Lead Waves of Success: Befriend Everyone!
Mark Paul works so that everyone in the organization shares a passion for the patient's well-being, regardless of their role. Mark also briefly discusses the symptoms of stroke, emphasizing the acronym "FAST" (Face, Arm, Speech, Time) to identify potential stroke symptoms and act quickly.
Mark’s team conducted clinical trials, including the groundbreaking Dawn study, which extended the treatment window for stroke patients, leading to a worldwide shift in treatment guidelines.
Mark’s teams’ work on innovative products have contributed to the transformation of less-invasive interventions and improved patient outcomes radically.
Mark is committed to engendering camaraderie among team members as a crucial factor in achieving success. Mark also acknowledges that even though multiple products are involved, the measure of belief in the mission of a specific product can indicate the team's success.
Mark Paul envisions a future where the neurovascular division continues to make significant advancements in saving stroke patients and improving patient outcomes. He believes that the division is just starting and considers it in the golden era of the medical device industry. With the convergence of technologies such as nano-level design, imaging, artificial intelligence, and robotic assist.
Mark acknowledges the challenge of balancing the increasing healthcare costs with the need for cost-effective solutions and better outcomes. Despite these challenges, Mark remains excited about the future of healthcare and medical devices.
Stryker Neurovascular: https://www.stryker.com/us/en/portfolios/neurotechnology-spine/neurovascular.html
University of Utah, Center for Medical Innovation: https://uofuhealth.utah.edu/center-for-medical-innovatiuofuhealth.utah.edu/center-for-medical-innovationon
Mark Paul's LinkedIn:
Mark is retiring from Stryker but not from working. He has accepted a position at the University of Utah Medical Center as the Center of Medical Innovation director. In this role, he will work with physicians, engineering, business, and legal students to bring medical device ideas to life. Mark believes that the younger generation, who have grown up surrounded by innovation, will develop more innovations than ever before.
Watch Mark's episode and, please, comment and subscribe.
Welcome today. I'm excited to have with me Mark Paul, the president of Strykr in Neurovascular. In fact, we're here at his division in Salt Lake City. How are you, Mark? Doing well, thank you. Good. I want to start with your personal career story. You have a very interesting early start in your career.
Like most people, you hit a time where you needed to change directions, and I'd love for you to start just before that. How was life going great, and then what was that exciting incident that changed your trajectory? Well, you could probably start when I was a college student. My ambition was to become an attorney, and as I was working on graduating, I had the opportunity to work with many university attorneys on campus. After seeing what they did all day, I realized that is exactly what I did not want to do for my career. So, here I am in my senior year, a little panicked and numb, but Proctor Gamble came on campus and I talked to them, and they recruited me to join their sales ranks and later go into some field marketing. But I remember asking them, "What do you do exactly in sales? I know you sell something, but how do you do that?" And they said, "Don't worry, we'll train you." So, I had this complete kind of midlife crisis my senior year and shifted completely to something different than I intended.
But that shifting was a really good decision because if I would have stayed on that trajectory path, I would have certainly become an attorney. I just don't know if I would have been very happy doing it, and I found other things that were more enjoyable to me, that were more mission-based. Yeah, well, I love the other part of that moment in your life where, talk to us a little bit about what you studied and how that should matter a ton or not in someone's long-term career, and then you had a personal incident that kind of changed your trajectory as well and gave you a new motivation. Tell us about that. You know, I later learned in my career that I was very mission-oriented in the purpose of my company, but as a young college graduate, I didn't really understand that yet. I was so grateful to have a job, and Proctor and Gamble is one of the best companies on earth, and it still is.
I still follow everything they do, and I had a great career. About five years in, we had our first child, and that first child had to be delivered by an emergency C-section, and I had never been in an OR environment. In fact, I don't think I liked hospitals. They were... I didn't know how to digest what happened in there. There are people that were born, there are people that died, they smelled funny. I just didn't enjoy going into the hospital environment.
That's completely different today. I love that environment. But I watched my first son be born as an emergency C-section. I was not a very good bystander. They put you behind this blue curtain with your wife's head and the anesthesiologist, and I stood up and watched that procedure, and I asked a ton of questions, and the doctor was great. He gave me full anatomical lessons of what was happening, what he was doing, his technique.
My wife was mortified, I must say that. She was a labor and delivery nurse. This was her team. I really embarrassed her, but I was so excited by what I saw that I decided to change my career once again, but now it was based on a different sort of feeling. It was mission-based, and I loved working for Proctor and Gamble, but I can tell you what, in the medical device world where I eventually landed, saving someone's leg from amputation, saving someone from having a heart attack, saving someone from having a stroke, was very different in how it felt than shipping 40 truckloads of Tide, which is a great product. I use it every day. It's a great product.
