Episode 107: Bringing An Anesthesia Invention From Drawing Board To Market w. Dr. Trevor Gibbs

Jul 19, 2021

This Episode

Interview W/ Dr. Trevor Gibbs

You Will Learn

Resources & Links

This week, I am speaking to entrepreneur, anesthesiologist, and inventor, Dr. Trevor Gibbs. Dr. Gibbs created Anestand, the very first Anesthesia stand. Today we discuss his journey creating Anestand and the company behind it.

Justin (00:03):
Hey, it’s Justin Harvey. Thanks for tuning into the anesthesia and pain management success podcast. With APM success, we take a close look at important topics pertaining to business, practice management, personal finance, and careers for anesthesiologists and pain management physicians. We work hard to take your critical questions straight to the experts. Thanks for listening before diving into this, week’s regularly scheduled programming. One of the briefly let you know I’m going to be at the Aspen conference. That’s the American society for pain and neuroscience at the end of July, the 23rd and 24th, Friday, Saturday, and would love to meet you. They’re going to be getting together with some other clients and friends, and if you’re going to be in town, you want to grab a drink. Email me, justin@apmsuccess.com would love to connect in person and meet you. This week’s guest, Dr. Trevor Gabes provided some really interesting conversation that I really enjoyed.

Justin (00:56):
He created a medical product that stemmed from some of the challenges that he was having in the ORs and anesthesiologist with just managing tubes and medications and all the different things that anesthesiologists juggle in actually giving a patient care and administering anesthesia in the operating theater. So he went on this really interesting journey to create a product that would assist in this and in, so doing talk to lawyers and accountants and intellectual property experts and medical device people, and went down sort of the whole process from taking an idea from the drawing board to having a finished iterated product that is being refined over time and getting it out into the hands of anesthesiologists. So hope you enjoy this episode today, as much as I enjoyed having it. Hello and welcome to episode 107 of APM success. I’m very pleased to be joined today by Dr. Trevor Gibbs. Dr. Gibbs is a physician outside of Chicago. He’s an attending anesthesiologist and a private practice out there. He’s also an inventor, the founder of Anna Stan, which he’s going to share a bit about today. Dr. Gibbs. Thank you very much for being here, Justin. Thanks

Dr. Trevor Gibbs (02:08):
For having me. I’ve been looking forward to talking to you for a while. I’m glad we could finally line it up.

Justin (02:12):
Likewise, your journey is a really interesting one and I’m looking forward to hearing all the different sort of steps along the way to get us started. Why don’t you just tell us a little bit about your background professionally?

Dr. Trevor Gibbs (02:22):
Okay. So I grew up in army Brett. I mean, if you go way back, I grew up an army brat. We moved around a whole bunch in somewhat early on. I thought I wanted to be a doctor. It wasn’t until medical school that I thought I learned a little bit about anesthesia and obviously eventually that’s, that’s where I settled. It took me to Northwestern for my residency. And then I settled in private practice outside of Chicago land in a town, a town called Naperville. And I’ve been here almost 14 years in practice now. So it’s been a great fit one practice the whole time. And I’ve already been pretty fortunate from that standpoint.

Justin (02:56):
So you’re one of the few physicians who found a job and kept it for over a decade

Dr. Trevor Gibbs (03:01):
So far. Yes. And, and I mean, I really like it, you know, we’re neither my wife or I are from this town, but you know it just would be really hard to lead this group. There’s a lot of things that I like about it. And I know that a lot of your listeners may be residents. You know, we have very good transparency from people that are partners and non partners. When you first start, you attend all the meetings. And, and so the, where we allocate work and allocate call is the same from day one to the most senior partner. So it’s just a very nice environment where we tend to work together. And so I think that’s something that if, if you can find that you want to be very careful if you’d ever leave it.

Justin (03:40):
I’m curious, you know, this, this, the idea of important career decisions is hugely impactful. Not only economically how much money you’re going to make, but also what the substance of your life looks like on a day to day basis. Sure. Looking back, would you say that you, you were glad that you found it and then you took the job or you sort of took the job, not really knowing what you were getting and then later you sort of realized over time what a valuable thing. It was

Dr. Trevor Gibbs (04:03):
Some of the aspects of the job. I would, that are beneficial, I guess. I didn’t know, but I pretty much did as much research as I could as a resident. We had different speakers come through on life after medicine, and I would go up and introduce myself and talk to them and we’d exchange email and things like that. And one particular one said, Hey you know, I deal with a lot of anesthesia practices when it comes time for you to go into practice, you reach out to me. And we went through things that were important. He mentioned, this is one group that he thought was good. But he knew groups all over the country. And so, so I, I appreciated the, the importance of payer mix, the importance of transparency and access to how people are paid and how work is allocated and things of that sort. And so when I got the opportunity to have this job, it seems like one that was a good fit for me.

Speaker 3 (04:51):
And so you’ve

Justin (04:52):
Been there for over 10 years now. I think 14 was maybe the number you said. And during this time you’ve been doing clinical anesthesia and have presumably, as you said, had a great experience, but there’s this other part of your life with Anna’s stand and being essentially an inventor and a product developer and subsequently an investor. And there’s a lot of things that go with that, that sort of happened at some point. So tell me the story of how that evolved.

