those things to 110% instead of a whole myriad of things and figuring out. So it's where you're placing your bets? I think the focus is really important. The other thing, um, that hasn't changed for us, and I'll back up maybe a second, is the people side of it. Um, I think the effort, the intention, um, very deliberate. Things we do around our talent, whether we're starting from recruitment or developing our talent and really pouring into people, um, is something that we've always done and I think are continuing to do, which I think that keeps us in a good way. Focus, um, is paramount as we get bigger. But I also think we're moving from this maybe fierce decentralization to a more coordinated decentralization. We're actually trying to all work together, right? There are great things happening across Stryker, um, outside of joint replacement, that we should be leveraging and working together and saying, how are we bringing a competency or a capability to orthopedic surgeons based on that?

Speaker B: So Stryker's a highly matrixed organization, right? I mean, you have, um, a spine division, an instruments division, endoscopy division.

Speaker C: Right.

Speaker B: Obviously, joint replacements. Um, as you think about that matrix reporting structure, right, you've got a group of, you know, your 4,000 folks working with you, um, but they need a new instrument, right? They need a new whatever, you know, new drill. Um, how does that work? How does that relationship work in terms of bringing in the resources that you need from another division, sending some of your folks to that you guys share resources. How does that all come.

Speaker A: It's evolved over time. I don't know that we found necessarily the perfect solution. I think there's been a big mind shift change in terms of the leadership, of how are we working together, um, and kind of an expectation. But you have to figure out how is it if we're looking for Something, is it mutually beneficial to them? Um, or how are we going forward together? Um, there's a lot of pride in what people do in our organization and uh, sometimes you can see or feel at times a little territorialism and we got to break all that down and say, okay, but at the end of the day it's this, this orthopedic. I'll take my lens. The orthopedic surgeon. How are we solving these problems for the orthopedic surgeon that we all have to come together around? So it's that common goal you keep coming back to. And what are we, what are we aligning to? We've made a lot of progress and

Speaker B: that's interesting listening to you. You know, we did a, we did a podcast with uh, Matt Abdul at Mayo Clinic and, and guys, if you haven't watched that podcast, it's definitely worth watching. Talked a lot about, um, leadership in that and kind of mission driven leadership and this, this sense of, you know, doing something. Because this is more than a job, right? It really is kind of a mission. It really is a vision and a mission. And um, I remember Brian Donnelly, who is now the CEO of uh, uh, Columbia, ah, Presbyterian in New York City. Brian and I worked together. We were, he was one of my attendings when I was a resident. We were partners together at uh, Cleveland Clinic. And uh, he was, when I was running Cleveland Clinic Florida, he was running Cleveland Clinic London. We were very, very good friends. And Brian used to always talk about incremental effort, right? It's. If you get folks to really believe in what you're doing, it's no longer a 9 to 5 job. People will give extra effort because it's show they find meaning and purpose in coming to work every day. And uh, I've always, that's one of the things that I've always liked about that vision statement, right, Is it really takes a for profit, publicly traded company, right, and says, okay, we're more, we're about more than the profit. We're about this mission. And you need to eat, breathe, drink and sleep on this mission every single day.

Speaker A: I love that 100%. And I think when you talk about the Matrix and how we work together, if you look at Mako rps, it's a great example because we're taking this power tool, knowledge that sits in our sister division and bringing that together with this um, robotic experience and intelligence from the Mako side and bringing it together to offer another solution for surgeons. Because staying close to our surgeons and we're hearing what they Want. Right. So it comes back to the voice of customer. It comes back to what are we here to do? And. And it brings the teams together, which is amazing.

Speaker C: Yeah, let's talk. Let's talk about some of that, if you don't mind. Let's go back a little bit because we've had a lot of conversations at, ah, you know, we are at the American Academy of Orthopedic Surgeons meeting where's, I think, uh, we started at 8,000 people is what we heard with the tenants. So 8,000, many of which are surgeons. And I've often been saying lately, the last, you know, year or so, the, the healthcare ground is shaking underneath us. It's changing rapidly from. And macroeconomic forces, the government, the payers, they're bigger than all of us. Right. And so those two things are, Are forcing us to change the way we do business. Um, we're seeing a large migration, and we believe this won't, won't stop a large migration out of hospitals and ambulatory surgery centers. How are you. And in your division and in Stryker as a whole, how are you approaching that this change is occurring so rapidly?