PNG remains water, saves water. Yeah, one of the best companies on earth, and the volumes were massive, the products were amazing, the talent of PNG is just incredible, but I found out what I needed for me was something around mission and helping people relieve suffering. Yeah, well, I want to follow that mission in your story. I want to stop for just a minute before we leave Proctor and Gamble because I do admire that company, and I found out something that was very interesting in some of my work, and I want to get your personal perspective on it. So, one of the problem-solving, you know, people, people are leading teams and companies down a path, taking specific steps over a given time, depending on their industry. They always hit some problems always arise, and so they require advanced problem-solving.
One of the problem-solving approaches we discovered was a linear version of ethnography. Sometimes people go out into the field, and one of the former CEOs of P&G used to do that. The very first thing he expected was to be in a homemaker's home, watching him or her do some laundry and clean the living room, etc. Do you have any personal awareness of stories or experience with something like that going on at P&G? All those stories are true. P&G is amazing that way. I remember going to the secret diaper testing facility in a state I won't name, and they were testing out new diapers for boys and girls. These guys had lab coats on, and the little babies were crawling around, playing. They had tight blue suits on and tight pink suits on. All the parents were sitting around the room, and the babies had little numbers on their back.
They were waiting for leaks, and when they'd have a leak, they would scoop up that baby and study the design of the product to see where the leak was. That's how P&G was so good at what they did. It didn't matter if it was a cleaning product, a paper product, or a food product; they knew the customer better than the customer knew themselves. And all those skills that I learned and trained on at P&G completely transitioned over to the medical device field and understanding deeply what that patient needed and what the doctor needed, everything from how the product shipped, how it was opened, how it was used, how it was disposed. We know everything deeply, and we do that by watching thousands of cases.
So, you were exposed to some of this thinking. Were you born and raised there, and did you have this sense of curiosity within, getting boldly immersed in customers' lives, problems, and solutions? And it carried into that C-section, it seems like. Oh my God, everyone at P&G starts at those lower levels, so you totally understand how the product is being used and how it moves through the grocery store system into the patients' hands or into the consumers' hands. It's no different. All those basic skills and principles are still true when it applies to medical care.
So, you told your wife's nursing team, "Look, this is what the greats do. We get in there and boldly immerse and understand everything." I'm sorry, but I need to know, so what happens next? You move on and tell us about that early part of your career and going to work each day in a new type of role.
Yeah, you know, after that procedure was done, this was before the internet, and I was a little struck on how to make connections with medical device companies. The recruiter called and said, "Hey, I'm calling from Boston Scientific. We want to talk to you about a sales position." I said, "I've just been waiting for the call." So, I did that day in the field. I was so excited to go work for Boston Scientific. Nothing negative about P&G, fabulous company, fabulous people. I just needed that mission in my life. And I started in the peripheral vascular world. And I can tell you, very significantly, when I was being trained and we saved this patient's life, that night driving home felt so much different being a part of that team that helped a patient who was suffering. It changed everything for me, and I realized that I was a mission-driven person, but I still had to succeed within this new world.
I left one universe, P&G, and I entered into a medical device world with Boston Scientific. That was a completely different universe, and I had to start out, gave up my management-level job, started up as a sales rep with a six-month lease. You either had to succeed, or you were out, and I had to hustle. I had to work hard, and it was a whole new world, a new world of language and a new world of anatomy, procedures, technique. You have to learn all that very, very rapidly. I couldn't get enough of it, but it had nothing to do with my college education. I really believe it's up to our own curiosity, our own drive, our own passion, and let that drive you to achieve different things throughout your career.
Those same principles drive me today. You know, well, I did witness a little bit of you in college, and we overlapped, so we gotta ask you about this in that stage of your career. Um, so nothing to do with your degree, you did learn to write and communicate a bit, I think, in your degree, but more importantly, in your experience in college, I watched you become an expert social engager who was very much a connector and very interested in people and their lives and such. So, tell me about the role that switching into this new world and doing this new job with a six-month leash had. It relied on your ability to meet new people and have bold encounters that way.
Certainly, it has changed over the years. I'm always very curious about where people are from, and I've always been that way. So, at Stryker Neurovascular, we have teams in 70 countries, and I have customers in 70 countries. I'm always meeting new people from different lands with different languages, different perspectives, different cultures.