Dr. Trevor Gibbs (05:19):
Okay. So part of the inspiration, the reason I ended up with this Anniston is, is somewhat the nature of our practice. Our practice was physician only, meaning I don’t supervise residents. I don’t supervise the anesthesia assistants or nurse anesthetists. You do your own cases. And oftentimes there’s not a lot of help because you’re putting patients off to sleep. And so I was at one particular time doing in a rapid sequence induction or putting the patient to sleep quickly because they had a bowel obstruction and we wound to minimize the chance of aspiration and the materials I needed, which were on the patient’s chest, which we, a lot of us use to hold. Things rolled off just as I needed it. The oxygen level were going down. When I finally picked up my supplies pulling on my Ivy tubing, which is wrapped around the wheels of the IB pole.

Dr. Trevor Gibbs (06:05):
And I thought this is a mess. There has to be a better way. There has to be an anesthesia stand after this case, I’m going to look to buy one. So I did that. I finished the case. Fortunately things went okay. I jumped online to find where I could get an anesthesia stand. And I, despite my looking and looking there wasn’t one. And you know, I thought for a bit about maybe I, maybe I could make one, or how would I make one? I didn’t know, the first step at all. And it kind of slipped out of my mind, but again, about a year later, I had a silver incident where I was frustrated putting someone to sleep. And I thought it would be nice if we had a stand at that point. I said, I didn’t know how I’m going to do it, but I’m going to figure it out. And off I set,

Justin (06:45):
I’m getting stressed out, just listening to hear you, listening to you, tell that story and putting myself in your shoes. So how long ago was this, this experience for you

Dr. Trevor Gibbs (06:54):
Seven years ago or so, and then five years ago, I just, about five years ago, I said, I’m going to figure this out. And so I started looking who might be able to point me in the right direction. And I didn’t, I mean, now I know that there are things called, you know, incubators and accelerators and innovation labs and all these things that are out there that are resources to help people. And we can talk more about that if you want, at some point to, to help people get started. But I didn’t even know those terms. I do nothing. My background, I never took an engineering class or business class or an accounting class in college. I was going to medical school and I was going to be you know, a medical provider. And that was, that was what I wanted. But I came across this organization called scores, service Corps of retired executives.

Dr. Trevor Gibbs (07:42):
And it’s kind of a business helps people a lot of generally aimed at people with small business looking for mentorship. And so I came across it, man, a chapter here in my area and I thought, well, this is something, maybe I’ll find one. And I looked at the list of mentors. There was someone that had been an engineer that had patent something and, and formed a business and sold it. And I thought, well, that’s kind of close to what I want. Maybe he’ll be able to help me. So I emailed him. He we exchanged emails. He said, Hey, I tell you what put together a little presentation you know, and come talk to me and then we’ll go from there. And so we met and I kind of ahead of that. I took pictures in the operating room, obviously when there’s no one in there.

Dr. Trevor Gibbs (08:20):
And I cut pictures out of our journals and magazines because I was trying to illustrate the problem to a non, not just a non anesthesia provider, but not healthcare provider. So setting the context, setting the need took a little bit of time. And, and that putting that together for him is something I had to do to a million other people as the journey went on. But I started with him, finished my, my con, my pitch. We had some conversations and he said, you know, I have a lot of people come to me. I think this thing has some legs. Here’s the next steps. So he put me in touch with a patent attorney. He put me in touch with a prototyping lab and an engineer. And off I went, I started meeting with all those individuals. And at that point I had no idea the rabbit hole is going down.

Dr. Trevor Gibbs (09:08):
I really thought it would take, I honestly thought I’d probably be about $30,000 to get this made and on the market. I mean, that was a number I was thinking of in my head before I met with the first other person. And so there, there, there was a million steps from there that we’ll go into, but I remember meeting with so they actually, that week I went and met with a project manager who worked at a prototyping lab that was associated with the local university. So it was, you know, a little more affordable and, and working, you know, businesses essentially my size. And he said, well, how much money do you have? I said, I’ve probably about $30,000. He’s like, they probably should get us through our first prototype. And I thought he was wrong. I thought he, I thought he must have just been over-exaggerating. But yeah. I’m

Justin (09:53):
Curious to zoom in on this timeframe, cause this is an interesting time of sort of the gut check moment. So you have this first, we experienced the hardship of for the second time, like, okay, I’ve got to do something about this it’s it keeps on happening. So I want to, I have an idea. You meet an executive, who’s an engineer who helps you build a deck and you have this sort of form, fully formed ideas where it’s like a pitch deck goes, that’s the first, the bare minimum to even communicate what you’re thinking at that point. There’s probably some like catharsis, like I’m making progress. And I, I can tell that there’s something here and I, as a business owner myself, and like I love entrepreneurship. I love brainstorming ideas, ways to fix problems. Sometimes that is its own end. Like it’s fun to think about ways to fix problems and try to figure out an economic model and then many ideas die on the side of the road. And for you, you’re at this point where there’s this moment of, okay, I can introduce you. The executive says to you, I can introduce you to an attorney and, you know, a design person. And these are all people who are gonna have a high, hourly billable rate, and we’re going to send you an invoice. And so now you have this increased level of commitment, that’s going to require tens of thousands. So tell me about how you processed that.

Dr. Trevor Gibbs (11:03):
Well, first thing I did was I was excited at this point. I thought, okay, we’ve got something. It looks like there’s no other anesthesia stand in the market. I’ve got someone that knows something and says, he thinks this is somewhat of a good idea. I hadn’t talked to anyone else about this. Right. Because trying to protect your idea you know, I didn’t, I didn’t know how I could contaminate the, the possibility of having a patent. And so I, you know, I was keeping it to myself. And so I met with these people, both of them the same week I met with this gentleman, I believe on a Monday, on a week that I was off, but not traveling. So it worked out that I could meet with both of them. So I met with the patent attorney.