Speaker A: Yeah. So, one, we're trying to stay really close to the surgeons and hearing what their experience is, because I think the pressures, um, that you all are under, uh, are tremendous as well. And so it has, um, one, it's opened our view. So I'll say from a joint replacement perspective, and having been here as long as I have been, we for a long time really just thought about the or, and now we're thinking about your entire week and what are those pain points and how are we solving them? Which is the other thing that brings us back to the broader striker and how do we come together to solve these problems, to take stress and strain off of you, your staff, throughout that week, whether it's clinic or. It's the or. Um, so we're staying really close to the surgeons, I would say, um, and being very conscious about the kinds of innovation we're coming out with. I'll go back to that. We want it to be meaningful innovation that has. There's a reason we're doing this, and that reason can't purely be financial. Right. What are we impacting for the surgeon, their staff, or the patient? Um, as we come back. And so as we talk about the shift to the asc, I think, uh, there's different parameters we're thinking about, and obviously there's a big efficiency play and push. But in my view, in our view, I don't know why that would be any different from what the hospital ultimately would want anyway.

Speaker C: So you're right.

Speaker A: There's everything that we're thinking about for that space. We're thinking about the. The broader context, um, but just also trying to be close and think about it from the different perspectives.

Speaker C: You guys are probably more. I would say you're probably better positioned than any other company to accomplish the goal that you just mentioned, which is help the. Uh. Because you have so many different divisions that touch so much of healthcare, you can probably have a better offering. I mean, even when I was with Stryker for 10 years, 10 years ago, we were still talking about. I remember vividly talking about getting all the divisions to work together. And of course, I'm sure it'll continue that way for 20 years because it'll never be as perfect as people want it. But I think you guys are positioned in a great. Probably better than most anybody to do that, uh, because your breadth of offering and we have Stryker stuff all over our asc, from lights to beds to. Right. I mean, to everything. Right. So you're probably in a position to offer more.

Speaker A: Yeah. And we're really excited to, um, I guess leverage those strengths together, like you said. I mean, so we. There's some things we figure out behind the scenes, but. But coming forward and creating a solution that actually makes sense for everybody who's involved, um, and being able to connect everything that we have. Right. It's not just implants, it's not just enabling technology, it's not just data, but it's the power is in connecting all of that and turning that into something that is useful to you, that can help you make decisions, you know, and can help again come back to the patients. Right. How is that impacting the patient's experience or their outcomes?

Speaker B: Kathy, let's talk for a minute about innovation. Okay. Um, I remember, honestly, you were probably in Europe at the time when the big head metal on metal, hips were coming out. Um, and Stryker said, not for us. We're going to wait and see. Right. Wasn't first on that bandwagon, actually never really got on that bandwagon. Um, but then when robotics were coming along, you know, Kevin took a big swing and bought Mako. And I remember being one of the folks in Stryker room saying, are we sure that this is the right direct. We just spent a lot of money. Does this make sense? Clearly. Turns out he was right. I mean. Yeah, he was very right.

Speaker A: Yeah.

Speaker B: But there are areas where I think, um, Stryker, ah. Leans in hard and fast. Go, go, go. And Then areas like in metal on metal, where you guys were like, well, I shouldn't say, yes, we.

Speaker C: Right.

Speaker B: Because, you know, full transparency. I'm a consultant for Stryker. But, um, you know, we made a decision to say we're not going to go down that path. Talk us through a little bit, kind of the process of deciding where are we going to focus our innovative efforts in these 12 months, in the next 36 months, in the next 16 months. How do you think about that?