One of my favorite things to do is to talk about with each of them, whether they be an employee or a customer, genuinely, where did you grow up? What was it like when you went to Sunday dinner or Saturday dinner with your grandmother and your family? When you went to your grandparents' home, what did you eat? And that's actually one of my favorite questions because they describe something that's so amazing and so personal. You can see their body language change, and I genuinely care. In fact, I'll say, "Hey, can I get that recipe?" And I like food. I'm a healthy eater, but I... it's just a way to genuinely connect. And then I would share the same with me, and you kind of have this bond of what it was like, whether you're from Japan, or whether you're from Germany, or from Morocco, or you're from Oklahoma. We're human beings, and we have these families, and we connect through these families. In a way, I felt like I was like a fly on the wall.
I got to be a part of their family that Saturday afternoon or that Sunday afternoon and really experience this neat thing that happens within their culture. Afterwards, I have this immense appreciation, and whether I see something on TV or read something in the news that connects back to that world, I send it to them in a text or an email and just say, "Hey, thinking about you, thought about our conversation, saw this today, thought you'd find it interesting." So, my other true passion in life is once I make a friend, it doesn't matter what generation they're from, I meet people with the intent of being their friend for life. So, I don't look at my employees. I look at them as colleagues, and I look at their families on the other side of them as an extension of employees. But I intend to be their friend for the rest of our lives. So, I don't think of relationships or my employees should not be seen in a disposable, short-term way. I look at them as a long-term investment into that relationship. I'll stay their friend forever.
That's remarkable. So, as you approach another human being or encounter them, you just plan on being friends forever and forever. It changes the whole dynamic, changes everything. You think differently, you behave differently. What you're demonstrating is, in the end of the day, you care. You genuinely care because you're gonna be friends forever. So, it's not a transaction ever. So, it's not a coworker, friendships are not like the DMV, they should not be.
Your colleagues at work, you should develop best friends at work. It's fantastic. In fact, why not? You're with your coworkers off times more than you are with your actual family and friends of your past. So, I'm one of those people that loves to develop best friends at work, and it makes it a rewarding work experience.
Okay, let's go to the next phase. So, you made your six months, apparently. Yep, worked out. Tell us what happened from there. Well, you know, I fell in love with procedures.
I fell in love with medical devices. I fell in love with the process, the process of medical teams that have dedicated their lives to helping people who are suffering from that disease. And I'm grateful for those people that put in 10, 15, 20, 30 years of expertise to help another human being who is suffering. You know, my world has always been primarily vascular, peripheral vascular, cardiology, and neurovascular for the most part. But when I meet my colleagues that do hips and knees and spines and shoulders, they have that same passion, and so do their physicians they work with. So, how we work is, you have to have that patient first in your mind, and every single thing we do, that patient is the most important thing. And we work back from that on the industry side, but so does our customer, so does the surgeon. We come together, we're both thinking the same way, how do we relieve suffering or, in our case, save a patient's life? How do we do that together? The doctor can't save that patient's life without the tools that we make.
We can't do what we need to do as a company without making the right tools for them. So, it becomes a very, very close relationship, and making sure we make the right tools.
So, patient-focused, always, always. Terrific. Let me ask you this. You say a lot of words that would scare a normal English major. Haha! So, there is some serious learning that has taken place. Yeah, so describe the process and how you approached it in as much detail as you can.
Like, how did you learn so much? I'm very curious by nature. Even when I was in that first OR setting, you don't know if you're gonna pass out or throw up or how you're gonna react. In that, I was totally intrigued by it. So, I think you have to be driven first by curiosity. And I think what you'll find is your college degree can teach, regardless of the topic. It teaches you how to think, how to break down a new element of learning and put it back together in the form of a paper or a test. But at the end of the day, you're actually learning the process of learning. That's what you should be doing now.
Some degrees are certainly geared towards accounting, nursing, or engineering or very specific, but the majority of degrees are very generic and high level. So, you have to learn how to transfer the ability to learn new things and be excited about it and apply it to your new career and to new jobs, new opportunities. So, I've worried that too many people narrow their life and narrow their opportunities because they base it on a college degree that they earned decades ago. But what they learned in those decades is more valuable to me as the division president than their college degree was 20 years ago, by far. So, within my organization, I move people around all the time. And I'll move someone from clinical to marketing, from marketing to training, and from R&D to quality. We move people around all the time because they want to grow and they want to develop and learn new things.
What I learned personally is to trust yourself and that you can learn new things. Of course, you can.