Dr. Trevor Gibbs (11:45):
He kind of went through some important points on how we protect this idea. And in short, we talked doing something called a provisional patent and a provisional patent. It’s very inexpensive. You, you basically submit that to the patent office. They don’t look at it. But you have one year to file the real patent. And when you filed the real patent, you get the date of the provisional patent. So you get the time protection, but you don’t necessarily have to invent the whole industrial the money. And so what we decided was during that time, I could make some prototypes. I could investigate a little further before we actually had to do the real pet. So I met with him, had a plan that I thought, okay, I can, I can kind of deal with this. And then I went and met with the the project manager and he showed me around his facility.

Dr. Trevor Gibbs (12:34):
Honestly I didn’t do a ton of research. It turned out that he was a good fit, but I didn’t even know all the other options. I honestly didn’t know who else in the area or how again, yet how to Google anybody else. So, pretty much I was excited to get started. I was going to go with them. He gave me his rate. He gave me, he was the first person that said not, you know, not just what your initial, initial prototype would cost, but that, you know, for most companies, you’re looking at hundreds of thousands of dollars to get things up and rolling and running, which again, I still ha was skeptical about it. I thought, no, I can be more efficient. I can be, you know, I can bootstrap and I’ll be able to do it a little more cost-effective but he that’s the first time that I, you know, my antenna was raised that there may be a little bit more to this, but I didn’t have to tackle all of that at once.

Dr. Trevor Gibbs (13:23):
So suffices to say, I met with this gentleman called Mike Mike. And he said, okay, I accepted, I had to sign some agreement and non-disclosure agreements and things of that sort. And what I had to do further than was further in my mind develop my ideas. And that part was awesome. So I was thinking about what I want and making sketches and looking at other things, how they were designed, looking at our workspace, measuring things. And probably about a month later, I sat down with an engineer. He had identified that he’d worked with many times in the past. And we had a meeting, we went through all the drawings I brought in clamps that I got from home Depot and different parts. And like, I think I kind of want something like this and like that. And he took that information.

Dr. Trevor Gibbs (14:12):
And then probably maybe a month after that, he came back with the first CAD drawings, computer assisted design, or computer animated design drawings that he emailed me, which was so excited when I opened those, because I could see more professional version of what I was thinking of. And although it’s somewhat primitive to what we have now, a lot of the parts are still the same. It’s still there. So, you know, within two, three months I went from concept to having something much more, I don’t say tangible, cause we didn’t have it made, but you could look at it and say, yes, that’s a professional rendering of what I want.

Justin (14:50):
Okay. And so a couple of months go by, you’ve got to design. And then I know there’s a combination right now of like operational, like building the actual hardware as well as you’re probably starting to think about like the legal intellectual property entity formation, maybe like, do we want to do an LLC or tell me about sort of how you begin to address these more complex challenges.

Dr. Trevor Gibbs (15:13):
I still didn’t dive into yet at this point corporate structure I pushed that off a little bit further until we were getting prototypes that I wanted to I wanted to test. And so when I did that and then the risk of somebody hurting themselves and they were working on it or someone’s making it and they got hurt. That’s what I went, went through that whole process. At this point, the process was more okay, now we have these drawings. Now I gotta make, make the prototype. And it was a combination of using some parts that are commercially available and some 3d printing and big 3d printers to make things that were, were big enough for this. And that took another month or six weeks once I gave them the green light. And that’s the first time I really got a bill that I had to swallow.

Dr. Trevor Gibbs (16:02):
And I’m like, I don’t know. It was, it wasn’t even huge looking back at it now, but it was probably $4,000. And I’m like, you know, I had never put money into something that was so uncertain. You know, I mean, you know, you buy something for your house, you get that thing. Or I can put money into, you know, our typical investments, mutual funds, different things like that. I mean, I just put this into this and probably most people would think you’re just, you’re out there. You know? I mean, it’s, it’s a huge risk. There. There’s no anesthesia stand in the market. There may never be a market for it. And so I started doing that on a regular basis, you know, continuing to pay for prototypes and then the legal fees started coming on and working on the patent and things of that sort. So that was the first point where I said, oh yeah, here you’re you’re in now, you know? Yeah.

Justin (16:49):
The first time you carried that prototype in your duffel bag into the Orr and you set it up and you know, maybe the surgeon’s looking at you and maybe the AA

Speaker 4 (16:58):
Is like, what is this thing? You know, what’s going on? Yeah, well,

Dr. Trevor Gibbs (17:01):
It was so it was kind of secret, right? Because, so what we did was once I had the prototype, the first prototype that I wanted to take out and, and I, wasn’t going to test obviously on a patient yet. I just wanted to see how it worked in our workspace. So that’s when I filed the provision patent, like the day before I took that in. And so I took it in on a night that I was on call because I didn’t want anyone to see it to, you know, and so I took it in and when there weren’t any cases going on I went in the operating room and I clamped it to be at the table because getting that clamp in a way to grab the side rail, the operating table and to grab the IB pole. When I first got the engineers, they said, that’s going to be really hard.