Speaker A: Yeah, for sure. And Mako coming in, um, it has changed our thinking in a lot of ways too, in terms of. To the best of ways, um, in terms of how we could be innovating. And it's really opened up constraint for us, which is, uh, fascinating and just in terms of thinking and for the engineers in particular. Um, but I think, uh. So we certainly are looking out kind of beyond the 12 months. Right? I mean, by the time you do the projects and particularly around the world, the regulatory clearances, um, that you get, we're really looking, you know, you're looking five, ten years out beyond for what is that next thing? Where's the next innovation? I, um, think we've learned a lot through Mako coming in that there's equally a need to focus on implants. And this is an. And this isn't an either or. Like I said, it's about bringing these things all together. I think that's where we're going to have the best impact. So, um, it's a lot of listening. I think it's a lot of, um, market research. I think as we lean in more globally and are trying to kind of shrink the world through our own view, um, there are some amazing things happening in other parts of the world and trends that we look at. Um, as well as listening to our surgeons here in the U.S. um, and now staying very close to tech companies. That's a newer area for us. I say newer. We've been with Mako for 13 years. Mako existed for seven before it. So 20 years of robotic leadership. Um, but we're. It's moving fast and so staying really close on the tech side. But at the end of the day, I think the underpinning to that is about the science. That's always been who we are. Um, different companies have different. Uh, they're known for different things. Um, for us, it's always been about the science and we let that lead some of the decisions. Um, and I personally, through the lens of specifically joint replacement, I take it really personally that we don't have unintended consequences and we take things backwards by bringing some innovation to market. Um, the results of total hips and total knees. Right, being what they are, you have just as much of a chance of doing that. And that's not something that we want to be doing as we think about and consider innovation. So we're always going to come back to being rooted in, in the science. I think that speaks to our past decisions and how we go forward.

Speaker C: Yeah, uh, yeah, you mentioned data to walk us through. You mentioned that earlier and that's something everyone's struggling with, I think. Yeah, right. Especially in the healthcare ecosystem. Who owns it, who, who, who, um, you know, who obtains it, who keeps it? It's this quagmire that I don't think everyone's totally figured out yet. Where, how do you approach that being a highly technical robotic company, how do you approach data and where do you see it? Is it going to evolve? I assume it will, yeah, for sure.

Speaker A: And I think we're learning along the journey we've been learning. There's so much data through MAKO that we have access to and it's so important. It informs how we can inform how we design as we go forward. Um, but I think the big part is how are we turning that into the insights that are meaningful to surgeons that make an impact in again their day to day, their decision making. Where is it impacting the patient? So, um, it feels like everybody's on this quest for finding this way to build these data lakes and to have this be really informed. Um, I think we're excited about AI and excited about how things can progress, um, but are also trying to make sure that we're staying rooted in the science. I'll come back to that. And that um, we're doing it carefully and for the right things. Otherwise it's just data overload. Um, we're taking that approach of trying to work with um, different facilities, um, and trying to maximize what we have. Um, but there is going to be a huge evolution, right. It's how do we bring this into the patient side, um, how do you connect all that to get true longitudinal data that is meaningful and impactful, that can again I come back to informing where we innovate and how we, how we um, are doing our research and development.

Speaker C: You know, it's been interesting to watch Medtech, uh, in our industry specifically for Will and I have a knee replacement or meetings in general. The companies are, they're really strong in biomaterials, biomechanics, manufacturing, this new world of data it's not in their wheelhouse. And I don't mean Stryker. I mean all the companies. It is not. This isn't a Stryker thing. This is an industry thing. Because we in Orthopedics for 50 years plus have been about putting implants in. We've been about designing great implants.

Speaker B: By the way, I did not prep them to say that.

Speaker C: Was that leading us.

Speaker B: Kathy hears this from me all the time.

Speaker C: Everybody's saying it all.

Speaker B: Everybody's saying. I don't want you to think I prompted.

Speaker C: That was the Pope. Okay, Michael, say that. Now. The thing I told about earlier. Go. Right. No, that was not. That wasn't planned. But. Yeah, but that's because everyone's talking about it. Right? I mean, those of us like Will and I on the surgeon side advise companies, and we know that that's not a core strength yet. But to pivot is going to take. It's going to take intentional, uh, effort, I think, and resources. And it's not. We don't. It's not like medtech companies that. Or I'd say orthopedic medtech companies. It's not like we have a hundred computer programmers just sitting around. You know what I'm saying? It's not their. Yeah, that's where the wheelhouse.

Speaker A: Yeah.

Speaker C: Well.