It's okay to learn a new language and to learn about a procedure and the anatomy. But you're doing it with the view of being a part of that mission, a part of that purpose to save that patient's life. So, your learning is very, very different. It's terrific. So, what happened after you started learning this and you were succeeding in sales? What was the next phase of your success as you started to build this? I wanted to do more than just sell in my career. I wanted to... I believed I had the skills and ambition to do more in my life than to stick in one function, say sales. So, I raised my hand to be promoted into marketing and moved to Boston, Massachusetts, and started out as an associate product manager.
And again, the same thing, curiosity. Learn everything you can about the customer, everything about the procedure and the product, and deliver on those results. At the end of the day, even if you have a ton of passion and curiosity, it's still a meritocracy. You have to perform. But when you can get all those things working together, doors for your career emerge. And then you take that next door and you take the next door and the next door. But the methodology is still the same. You dive in, you become passionate about your product, the procedure, and the product, and deliver on the results.
And then, soon, you're managing a group of product managers, and then you're the director of marketing. And then they say, "Hey, why don't we move you to Europe?" And move over to Europe and lead our team over there. And you're like, "Fantastic, sounds great, I want to do it." And it just kind of kept going. And when I came back, they were like, "Hey, why don't you lead marketing for international for all divisions?" And I loved it. So, as you go along your life, you're building eclectically all these experiences and passions, and you just keep reapplying those core skills. But along the way, you learn from great leaders, you go through additional training, and you seek development at every opportunity you can because it always pays off down the road.
I'm going to ask you a question before we go. Post-Boston and post-Europe, what happened to arrive where we are today? I want to ask you about purpose. You know, in my work, we found a predictor of success for leaders where they really got focused and passionate on how they benefited the particular subset of the population we call customers or patients.
And yet, there's a lot of talk these days about purpose in a different way. In fact, I feel like they've hijacked a little bit. They talk about profit on one hand, first and foremost, as the purpose, which doesn't make sense in my research. And then they
Help early on in my career, I was a peripheral vascular rep. I would set up that room for the case, but next door was this brand-new procedure called neurovascular. I had no products for them, but I would go over there, do my case, and rush over to the room next door and ask the doctor if I could just watch the case. I was so intrigued by it. I loved it.
In fact, he always used to say, "Do we have anything we can buy from you? 'Cause you're always here." And he was training me on the anatomy and the steps of the procedure. It was fantastic. But when I saw how the patient's life was saved, and as I was leaving the procedure room and cutting through the hospital waiting area, I could see that family waiting. I can't say I can solve the world's problems, but I could help that mom on the table. And when you look at stroke, 60 to 65% of all stroke patients are females. More women are impacted by stroke than all female cancers combined. I can't save global warming. Those are great causes.
There are all sorts of great causes. But where I chose to focus is picking something where I could make a material difference in treating the complex disease of stroke and saving all those moms and sisters and aunts on the table and what they do for their families and how important they are to their loved ones. That mattered most. Now, along the way, we try to do lots of other things. We work on packaging that's more effective for the environment. We try to be more effective in everything that we do to lessen the impact on the earth. But we have to save that stroke patient, and that's what matters to me. So, choose your mission, choose your path, choose your purpose, but you can't boil the ocean.
You can't do everything all at once. But you can find a way where you can leave a material impact on patients around the world. In our case, even length this interview, patients' lives were saved multiple times during the length of this discussion with my products. So, we're saving lives, and that's the purpose of what we do. Wow, well, another interesting thing that you've told us earlier before the interview, I'd love you to get on tape. So, you talked about how these women have strokes so often, and in two essential parts of the definition of purpose for all of us English speakers, is that it's a focus. By definition, purpose is a little bit focused. And it's also a reason, you know, why we gather here in the company, and in your case, in multiple areas across the world, why we gather each day on Zooms together, why we're trying to do the work we're trying to do.
And it is the patient in your case. So, tell us a little bit about those women and why we don't know that it's such a big problem, right? I was shocked when you told me that. It is a little bit about that, and we don't know why females have more strokes, both hemorrhagic and ischemic. We don't know why, but in every clinical trial, that's sort of the ratio of male versus female. And I remember we had a new product that just got FDA approval, one of our biggest product launches in the history of our division. It was a device that pulls clots out of an excluded artery and pulls that clot rapidly and safely out of the body and restores oxygen blood to the patient. And we were in Boston, and this young mother had thrown a clot while delivering her second child, and they rushed her down to the procedure room. We had just shipped the product to the sales representative.