Dr. Trevor Gibbs (17:41):
And I was actually driving one day and I pictured my whites hair clips, you know, how the teeth kind of intermesh and they pass by each other. And that’s how I pictured. I came up, maybe would the, and I was thinking if this clamp doesn’t grab the rail on the operating table, what if I split the bottom jaw? So they pass by each other and then grab any equal size either. And once I came up with that, it works so nice. So, but now is my chance to test that concept. And so, although it was very boxy and primitive, it, it did what I wanted to do. So it was really awesome. There’s a lot of things that needed to be revised, but I could see in my mind, yes, we’ll fix this up, we’ll fix this up, we’ll make this better. But I had something that was, I could see, could do what I wanted to do.

Dr. Trevor Gibbs (18:25):
And that was exciting, but scary. Like I said, I want, I want to see it. I did, it was trying to keep it private. And so I tested it a little bit and then I just kind of put it back in my bag and then I put out some paper and I’m like, sketching, no, this, we need to change this to change this and change this and change this. And and so that was kind of the first experience of, of bringing the operating room and saying, okay, are we, are we close at all? Or are we just way off base? I

Justin (18:49):
Love the story of the moment of epiphany for people. It’s, it’s actually you’re you were driving. It reminds me of the guy who a little bit of a different area, but he, he developed the science around nuclear vision. Leo’s a Lord is his name. And he was known as like the stoplight epiphany or something. There’s like a famous thing where he’s like his he’s pulling up his car to us, traffic light and sees the red, green, yellow, red. And he has this like epiphany about the chain reaction. It’s a different paradigm and it enables all this discovery. So that’s, that’s a fun story. So tell me about you know, you’re, you’re in, you’re, on-call, you’re sort of setting this thing up and then you’re you’re starting to iterate, you’re, you’re trying to improve. You’re trying to make it better. Presumably at some point you’re like, I got to start getting some feedback from people. Maybe have a few friends, try it out, tell me about how that continued to evolve. So

Dr. Trevor Gibbs (19:40):
I like I said, I, I, the initial prototype, I could give a lot of feedback on that, knowing what we need to work. So I I made a ton of notes. I tried it on different things in different places we might work and just continue to get as much feedback from this very expensive to me at that point prototype which was lousy and, and, you know, the, the the the plastic or whatever you make, the 3d printed thing is weak. And everything has to be, you know, careful or you’ll break it. So you can’t, couldn’t really fully test it, but it gave me plenty of information. So we sat down with that and I typed up pages of emails, of an email, you know, to the engineer and to the the project manager and pictures and sketches and scanning things. And I gave them a report. And so then they put that into a new drawing, a bunch of new drawings back and forth. We get to the next prototype. And that’s when I had one of my partners that I had signed a nondisclosure agreement, come over and look at it. And he wasn’t too positive on it. He was kinda like, eh, you know, what are you doing here? You know, he gave me some feedback, didn’t seem like something he said he’d need. So that course wasn’t very encouraging. And you probably

Justin (21:01):
Didn’t want to admit, yeah, I’m like 20 grand into this.

Dr. Trevor Gibbs (21:04):
No, no. I was embarrassed, you know, I mean, you know, I still, probably, most of my partners don’t know the, you know, the investment in time that that I put into this. But he did give me some thoughts on it. We came up with a better iteration and that process went round and round multiple times until I got to something that was much better than I wanted to show to other people. And that got me to a step where this began to be a lot of work. Right. So you started thinking about as you mentioned, okay. I got a form, a corporate structure. I knew nothing about that. You know, S Corp C Corp, LLC, sole proprietorship benefits of each, you know, I went, so this score organization has all kinds of presentations on all kinds of things you might need to go to.

Dr. Trevor Gibbs (21:50):
And one of them was corporate structure. So I went there and went to that, and they had a corporate attorney there who I ended up using to help. And we started with an LLC. And then I later on the advice of my accountant in the tax laws that Trump had put in at that time there were some benefits to being a C Corp because we held it for five years and you could exit the first certain amount tax free. And so we changed it. And that was fine, but a whole nother process, I had to basically shut down the LLC and then go with the C Corp. So a lot of time, just for something like that, a lot of paperwork, a lot of submitting stuff to the state of Illinois on something that I knew nothing about. And of course, you’re paying your attorney to help with that.

Dr. Trevor Gibbs (22:32):
And that was a whole, that was a whole process along with many other things that we’re thinking about putting together, right. And so I said, I need, I need some help. And so at that time, I had been put in contact with a company, a medical device company, and that a friend of mine knew the chief medical officer and they were looking for new ideas. And so I got in contact with them. They were very interested. But, and so they may be an offer and I didn’t, it wasn’t a great offer. And I thought you know, I’ve kind of injured this journey, but I, but I need some help. So I, at that point I worked my prototype and I went around to some of my partners and I said, what do you think about this? And several of them liked the idea.

Dr. Trevor Gibbs (23:16):
I said, okay, what do you think about it? But are you reeling to invest? Not just time to help, but money, this isn’t a passive investment. You need to be able to help me and you’ll be able to delegate tasks and you got to put a significant amount of money in. And when several of them said, yeah, yeah, we’ll do that. That kind of validated my idea. All right. If they’re not just willing to pat me on the back, but, but slide some money across the table and significant amounts, then I said, all right, then I’m going to, we’re going to continue on our own. And so that was kind of watershed moment when said, okay, we’re not going to go to the big company. We’re going to continue to do this alone.

Justin (23:52):
Yeah. So tell me about sort of you processing that maybe like you went home and you’re, you’re talking to your spouse and it’s like, I just had this conversation, like a couple of people want to throw in a meaningful amount of money who are professionals who think that this thing could be useful. How did, how did that feel?