Speaker A: And it's, I would say, specific to us in joint replacement because other parts of Stryker have other capabilities they've built over a long time. But as we got into Mako, um, and then we did that acquisition in 2013, it's. That brought us into software. And even that idea of iterating when you're in software is totally different than metal and plastic.

Speaker C: Totally, totally.

Speaker A: And so bringing these two worlds together and saying, how can we speed up? How are we actually doing this? Well, um, but to your point, and we have these conversations all the time internally, we look at our talent and we go, what capabilities? What gaps do we need to fill? How do we need to evolve to your point? Because it's ever increasingly more important.

Speaker C: Yeah.

Speaker B: Let's touch for a m. Minute on, um, the global aspect of Stryker. And in many ways, you're kind of uniquely positioned because you've led in the United States and you've led in Europe.

Speaker C: Right.

Speaker B: How is it different? I mean, when you're selling in Europe versus selling here, how's it different? How do you think about, um, approaching your customers over there versus approaching customers over here? That the hospital side, the governmental side, what are some of the differences?

Speaker A: Yeah, it's. Well, and I would love to go Live in the rest of the world and learn all of those systems too. Because it was definitely for me, um, the most accelerated learning I think I've ever done.

Speaker C: What countries were you?

Speaker A: Ah, so I was responsible first for Benelux in Poland and then I moved to uk, Ireland. Um, yeah, yeah. Um, so there are some things that for me felt very, um, like foundational and consistent, you know, quality of the products that's expected. What a surgeon might expect from their sales, ah, representative in the room, uh, that they work with. Um, and from, at least from the Stryker side of all the reps that I met, that, that passion to deliver and be there for their customer, it comes back to that, that mission, um, that was really, really consistent. Um, I think the rate of adoption of technology very different depending on the market that you're in. Um, there are some places that, uh, I'm, uh, not going to name names, but they really wanted 10 years of registry data. That is how they operate. So, you know, in the US we might get criticized for having an old something or other design and in other places they're going. Is the best thing you could do is 20 years of clinical celebrating it. Right. And it's very different.

Speaker C: Even, uh, in Europe. It can be. In Europe in particular, it can be. The countries are. You could have one philosophy here and literally 100 miles over you're going to have your philosophy. It's fascinating to me.

Speaker A: There's, yeah, there's no, you know, internally it's like what's happening. It's not Europe, it's all of these countries because they are very, they do

Speaker C: have their nuances to them. They have their CE mark and whatever. But there's nuance.

Speaker A: There's nuance. There's nuance in what they're looking for. Um, so I think that's a difference. Um, the healthcare systems are different. I don't think I've met anyone who thinks any, that any one system has been perfect in all of these markets. Um, there's always opportunity. Um, and so I think that part's been really interesting as well as how care is provided. I think everybody, uniformly around the globe is trying to bring more access, trying to bring care to more people, um, which is something that we can get behind in any way that we can play a role in that. But that, that varies country to country as well. Right. With wait lists and different things. So it's um, as we are kind of leaning in and truly, um, wanting to be thinking and acting globally, taking all of that into account, I think having some Focus. I'll pull on your point before. Of where exactly are we saying that's the case? But taking all that into account and letting that inform our innovation, um, is I think critical as we go forward, uh, for us. And if we can be more efficient in delivering implants and technology, um, then I think that benefits the whole of the system, and I think that's us leaning into our mission.

Speaker C: Do you think that our healthcare system's heading towards more European model over time? I hear people say that. I just wonder. I mean, you've been over there. You probably have. You have more experience than I do because you were over there. What do you think?

Speaker A: I don't. I don't know.

Speaker C: I was gonna put you on the spot. I was gonna put you on the spot. I sort of think we are to some degree, um, with the macroeconomic forces a little bit, but I don't know. You know, it could. It could take some pivots and turns, depending on our political cycle, unfortunately. But you could. Right?

Speaker A: Exactly. Can all of those other markets.

Speaker C: Right.

Speaker A: Get politically impacted by things? I've seen it happen. Um, yep. But I don't know, with healthcare consumerism and people really wanting to have say in. In their care. Um, you know, so I. I don't know with. With that push.

Speaker B: It's.