He had it in his car. He rushed out of the car to get the sterile package and rushed back in, and we were waiting for that case to start. I was looking at this young African American woman who was delivering her second child. I learned while I was waiting, she had a two-year-old at home. Sorry, I apologize, she had a 2-year-old at home and just having her second child. And I thought, if she lives, how do you take care of a 2-year-old and a newborn if you can't move the left side of your body? How do you change a diaper? How do you chase after a toddler? And that impact is dramatic. So, when I work with our employees in small groups, big groups, we talk about the impact on patients with stroke care. And yes, these challenges are immense, and how we design and build these products, our clinical trials take forever, even eight years to get a PMA-level product approved in the United States, and then equivalents in Japan and China and Europe around the world.
But it's worth it, and I tell them, if you don't think saving that mother's life is important to you, then don't work for me. I'll help you get a job in some other division, hips, knee spine, or another company. But if you're gonna work here, guess what we talk about all day long? Devices for stroke training, doctors for stroke, clinical trials for stroke, everything we talk about is stroke. So, if that's not a driving force for you and saving that patient's life, then go work elsewhere. And, you know, this is just my personal experience. It's not a political statement, but the women in my life have always been the glue of the family. Yeah, and do you actually get to say that part of your purpose? I do, in fact. I talk about, I share personally in my family, if you take out my wife and my mom and my sister and my aunts, my family would stop functioning.
So, I look at it where, yes, we're saving that patient on the table, but we're saving family units around the world. Every time we save that mother and a father, we're saving that family that relies on them. And so, you're not just helping society save someone who's having a stroke and treat them in such a way that they can go back to work, they can drive a car, they can take care of their loved ones. That saves society, and boy, is that a great focus, and boy, is that a great reason to, yeah. Well, the majority of stroke patients that survive live in your home. Hmm, so you, but you're now gonna be living in your loved ones' home with a diminished capacity, where you can't swallow or you can't speak or you can't feed yourself, or someone needs to clean you. Hmm, that changes the family dynamic dramatically. And we know if we can get them on the table within a certain time window, we can have an outcome that is so dramatically beneficial to their healthcare and then go back to work, they can take care of their families, they can feed themselves, they can clean themselves.
Yeah, that's why it's so important. Well, I love how it's an example of when you talk about a deep purpose, it's not broadening it to all of society, in the whole planet, in the world. That is, those are great objectives, and everyone should be working on those. Overdrive, but to be focused on what we're actually trying to do together, it's really powerful. Because you deepened it by saying, "Okay, we weren't, you know, we would probably consider you in wellness or healthcare, in health itself, as your deep purpose, one of the 12 essential needs humans have." But you're saying it's broader than that. It ripples to the family and connections and relationships and practicalities. And those are very deep, if not the deepest reasons for us being alive: our relationships and connections. And so, it's very deep, very deep.
Well, what I find is that passion for the patient and that passion emission, it's not limited to any one function. Sales, marketing, R&D, clinically, regulatory, quality, HR—they're all in on that mission. And we know that we can't make that product, make it safe and effective, without all of us working together all the time. So, we focus there. And you know, another important aspect of this interview is we should probably take two minutes and talk a little bit about the symptoms of stroke. Do it. Most patients we only treat 25 to 30% available patients. The reason we do is they're either found at home and it's too late for treatment, they miss that treatment window, in their brain has already died, or they've passed away, or they go to the wrong hospital. So, I want you to think of the word "FAST." When someone's having a stroke, half their face will work and the other half will not work.
So, when your mom says, "Hey, I feel really weird and odd, I don't feel good, I'm gonna go upstairs and lay down," you say, "Wait a minute, Mom. I want you to look at me, and I want you to smile." And half that face will smile, and the other half won't. "A" stands for arm. Arms are almost always involved. It'll just be one arm or the other. It's never both, and it will act differently than normal. It could be shaky, they can't lift it, they can't grip, grip but something's different, and it will be on the same side of the face that didn't move. "S" is for speech. Speech is almost always involved. Slurred speech, drunk speech, can't speak, repeated speech, but not normal speech.
And then "T" is for time. You have to know which hospital to go to in your area that's a comprehensive stroke center. That means in your community, you may not go to the hospital where they do appendectomies and do total hips and total knees. You have to go to the hospital that does stroke treatment. Going to the wrong hospital costs you three to four hours before they transfer you. In that time window, you could lose the majority of your brain and its capacity. You're losing 2 million neurons a minute. So, you want to get to the right hospital, and you'll have a great outcome. FAST, FAST. Alright, so let's move to the next part of your career.