Dr. Trevor Gibbs (24:08):
It felt, it felt validating, you know, and one of the things throughout the process as you want, or you enjoy when you’re validated. Cause there’s a lot of people, you know, as you, I’m sure you read a lot of entrepreneurs, they get a lot of nos. You get a lot of naysayers. You get a lot of, well, that’s a good idea, but it’s hard to enter the market, but it’s hard with the FDA, but it’s, you know, just, just so many reasons that you can’t. And so anytime you get validated, it felt really good. And I felt inspired like, all right, we can do this. You know, when I take a step back when I first had this idea and before I even reached out to that that first mentor I went, I thought, well, maybe I’ll go to these big companies, striker.

Dr. Trevor Gibbs (24:47):
Arthrex just different medical device companies. And you go to their websites and they have all this verbiage on how you need to be really careful. And the idea has to be protected and don’t come to us with an idea it’s not protected. And you, you know, we can’t promise anything. It was all scary to me. And I’m like, well, how am I going to, why would I patent something? I don’t even know. I wouldn’t even know the steps, what it would cost. And so it kind of scared me off. So I had been away from medical device companies, this other company, again, validated me. They wanted it. And they went through all these steps and sequences and, and they said, you know, once we go through this, the chance of being successful or that your product is, is, is viable, is this high. And we’ve done that.

Dr. Trevor Gibbs (25:27):
Here’s our numbers when they did all of that. I said, oh, they like it. Maybe I should like it. So I had a couple pieces of, of, of somewhat external validation at that point, inspired me to take these next steps. So with that, I had to form not a quote, not only a corporate structure, but investment structure, our evaluation of the company roles for people what, what would they be their compensation for being involved with a company? How would they, what would the metrics be to say that they earn this amount of equity? What would be the tax consequences of that? So think of all the people that I’m bringing in step-by-step, and as I mentioned, going further down the rabbit hole that I had no idea it was going down. And it was an incredibly informative process. It took a lot of time. I mean, I’m reading all kinds of stuff. I’d never thought I would read. And, and where I’m at now. And some of the things we can talk about that I’m working on now it was, it was, it was great to learn that. I mean, I just have such an understanding of being an entrepreneur, being a, being educated investor, being educated, taking investments. It was, but it was a lot of work, a lot of time, and I definitely needed the help that I got. So

Justin (26:38):
At the time when you’re soliciting your now partners sort of feedback and money, and then you get more formalized structure in place, where are we at in the timeline?

Dr. Trevor Gibbs (26:47):
I, I’m probably two years into the process at this 0.2 and a half years in the process. So the point where like, you know, I need, I need the validation, I needed a little bit extra funds and it all came together just right. You know, we were getting closer to I was going to make these, the plastic parts out of an injection mold, injection molds are very expensive, hundreds of thousands of dollars. And so having those funds were were just the right time. And they’re just the right health. Got it. So

Justin (27:18):
We’ve got a team, we’ve got some more money, and now you want to sort of take things to the next level at that point. So what was your next step?

Dr. Trevor Gibbs (27:25):
So I started thinking about the the regulatory processes, you know, how were we going to get this approved for sale? You know, was this a medical device? And if it was, how are we going to get it get it approved. And so I, we, we were looking for affordable ways to do that. Initially, when you, when you Google that you find the course, these big companies, and they say for $55,000 a year, we can keep you compliant and help you with the process. And I’m thinking this thing is kind of simple. I’m not sure if I need that. And so we were able to find there’s a website called upwork.com. Maybe you’ve heard of it, but it has several years ago, I hadn’t, but I came across, it has a lot of freelance people and has everything on there, but including some, some good regulatory people, people that have worked for Medtronic and all these other bigger medical device companies as years experience.

Dr. Trevor Gibbs (28:15):
And I came across one as well. Someone on there who for a pretty reasonable rate, hourly rate would do what I needed and had a lot of experience. And he still is with us today when I have questions on regulatory issues domestically and internationally, which he is experienced with both. He helped me through that. We had to put together a quality quality plan for our company. And we had all in addition to the regulatory hurdles that the FDA offers, and we put that all in place and we have regularly he and I have regularly quarterly quality meetings where we review any feedback or any problems, or just even we can say that there was nothing this quarter, but putting that altogether and understanding what, what bigger companies would need to do was, again, something I had to learn about, but, but now we kind of have it all in place. So

Justin (29:07):
I’m actually shocked that you found somebody like that on Upwork. I think of Upwork, I think like, oh, outsource executive assistant, or like a, you know, somebody to like do data entry, but you’re talking about like very technical very complex legal regulatory questions. And you found somebody to do it for an hourly rate. That’s PR I would never, I would have never even considered that

Dr. Trevor Gibbs (29:25):
Look, there’s even anesthesiologist on their offering. They’re consulting a bill, you know, consulting work, not for anesthesia providing, but you know, if you need an anesthesiology consultant for your business or for your hospital, I mean, there’s, there’s everything on there, which I didn’t know, but but we found that we needed and a lot of good people. Actually it was challenging to pick one. There was a lot of good options and again, I had never picked somebody like that. I didn’t really have somebody, I couldn’t really pay someone to help me hire someone. So I did the best I could. And this was something I delegated to one of my new part of my team. Awesome.