Speaker C: We were talking about this earlier. It's very interesting you mentioned healthcare consumerism, because that is something, but it's not everywhere. So we're talking about two different markets in Indiana. I have northern Indianapolis, where we have a facility, an ambulatory surgery center. And then we have my hometown of Terre Hood, Indiana, on the Indiana, Illinois border with a 25% poverty rate. And the health, literacy and education and ability to be a consumer are varied between the two. Some people limp in and they've been ignoring their. You know, they're probably a little more overweight. They probably don't eat the best. Their knees are horrible. Meanwhile, you've got. And that's maybe in the. In my Terre Haute market. Meanwhile, in my northern Indianapolis market, they're coming in with their. I've been doing my research on Google and I think you should put in this implant and this approach.

Speaker A: Yes.

Speaker C: And by the way, why don't you do this fancy knee? That's. That's being that I just found all over the Internet, The fancy knee. Yeah, that's what I should call it.

Speaker B: Which isn't so fancy.

Speaker C: The fancy me. We'll just leave it at that. Anyway, I'm quoting the fancy. But you see what. You see what I'M saying. Yeah,

Speaker A: completely. I was just meeting with a surgeon talking about this who's in a safety net hospital and he's doing amazing work and it's incredible. Um, so you're right. Um, but I do think about the Access piece. I think about my husband, who is British and who moved here, and his experience in navigating the different systems. So there's kind of this, yes, you have care for all and where he's coming from. Um, but the access, the experience and what he's finding here is very different. So I do think we all.

Speaker C: I mean, I. I would say better access, probably. Right. I mean, depending on what trust you are in the uk.

Speaker A: Yes, exactly.

Speaker C: Some of the waitlists I've heard are up to two or three years in some of the trusts, if you get, which is wild.

Speaker B: But better access for primary care over there.

Speaker C: Yeah.

Speaker B: You just walk in.

Speaker A: Yes.

Speaker C: Yeah, Right.

Speaker A: Completely.

Speaker C: Right. So that's what I mean.

Speaker A: There's puts and takes of everything and I don't have any one system, but I. So I think it's, um. I guess my hope is that it's some combination of things as we go forward. I think there are things to learn from some of the models that are. That are over in Europe and around the world. Um, and I think there are great things about our model here and how do we manage this. A lot of it is coming down to cost, too. And how are we managing it and doing the meaningful things. Keep using that word, um, that are going to be a better, I don't know, life for the patient, better outcome, better overall experience, an episode of care as you guys deliver that.

Speaker B: So, Kathy, do you get the sense, I mean, when I first went into practice, there was, at the hospital level, it was always the sense of, we are the hospital, they are the vendor. Right. It wasn't a partnership, it was a business transaction. And I know that, um, Stryker has worked hard to foster relationships that do really create a true partnership as opposed to a hospital vendor relationship. Just touch on that. I mean, is that important to you? What does that look like? How does it change the dynamics of the relationship?

Speaker A: Yeah, I think it's really important to us. I think it's important for all of us in terms of the solutions we can provide. Coming back to the data question, um, I think that's really important. And so I think there's evolution on both sides of that relationship that have to happen. I'd like to think that we're poised to enter into those. I think we learn along the way and Sometimes we have to, like I said, we have to evolve. Um, a lot of places, um, we hear the word partnership a lot, but I don't know that everybody really is looking for it, means it, um, in the way that we would think. And, um, for maybe some folks we're sitting with, all they care about with that is how cheap can you get it? And we want to elevate the conversation beyond that. I, um, think that's part of our role. We have to be there and, um, be open to different, different models and different ways of doing things. But I think we want to go beyond that because that's still us living in that vendor hospital scenario. And I think we could achieve more, um, if we were doing certain things together. And I think that's what we're trying to really march towards.

Speaker B: Yeah. This idea of, I think, eliminating the friction, you know, between the industry partner and the healthcare system and truly creating, you know, more seamless flow of information, a more seamless flow of effort, of knowledge, I think is, uh, definitely a great area for innovation that I would honestly say has lacked across the board up to this point. Right. I think, um, it's based on hundreds and hundreds of years of very traditional relationships. And today, I think, is an opportunity as we're all kind of swimming in the same pool right now when it, when it comes to, you know, to.