You had tremendous success, you made these changes we talked about, and then what? How did you arrive in this stage before and now? Well, when I was younger, I was a product manager over the past year on a bio products. I had been doing that for a couple of years, and I heard a rumor that they were starting a division to go into neurovascular. And if you remember earlier, my story, I used to go watch those proceduresI physically ran in Vedic Massachusetts through the building as fast as I could to the president of the company and burst into his office, saying, "Hey, I heard we're gonna start a division for neurovascular. I wanna be the first neural product manager." And he said, "Okay, we are, and yeah, you're it." So, there's a little bit more to the story than that, but that's a true story of me physically running, and I was so excited. So, I was passionate about this, and I didn't want to give up on that opportunity. I wanted to be the first one, I wanted to make that happen. I just have to say that you, coming out of sales, you have six months. If someone is curious in any way and they touch our company, and if we don't respond within five minutes, the probability of getting a success just falls off a cliff. And so, here you are, you hear there's something involved with that curiosity, you've been poking your head across the hall, and you sprint and you get to the top. It seems like it's a little bit of a sales background that helped.
Well, for sure, hey, sales is always involved. How you position yourself, how you position your thoughts, your thinking really matters. It doesn't matter what function you're in or what level you are, you're always selling an idea, a notion, a concept to someone to change their heart and mind. And in my case, it turned out to be stroke, but I loved every minute being on the groundwork of the very first earliest products for stroke care. And we had to figure it out, doctors and the company site, it was fantastic. I look back at that, and I cherish those years, never easy. You know, we look back and now say, "Oh, it all worked. It's a 4 billion dollar industry." But in the early days, I had surgeons pat me on the head and shoot me out of their office, saying, "This stuff's never gonna work." Where today, 80 to 95% of all aneurysms in a hospital are treated less invasively. Wow, wow, we started at zero. Amazing. Okay, well, I'm gonna talk to you about your next little adventure that's big.
But let's finish this. So, how did you arrive where you are? What have you accomplished? Put your modesty aside and tell us how and what you've accomplished today with the neurovascular division. Yeah, yeah, we've done some amazing things. I'm really proud of my team and what we've been able to achieve. We ran clinical trials that used our products but were for the benefit of mankind. One of our most important trials we did today was called the Dawn study. While we are treating these patients who are having strokes from clots that had moved into their brains, the thinking then was that your brain for the last hundred years, every doctor role would say your brain's dead at about 6 hours. Sometimes we pushed that window to 8 hours, and that was our initial indication, that was our clinical trial. And we launched the Trevo device to grab clots and pull them out of your head. But along the way, we would have these doctors that would pull me aside at a meeting or they'd give me a call and say, "Hey, I just treated this 80-year-old man, and it was way outside the window. It was his last time seeing well was like 15 hours ago, but it was a bluff surgeon at the hospital.
His family was begging me, his wife was there. I said, 'Okay, we'll do this procedure, but there probably won't be a change or a good outcome.' And I pulled out this clot, this 80-year-old surgeon had a full and complete recovery." So, I started hearing these stories that were way outside the window. So, we started to organize with two key leading doctors in our space, and we designed this study to go out to 24 hours. It's also important to note that many people wake up with strokes. We don't know why, but they wake up with strokes. So, you don't know when they had the stroke, was it 10 minutes ago or six hours ago? So, a lot of these patients weren't getting treated because we would have to stay within the FDA guideline of the treatment window. So, we went out to 24 hours, and we took all commerce, and we had a significant outcome from that study. The results were so profound that it stopped every trial on earth because it would no longer be ethical to treat them in a study because this outcome is so profound. And it changed guidelines in 70 countries around the world. We now go out to 24 hours. We've done other studies along the way that are very similar in regards to imaging of which patients can have the greatest effect.
But again, these studies have changed guidelines. I'm very, very proud of that. I'm very proud of our coil. We've now treated over 2 million patients around the world with a great outcome. I'm very proud of how we train our doctors. I'm very proud of the quality system that we have, which makes our products so reliable in the surgeon's hand. I'm very proud of the ethics of our division, how our employees act, and that we do things for the right reasons, the right way, which in the medical device world is paramount because you have to start with that patient on the table. I'm just very grateful for all the things we've been able to achieve because it changed healthcare. You know, a little kid from a suburb of Salt Lake City, there was nothing special. I think anybody can do that if they just stay focused and become curious and driven by a mission.
I think you can go change some things out there in the world. I'm fascinated by all the locations.
Some of the locations that exist in your company or division. For my division, we make our headquarters in Fremont, California. Our headquarters are still there. We have a large factory in Salt Lake City, Utah. We also have a sister factory in Cork, Ireland. Additionally, we have sales offices in all 70 countries. Furthermore, we have significant operations in Amsterdam, where our international and European marketing teams are based. Currently, we are expanding in India, building up a training center and an R&D team. As our customers' needs expand, we will continue to expand as well.