Justin (29:59):
So for anybody listening if you want to understand w we’ll link to some of the resources that Dr. Gibbs has used throughout the lifecycle of his company, I’ll get some of these offline after we’re done with this conversation. So go to APM success.com/ 1 0 7, we’ll have a list of all of that stuff. Upwork.Com obviously, and check out his website and a stand.com a N E S T a N d.com. We’ll also put that link in the show notes. So you’re getting traction where you at all intimidated, I’m, I’m thinking about, you know, is this like an FDA thing that just to me, that feels like years and lots of money, as soon as you have to reach these certain levels of you know, regulatory compliance and a lot of scrutiny. And I wouldn’t even know what I don’t know. And it’s just

Speaker 3 (30:42):
Kind of, it sounds scary so

Dr. Trevor Gibbs (30:45):
Well, I spent a lot of time reading what was on the FDA website and they pretty much have all the rules on there. So as best I could, I did a ton of self-education just so I could really communicate these regulatory people. And as best I could tell this was a class one device, non sterile not measuring any vital signs or anything like that. So it was the lowest level. And, and then I found that there was a category for anesthesia, trays cabinets and things of that. And within that, it was five, 10 K exempt. It was it was, it did not need any evidence to prove or validating evidence. So basically you just needed to register the product you did. And you had to have as, as part of being registered, you had to have a quality program you had to have.

Dr. Trevor Gibbs (31:30):
And so those things I was able to put together, but it looks like that this would not be insurmountable. And so when I found the consultant, I talked with him about that. And he, he confirmed my thoughts that, that yes, there is these things you need, the expense was not as big of a hurdle as I, as I thought it would be once we had these quality plan together. And so it was not as bad as I thought. But you know, it’s kind of nice, you know, people hear that your medical device and you go through the FDA, they, it seems like a huge barrier and a huge wall. And for most things it is, but for something like this, it’s, it’s, it’s not insurmountable. Got

Justin (32:08):
It. So for a business trajectory like yours, obviously you start by just swiping your own credit card. Eventually you kind of run out of money, or you’re no longer interested in spending your own money. So you solicit partners for their expertise in time, as well as their own capital. And now you’ve got a little bit more money to spend, but at some point you’ve got to start selling your product or solicit even more investment from other outside investors to continue the snowball rolling. So tell me about sort of, how’s your checking account looking at this point in terms of you’re you’re doing the FDA stuff. You’re, you’re asking these questions of what does the future look like? Operationally? Are we gonna need to raise more funds? Do we have what we need, do we need to start selling? Do we need to hire a sales team? How does, where did you go from there?

Dr. Trevor Gibbs (32:48):
So we you know, I got that round of investment and we ordered her injection molds and we started paying most of the mold we paid off at about 20%. They finance the company. And so we were paying that and we’re getting closer to, it took a year from when we ordered those molds until when the, the product was ready, it took a year, a year to, you know, you had to make the molds. And then just when they, once they make the mold, then the first parts that come out aren’t right, then they have to alter the mold. And then there’s something of this overmold that they made, and then they made it wrong. And so then we’re negotiating, oh, well, you’re going to have to make a new mold, does that my fault or their fault we had to pay for it.

Dr. Trevor Gibbs (33:30):
So, you know, one of many hurdles, nothing is as smooth as you just ordered off Amazon, it shows up your door. And then they’re sending me all these parts. And like, what if we make it from this plastic? I’m like, I don’t want it from that plastic. Well, it’s only working with this. So a lot of back and forth, and finally get, after a year, the parts are ready. I’m getting ready to release this product. Now we’re talking late 2019. Right. So think about late 2019, which just around the corner is COVID right. So you know, so we finally have a product ready to launch and try it. And so I had lunch and launching means I’m announcing where here, but I don’t have any way to really sell it. Right. So I got him, I’m looking for sales partners. And so we start to get some specialty distributors of anesthesia products.

Dr. Trevor Gibbs (34:19):
They are interested and then we’re going back and forth. You have to negotiate. What, what is, how are they going to buy it? Are they get, you know, what are they going to pay for it? How many samples are they going to get? What is their territory? Is their territory exclusive? All of these things. You know, some, some companies don’t have sales reps that go in places and they just want to do phone sales. How do you keep them in their territory, out of someone else’s territory? So we’re putting that together, right. And this takes us into basically right at the launch of COVID, you know, now I have my sales team and nobody can go in anywhere and know everyone’s on locked down. And, but, but I still have my monthly expenses. Right. So now we get into, okay, am I going to try and raise more capital, which is a whole process, right?

Dr. Trevor Gibbs (35:00):
And so there is a, there’s a like a time limit, like you, you, that there’s an offer window. So I would have to go back and make a new like prospectus on the company and where it’s at, or looking at our data sheets and our profit loss statements. And, and, and how does that dilute the initial investors? And, and I didn’t really want to do that. So I, now I’m putting more money in it again. Now it just starts me again, writing checks, you know, changing my personal investment and saving plan. And, and I’m not working, right. Because remember the, or shut down, you know, everything shuts down, but, you know, we’ve all this money’s in, you know, and the only way to dig out is to put more money in, but you don’t want to throw money down, you know, down you know, throw good money after bad.