Speaker C: Yeah, I think everybody back then, hospitals made a bunch of money. Made a bunch of money and they would fight. I mean, I remember it wasn't that long ago. Even, uh, in. In our own institution, there was this. There was a surgeon that got up and said, look at how much they started the negotiation by putting the Wall street stock price up for the company. That's first of all, horrible leader. Say right now, he's one of the worst leaders I've ever worked with. Uh, but he put it up. That's how he started it. And of course, you immediately create a division, right? You immediately puts everybody on edge. Right. And meanwhile, that company is a. That company has $10 billion in the bank. So it's a little bit like, uh, you know, uh, calling the kettle black, if you will. Right. I mean, are you kidding me? Like, how are you worried? How are you making those claims? Hopefully, hopefully, that division will go by the wayside when the players that have the most influence and wealth are the commercial payers in our government. Right. They're the ones that are pushing. So we got to band. I say we got to band together and figure out how to solve these problems together rather than be Too busy, uh, punching each other.

Speaker A: Yeah. I mean, I agree that's, that's where we want to be. And I think there's, there's mutual benefit, um, that you can find many, many times. It's, it's not, um, doesn't need to be that way.

Speaker C: Right.

Speaker A: The pressure that you're under, um, just translates to the pressure that we're under. Right. In so many ways. So, um, so we have to be, we have a lot of, um, initiatives going on to make things more efficient on our side for that very reason. Right. And how are we able to flex and move and be where we need to be? Right. We believe in our technology, we believe it has value and it adds into, um, your lives, the patient care that comes out of it. Um, we believe it has value, but we also need to, we're operating in this space. Right. And so we, we need to be realistic. I think in that sense that's certainly how we look at it. There's conversations we have and, and um, clinical. Could be clinically sound development that's worked on. But if for some reason you can't control costs. Yeah, it, it is not a viable solution for our go forward.

Speaker C: We'll see the light of day. Um, Yep.

Speaker A: And that's because of everything that we're talking about.

Speaker B: So get a little personal here on something. All right. So I have three daughters. Three daughters, yeah.

Speaker C: Three.

Speaker B: You have three daughters, three boys. And we're all in a field that is extraordinarily male dominated. Right. The surgeons are 95% men, probably in orthopedics, I would imagine. Um, in industry, most of the sales force is meant different than in the pharmaceutical world, but I mean, in the implant world it's different. Um, and I can guarantee you that my daughters and his daughters are going to be listening to this podcast.

Speaker C: Right.

Speaker B: Because it's awesome to see a woman that has worked at an organization for 23 years and climbed the ranks and is now running a large division of the organization. How has that changed in 23 years? Right. I mean, what was it like 23 years ago to be a woman in orthopedics? Well, I guess you started in endoscopy, but eventually in orthopedics to today being a woman in orthopedics. And I don't, I mean, to be clear, I, uh, I don't want to, you know, do this in a way that's like calling so much attention to, you know, male versus female.

Speaker C: Right.

Speaker B: But it, but it is true. It's a male dominated industry and you've kind of broken that mold.

Speaker A: I think lots paved the way before me, that's for sure. Um, in the industry. And um, as we've been doing some kind of, uh, women in arthroplasty meetings, it's been amazing to meet all these amazing women who've been in practice and doing these things for years. Um, so, uh, it has changed. Um, I'd love to see it change faster, if I'm honest. Um, we have a lot of focus, um, at, ah, just overall diversity and really making sure, like I said to you before, like, diversity of thought, diversity of experience, I think is critical for my leadership team. And if you think about that, I mean, that's what we're trying to take through our organization. I'll tell you that we look very different in the US Than some of the teams I worked with, I had the privilege of working with in Europe. Um, I think when I go to. If I look at my Polish team, um, my Dutch team, they're 50% female, maybe more, um, very different to here. So, um, even, uh, I sometimes will get hit with various opinions even within my own organization. And it's entirely possible, and I think people are proving that. Um, but I also think it's, um. I know certainly it's been my experience that if you're showing up every day and you're passionate about what you're doing and you care, and you could say that about so many people, but you just need to give people the chance. But it shouldn't matter, right? The best thoughts, the best that you can bring to the table is what we want from folks. And to me, there's no mold for that. Um, and I often ask myself, do we mirror our customers? And that's not just an orthopedic surgeon question anymore. That's hospital administrators, that's nursing staff. That's, you know, if we're walking in a room, I'd love for us not to have a mold. I've heard that comment so many times, and it's probably true of the industry, um, as much as it is of strike or joint replacement. But it's like, oh, the mold. I could tell you were a such and such rep, and we want to break out of that. So it's been interesting. There are not a lot of times where I felt that I was in any way disadvantaged. I will say that I certainly never felt it. There were some experiences I can recall where I felt like, um. And I'll say it was. It was a couple of surgeons over my time, um, I feel like they Lower the bar, maybe when they see you. And I say this about when I was younger and I was starting, compared to my same age as me, it was like we were running a study. Male counterpart. We both happened to go in a room and start to have a conversation. But in my opinion, if you're going to lower the bar, like, that's on you, because I'm going to step right over it.