It's amazing, simply amazing.
Now, in a minute, we're going to talk about your retirement, or however you describe it. But before we get there, you're still on the job and have a couple of weeks left. As a president or leader of a large group, like you are, I want to discuss some team and leadership aspects. I'm curious which direction you would like to start with. For example, would you prefer to begin with a chronological approach to general leadership situations, starting with individuals and teams? Or would you rather start by discussing the vision and then come back to the mission, etc.? Where would you like to start, Mr. Successful Leader?
Well, I can tell you what I've observed over the years. It took me a while to figure this out, but it's a true principle. I've seen it work in 70 countries, so it's not determined by culture, language, religion, or location on the earth. When you have a group of people who are dedicated to a mission or purpose that's larger than themselves, and they love who they work with, great things happen, even in really difficult situations. They work together so well.
I can show you with our Gallup scores, as we believe in Gallup surveys. I can show you my best performing teams and my least performing teams. When it comes down to it, I can tell you who's all in on the mission of that product, to treat that patient on the table, and how well they get along with each other. In other words, they're best friends. That dynamic creates the best outcomes of anything I've ever seen. And I see it in Korea, China, France, England, Boston, Denver. When you see these teams come together with that passion, that commitment to mission, and they genuinely enjoy working with each other, great things happen. If they're not all in on the mission, they quit. They're just not into it. Or if they don't get along, there doesn't seem to be the capacity or energy to solve complex problems.
Let me ask you something about that. It sounded like one part of that description, you said their products. So, if you have multiple products, it doesn't matter. You're saying that what the product is, if you believe in what you're trying to accomplish with that product, just the measure of how much they believe in crushing that mission of that product specifically can tell you how successful they are. When they speak about the product like it's one of their children, you know where they are in their mindset. You certainly were chasing the mission of complete stroke care, but there are multiple products that are used together to improve that procedure and the outcome for the patient. You can't develop all those products at one time; it takes years. So, you have people working on guidewires, coils, flow-diverting stents, and different ways to remove clots from the body. Each has their own unique role to play within that broader mission, but we know they are all enabling one another. We have the new flow-diverting stent over here, and this team is working on that delivery system.
Once we get that right, we can have better outcomes with the implants over here. They are very interconnected, but they take complete ownership. And when you see that, the team working on it with a passion like I've never seen before, yeah, so
Each team has its own target, but it's a wave together of these new innovations that you're putting out into the market. They work as waves because clinical trials can take a long time, five to eight years per clinical trial. So, they literally work like waves as you bring things to the marketplace and treat patients. Now, we are a growth company, a growth engine within that company. We're a growth stock. We talk about those things, but we always talk about the patient on the table first, the mission to treat that patient, to project, treat those cells, and Mark are the cells and revenues and profit margins. They'll come over time, and we have folks that take care of a lot of those things first to make sure we do them effectively and efficiently. But if we don't get this right, none of those things happen.
So, you always start with mission and patient first.
Well, you also said very interestingly, I think you also said that you're not just looking for people who come to work and are civil. You're going with camaraderie and going past camaraderie to an Esprit de corps. It sounds like where "I've got your back" in the foxhole kind of thing. Is there a way that you generate that? Is it just hiring? I mean, how do you get that Esprit de corps on the team?
I invite them to join the mission. So, I meet with every group of new employees. I've been doing it for 15 years, and I talk about three different levels. I make it really simple. I know that there are different ways to measure employees and how they perform over time. I keep it really simple. There are three levels.
Level 1 employees are terrible. They're not in on the mission, and they don't get along with others. They're just checking the boxes to get a paycheck. I don't want that level of employee to feel welcome at all in my division because they're not effective, and nobody wants to work with them. Now, we have tons of level twos. Level twos are great employees. They're off the chart rate. They want to do a great job. They're in on the mission. They want to get promoted.
They want their bonuses. They want the product to succeed. But there's this when you get the right thing I've described between passion to mission, and you love your friends, you get this heart and mind thing that's very different. I call them level 3 employees. And it doesn't matter what function you're in. It doesn't matter what level you are in the company. I have employees stop me in the hallway and say, "I want you to know I'm a level 3, off the chart, above a level 3." But those employees change companies and consistently deliver results over time. They're not short-term thinkers. They don't come into a company and stay for two years, then jump to the next. They stay for five, ten, fifteen, now thirty-five years.