Dr. Trevor Gibbs (35:44):
So at any rate, we are going through COVID and we’re getting some sales, you know, some interest we’re doing a little bit of marketing. And and it was great because we got some really good feedback on what was good enough and what wasn’t. And so basically like by summer, we said, okay, we need to fix a couple things. And so we shut down, stop marketing. I mean, it was out there. The sales reps showed a little bit as best they could. We shut down. And we came out with second generation and we made a few changes. And mostly it was the support NEC we went to something with a dual ball and socket, and that was much, much better. So we put it together. When you get a maid, we build an inventory, we send it to our sales team. And then, you know, then COVID is winding down. Sales reps are going out. And the sales process is long time, right? So from when someone first hears about it, it might be two months before they’re even cleared to bring it in for trial. Then the trial gets set up and it might be once they finish the trial a couple months where they agree to pay for it. So now finally, now I haven’t put money in for a little bit. Our, our account is going in the right direction. And there’s a lot of exciting developments going on.

Justin (37:01):
Awesome. So I’m curious in terms of sales strategy, this is one thing that, you know, if you think about business and abstraction, once you get granular, it gets very confusing. Like we have a widget, we need to sell to someone who wants to buy the widget, but are we selling one widget to one person? Are we selling one widget to a group of people? Are we selling a bunch of widgets to a group of people? And if there’s a group of people, is there one decision maker who’s going to decide if you’re gonna buy a bunch of widgets. So tell me about how you decided about your, your sales strategy. Like, how do you find the people that can decide, are you doing like a, B to C, which is like selling to an anesthesiologist or doing B2B, like selling to a program or a department we’re

Dr. Trevor Gibbs (37:38):
Really, we’re selling kind of business to business. So we’re selling our buyers are, although the, the person interested in them as the anesthesia provider, usually the facility provides your anesthesia equipment, right? So surgical centers, hospitals dental clinics you know, those are, those are the people that are paying the bill. And so so that, so we, we advertise to anesthesia providers, but we’re really, the payers are the facilities. Right. Makes sense. And what surprised you,

Justin (38:10):
What did surprise to you? What surprised you most about this journey?

Dr. Trevor Gibbs (38:14):
How long everything takes you know, I learned that as a small business, you are nobody’s priority. Nobody, you know? I mean, I honestly, I mean, or not honestly, but I understand, right. So if you’re a company and you have one, one person that is providing you lots of business and someone like me that may provide you just a little bit of business, you get pushed to the back, right? So balancing being persistent without being a pain and annoying, the people you need to help you was a very big challenge, but you are nobody’s priority. Everything takes longer than, than I would have thought. And I did my best to never be the delay. Right. I would turn things around as fast as I could. And then you wait, you know, and so the process, and this is, this is common, right? You hear it all the time, but you think that if you’re more efficient, more harder working, you’ll be able to be different.

Dr. Trevor Gibbs (39:04):
But, but really with if, unless you are extremely, well-funded, it’s just tough to be as fast as you’d want to be. So things took longer than I expected. You, you know, there’s unexpected challenges, right? COVID and then just the sales cycle, how long it takes, how long it takes from when someone who’s interested in it until they actually, and then if they agree to buy it, then it’s like a long time until they actually pay it. You know what I mean? It’s, you know, it goes through you know, however the hospital pays things out. So how long everything takes, how much everything costs and how hard it is when you’re just, you don’t really matter.

Justin (39:43):
Yeah. There’s a long time when it’s just like your grit and determination and your belief in the dream. That’s probably the only thing it kind of allows you to persevere. I would imagine it’s, it’s, it

Dr. Trevor Gibbs (39:52):
Really is. I mean, it’s really frustrating when there’s the rejection that you hear about when you, when you, when everything is harder and it’s just basically you and your wife listening to you you know you know, w some most 99% of time, I was positive, but when I wasn’t, she’d say, you know, just, just keep going. It’s good. It’s going to be okay. You know, and I thought she didn’t know what she was talking about. But, but now we’re, we’re finally somewhere where I I’m finally starting to, to be confident that we’re, we’re in the right direction, really myself.

Justin (40:26):
What was the low point for you on this journey?

Dr. Trevor Gibbs (40:31):
There’s there was a few, I would say there was a time when I brought back one of the prototypes further along, and it just, wasn’t where I thought it would be, you know, it wasn’t as good as I wanted it to be. And I thought, we’re just never going to get this there. You know? And then another thing is actually about a year ago, a little over a year ago, when the device was on the market, we kept having the same problem. And I wasn’t sure if or how I would be able to fix it. And I thought, you know, girls money and time, and people believed in me. And I just don’t know. I don’t know. I just don’t know if it’s going to make it. And then when you think, when you feel like that, there’s that the end is there, those, those were low points. So two different times, I didn’t think I had the product. That was good enough. That was the hardest, hardest steps for me. I know,

Justin (41:21):
As an entrepreneur, that there’s so much, I mean, what you’re describing is like the polar opposite of the physician career track, which is like, as soon as you’re accepted to med school, you’re borderline guaranteed to like, earn a good income your life and have some semblance of stability. Obviously there’s that waxes and wanes depending on if there’s pandemics happening, but there’s a certain baseline level of certainty and you’re, you’re throwing yourself into this totally different, totally different unique trajectory that has no safety net and no guarantee of anything. I’m curious if you had to do any sort of like mental rewiring or any work on yourself emotionally, to be able to do all the work without any positive feedback. And then you asked your partner and your partner kind of shoots you down, and there’s, I’m sure like some internal wrangling in a way that was perhaps new for you. I’m curious how you process that,

Dr. Trevor Gibbs (42:16):
Right? You have to get used to this uncertainty, right? Once you’re in the medical school, there’s always that certain it’s going to be a job there when you do the job, you’re going to get paid. You know, there’s generally plenty of work available jobs everywhere, especially now for anesthesia providers. So then to go in where you’re, or even in our typical investments, you put money in a mutual fund, you can see it there every day. It’s a little bit up or a little bit down, but yes, to this huge amount of uncertainty, without anyone to be able to, you know, I didn’t have a perfect mentor. And I think most people don’t, there aren’t many people that have gone your exact same path that can tell you, this is exactly what you need to do. So you’re piecing it together. You’re trying to get any information you can, but, but dealing with that complete uncertainty has, it was challenging.