Speaker C: That's right.

Speaker A: So I don't, you know, you don't react in those. In those moments, but I haven't felt disadvantaged, but it's real. And I think making sure that people feel. I'll pull on your comment earlier, Dr. Mani, but feel like it's a safe space, feel like they're welcome and can be here and contribute their ideas is what I care about.

Speaker B: Yeah, I mean, it's pretty amazing. I mean, if you look today in the orthopedic world, looking at Stryker, right, A woman head of joint replacement, uh, within the joint replacement. Lisa running the knee business, right. Um, uh, Antonia Chen, uh, a very significant contributor to the work that Stryker does. And again, I mean, kind of looking even, you know, further back, I mean, I think Antonia's got over 300 publications now.

Speaker C: Probably well over 300. Antonio and I had a very interesting conversation about this years ago when she was an insult fellow. And tomorrow night at this time, I will turn over the anchor's presidency to Antonio. I'm very proud to do that. I think she's great. But she and I had this really interesting conversation. It mirrors what you were saying, because I said this was years ago. And I said, antonio, what do you want to do? Like, we were having wine and we were sitting at one of the ends all over when she was an insult fellow in Indiana. So what do you want to do? Like what? Tell me what you're not. Write more papers, whatever. Like, what is your career aspiration? What do you. She said, I want to be. This is. I don't know whether I'll have the courage to say it out loud when I introduce her, uh, tomorrow. But she said, I want to be, AKA President. And I said, why? Goes back to the why we talked about earlier. She says, because I want to represent women, uh, in that leadership role more than it's been done before. And I said, okay. Said I. And I said, I applaud. I applaud that thing. That's amazing. That's a ceiling breaker. I love that. Love that my mother was my biggest inspiration. Love that she did the same. I said, but how about also doing it Just because. This goes back to your point, just because you're good enough, you're going to tell you 10 to do it.

Speaker A: Yeah.

Speaker C: Right. And she, like, froze a little bit. I was like, I'm not minimizing why you're doing it or what you're doing. But you deserve it. You deserve it because of who you are. Not necessarily. You're not. It's not. It's your point. We're not lowering the bar. Right. And I think that's the, it's the safe space in the room for everybody to say. It doesn't matter what they look like. It doesn't matter what gender they are. If they can do the work and they are the talented one, bring them in. Doesn't matter who the hell they are. Right. That's what I, that's the purest form, in my opinion, of, of not having bias towards people. Right. And you and Antonia are ceiling breakers for a good reason. But it sounds to me like what I love hearing is like, I just show up every day and bring everything I can in terms of my talent, my ability. And you've, you know, other than a couple surgeons, which are not surprising couples, probably low, I would imagine that lowered the breakable surgeon. Lower the bar.

Speaker A: Yeah.

Speaker C: You just said, fine, lower it. I'm going to go 10ft over it. Right?

Speaker A: Yeah.

Speaker C: It's awesome.