They're fabulous, but they want to be that person who delivers over time. So, when I meet with the new employees, I tell them stories of level ones, twos, and threes. I give them examples of each, and I say, "You know what's amazing about that? As you get to choose. It's a choice. It isn't us, it's you. So, you get to choose what level of employee you want to be. But if you're level 1, I don't want you sticking around very long. Level 2 will take you, but level 3 is where you change things, and you have this career that will be mind-boggling fantastic. But you get to choose." So, I say, "When I see you next, I'm going to ask you, what level are you aiming for? What level do you want to become?" And I've already talked about making friends for life. So, I've already introduced myself. I already know where they're from, their backgrounds. I try to memorize all that. And when I see them, I'll look at them, give them a smile, and they'll say, "I'm aiming for level 3.
I'm a 2 now, but I'm going to 3." And so to me, it's a personal choice. You get to choose to make your company better by your own behaviors. You choose to make your teammates better because you're there. You choose to do your part and look how you can help them to do their part. It's a choice to help solve problems when they're really, really hard and not give up. You choose to make the world better. It's all a personal choice. Don't look for excuses. Don't Blaming others, what's your role in all this? And is the team better because you're on the team or not? Only the individual can look in the mirror and make that determination. So, you invite them to make the choice, I invite them to make that choice, and you invite them to help achieve the target of the mission and to be a team player, to the extent that they love each other. Right, and my um, we are people who stay for years, decades. I think that's, I've stayed, my senior staff has stayed for decades together. So, we demonstrate it not just in words but by our own behaviors.
Okay, well, with a couple more things, let you go.
Um, first, you're on this path, it pursued saving stroke victims and some manners, and you are ending your path here. But if you look to the future and you look several years out and you're to see a scene of helping those patients and you see your own vision. I realized the newly will have his own vision or her own vision, but what do you see for this division? Striker going that far out, what do you see?
You know, I was there at the very beginning when the first procedure started. I've led the last 15 years of my 31-year career as president. Actually, I think we're just getting started. I think the golden era is right now. It just started. I'm sorry that I'm the guy aging out, but this is happening. For the first time, we can build and design at nano levels that we only dreamed about decades ago. I'm watching imaging of how we look at the brain and how imaging attaches to the devices. Mind-bogglingly effective. We're seeing robotic-assist technologies coming in. We're seeing artificial intelligence coming in. So, it's probably not three years out, but it's not 10 years out.
Probably four to five to six years out, you're starting to see a convergence of technologies that will change everything. Not just in neurovascular, but for shoulders and hips and knees and spines. We are going to see a convergence of digital tools, artificial intelligence, imaging devices, robotic assist that will all converge to make new products significantly better than what we do today. Now, it's going to be hard. It's going to be challenging, but it's going to be mind-bogglingly exciting to watch. So, all those things are in place within our vision and our mission. Those things are all moving and happening in different forms and shapes. Some of those things will succeed, some of those things will fail, but it's going to be exciting. That's why I've had other public forums.
So, I've talked about being in the golden era of the medical device industry. We're certainly in the golden era of neurovascular. Wow, wow, that's exciting. That's an exciting vision. It's a great outcome for patient care.
Now, the challenge will be those things are going to cost more money, and we have the greatest population entering healthcare ever before in the history of Earth. The baby boomers are all retiring in all 70 countries, so you have all these patients coming to healthcare systems. How are we going to pay for this as governments and as societies? It's going to be costly. So, we have to figure out how to develop these technologies but also make it more cost-effective and have better outcomes in healthcare and medical devices. It's never easy, but I'm so confident, believing, and optimistic that we're going to figure that out.
Well, you are not old enough to retire, when you are, and you're going on to the next thing, and it relates to the education, the solving of some of those problems. So, tell us a little bit about that before we end.
Well, I'm retiring from Striker but not retiring from working.
I've decided to take a position at the University of Utah Medical Center to be the Director of the Center for Medical Innovation, where we work with physicians who have medical device ideas across the full spectrum, and engineering students, business students, and legal students in forming small startup companies to bring those technologies from a design on the back of an envelope all the way through to a real medical device that could be prepared to
Transitioning to a startup or a strategic organization to make it a real product, and my belief is, over time as we age, we innovate less. The younger generation innovates better and quicker. The kids that are born and are in college today, their whole life has been centered on innovation. They expect innovation, they have innovation in every form of their life.
I think this next generation is going to develop more innovations than anything we can ever imagine. So, what I believe is, people in my position and phase of life should share the wisdom that we've learned along this path with the generations coming, their innovators. And I think by that convergence, I can make the world a better place. And that's what I want to work and develop, the next generation of innovators for the medical device industry.