Dr. Trevor Gibbs (43:04):
Right. You know, and it wasn’t until net right now that I feel very optimistic on where we’re going. And, and, you know, like I said, that our, our Cashin is above our cash out and there’s an advertising. Isn’t such a hand-wringing exercise. Like I really want to put money into this or that, you know, we’re going to be at, we’re going to be at the ASA. We’re going to be at the anesthesia tech conference and we’re putting tables up and, and we have a whole new partnership. I’ll you know, the, it now is making anesthesia and a lot more, or anesthesia is going to have a whole line of anesthesia products, endotracheal tubes, and anesthesia circuits, and all the things that we use in the operating room. So it’s, it’s gone from uncertainty to a lot more excitement.

Justin (43:48):
Awesome. If you had to go back and give your younger self, the self that had this idea that perhaps there’s a product out there, give that self, some advice, some perspective based on what you know, now, what would you share or for anybody else listening. Who’s like, you know, I’m interested in taking this journey and inventing, or product or waiting into the FDA regulated side of the world.

Dr. Trevor Gibbs (44:12):
Well, I would have started when I first had the idea I would have, you know, rather than let it simmer, I would have said go. I mean, the first thing I would’ve told myself, just go look up an innovation lab and accelerator and incubator. Any of those will get you in touch with someone who’ll be able to point you in the right direction. And I could have gotten started several years. So that’s, that’s one thing I would have done. I would have with my prototypes, gotten a little more widespread feedback. There’s a couple things that, you know, when you’re only getting feedback from your facility, you do things in a certain way that may be different or very different from how they’re doing things, their workflow in other environments. So earlier on, I probably would’ve gotten more outside feedback. So those are, those are two things I would have done.

Dr. Trevor Gibbs (45:02):
I may have also, and this is a risk, I’m not sure pushed my first patent submission later a little bit, because once you file that pat, right, then you have one year to file the full patent. The other thing though you have is you have a limited amount of time before you can file patents in other countries as well. So I filed something called a PCT foreign patent cooperation treaty form. And when you file that, you basically have 30 months from that first date of my original patent to file on any other country and get that initial date. And you know, there was a lot of time, things all took longer. I, and, and I wanted to see these things selling before we really dove in other countries and start paying for patents there. So if I could have given myself a little bit more time, I may have done that, but someone else files the day before you, then, then you’re out of luck. So I don’t know if I would change it, but it’s, it’s something that pushed me, put me a little bit more under the gun and making decisions on filing in Europe and different places subsequently

Justin (46:01):
Got it. Have you had any role models or other professional contacts, or maybe like anyone in your life who has been instrumental in helping you get through this? And you would say, if somebody else is interested in trying to walk this path, you need to find someone like this, or with these skills or this perspective to allow you to do what you need to do.

Dr. Trevor Gibbs (46:22):
I would say I didn’t find one particular person. I think you need to find lots of people and connect with lots of people and many different people may be able to offer one, one type of advice. You know, whether it’s on finance, whether it’s on accounting, whether it’s on engineering. And so if you want to take this journey, reach out to a bunch of people, if they’re crazy and have bad advice, you can say, thank you and ignore it. If they have good advice and you may find someone that is this, the perfect mentor I don’t, I’m not sure that that, that exists out there. I think there’s lots of people and nobody’s an expert in everything and nobody walks the exact same journey you do. So, so get online. And even in, I had never seen shark tank before I started this journey.

Dr. Trevor Gibbs (47:06):
And I think, I just think the entrepreneurial journey is, is a lot more, there’s a lot more spotlight on it. There’s a lot resources out there, but I am a resource. So if anybody emails me, I can put you in contact with people, but I’m not a perfect resource. Either just get online and start connecting with people, start reading, get on Facebook groups or, or, you know, clubhouse, you know, app, all these different things. See what’s out there, connect with people and you’ll find, you’ll find the right people that can give you the information, you know. Awesome. Well,

Justin (47:38):
Dr. Trevor Gibbs, founder of Ana Stan, it’s been a pleasure speaking with you today. Thanks for joining us on APM success.

Dr. Trevor Gibbs (47:44):
No problem. I appreciate it. It’s it’s always fun to talk through this. It’s it’s you know, when you finally getting success, it’s just, like I said, it’s, it’s a little more than a medicine cause it’s expected. This is it’s truly a surprise or it’s uncertain. And when you, when you get that validation, it feels great. So I hope I hope other people take the journey. I know anesthesia providers have a lot of sources of inspiration with challenges in our workflow and they’re problem solvers. They solve problems every day and there’s a lot of other problems to be solved. So when you have that inspiration reach out to people, you know, there’s a lot of ways that you can bring it to market, whether it’s through a bigger partner and you just license it and get a royalty, whether you do it yourself, whether you partner with other people there’s a way for you to act, remember inspiration.

Justin (48:32):
If you liked what you heard this week, head on over to APM, success.com, where you can find more content and free resources to help you build a successful career in anesthesia and pain management. If you want to leave a review in iTunes, that also really appreciate it. Thanks for using some of your valuable time to join me today on APM success.