Speaker A: Yeah. Yeah. Well, and I think, and it, uh, may be my ask, you guys are leaders in, in your field and what you do, and if I can give you an ask. I know that wasn't. Was part of our, um, discussion ahead of time, but, um, I think it's about not moving the goalposts, you know, And I hear that, um, this is really interesting. I had, I was at a European sales meeting a couple of years ago, and it was a marketing person within Stryker and asked a question and, and she was very much feeling like the rules are different for me. Um, and she was feeling that at times. Um, but I hear that from a lot of women, um, in general. So I guess as you guys with leaders in your organization, in your world, um, they were not saying, oh, that's great that you did this. We also do this and this and this. But that wasn't the same requirement as somewhere else. And this feeling that's out there.

Speaker C: Yeah. That shouldn't be. I mean, there's no way it should be different. It should be the same. Right, right, right. But. But the reality is, and many women, many women experience this. The reality is, unfortunately, there are some people and some organizations that do move the goalpost. They shouldn't be moved. They should sit there inked in concrete so everybody can go through them, right?

Speaker A: Yeah. If they're moved, they're for everybody.

Speaker C: Yeah. Yep.

Speaker B: Anyway, so last question for you, Kathy. Advice. Advice that you give folks today who are thinking about getting into the musculoskeletal, you know, industry, business, med tech business.

Speaker A: Um,

Speaker B: what do you tell them? Are you excited about this? I mean, is it something that, you know, that you would. I mean, you have a new son at home, right? Is. Do you hope one day. Listen, I hope I would love it if my son follows in my footsteps and does what I do. Um, what is the advice that you give?

Speaker A: Yeah, I mean, I think it's really exciting. Um, I tend to ask a few questions about. I come back to what, your conversation with Dr. Chen. Why? What. What's interest? Because I'm curious, um, as to what motivates them. Because for. For me, I've certainly felt like it's been a space, uh, where there's no two days are the same. You're learning every week.

Speaker B: Right.

Speaker A: Things are evolving. Um, and if that's some of your kind of wiring and the possibilities about being in this space where you get to work with amazing people that are delivering care to patients and making their lives better, um, I mean, that's an incredible thing. So, um, after my questions, that's usually where I go with it. Um, but that's. To me, what is so exciting about this? What has been exciting? I mean, in my head, while I've been here 23 years, in my head, I'm still somehow 25, and we all are. It just doesn't feel like it's been that long. And it's because I've thoroughly. I feel very lucky in that I've gotten to work in a space that, um, does all of those things, and I've just gotten to love it.

Speaker B: I was walking through the exhibits earlier today with. With Allison Klicka. I don't know if you. If you know Allison, but Allison ran, uh, um, orthopedic research for Cleveland Clinic for many, many years, and we worked together and. And then we brought her over to Hopco, and she's another, like, superstar woman in orthopedics. Yeah.

Speaker C: Yeah.

Speaker B: She's got over 300 publications. She's a beast. We were walking through the academy today, and I was like, do you remember the days when we would walk through and we were seen as, like, the. The young up and comers in orthopedics now? We were like, get out of the way. It's time for the next generation old timers.

Speaker C: Move.

Speaker B: You're still on the podium.

Speaker C: Somebody. What are you doing here?

Speaker B: It's sad, really.

Speaker A: Wait, I just got here.

Speaker B: I remember the days when people be like, yes, ask that new young guy.

Speaker C: He'll.

Speaker B: He'll know. And I'd be like, oh, me? Yeah, like, yes, ask him. He's like, uh, he's the senior guy.

Speaker C: He's the guy.

Speaker B: I don't like that. I go back to the young days.

Speaker A: But that's. If we think about, that's who we're designing for right there. And there's different desires there. So it is. Is so interesting to, to watch and see and be part of those conversations.

Speaker B: Yeah. Yeah. Kevin, look, I can't thank you enough for taking the time.

Speaker A: Thank you. Thank you.

Speaker B: This was awesome. Absolutely.

Speaker C: Thank you. Congratulations on all your successes. Awesome.

Speaker A: Thanks. Thanks for having me. It's been a pleasure.

Speaker B: No, it's, it's our pleasure. And I want to thank everybody for, for listening today and, and, uh, joining us. I also want to thank our sponsors, Healthcare Outcomes Performance Company, who, uh, makes it possible for us to get to spend time with incredible people like Kathy Trupy and talk about the future of healthcare. So thank you guys all very much.