EPISODE 20: GUY VINOGRAD, CEO AT BIO-T

EPISODE 10: JONATHAN ROURKE, CO-FOUNDER & CEO, MITRASPAN


Jonathan (Jon) is co-founder & CEO at MitraSpan —a medical device development company that is exploring minimally invasive mitral valve repair techniques for treating type IIIb functional mitral regurgitation in heart failure patients.

Jon's career in medical devices and cardiology began in 1991 in the ultrasound imaging business at Hewlett-Packard Medical Products (now owned by Philips). He worked on engineering challenges related to manufacturing high-frequency ultrasound transducers for both TTE and TEE devices. In 1995, he led the IVUS catheter program, a joint venture first with Boston Scientific and later Guidant. This business was later spun out to Volcano and then recently acquired back by Philips.

In 1999, Jon moved to the venture-backed startup world where he has remained for now 20 years first as VP of R&D at Endotex where he focused on the development of a carotid stent. He led this program through successful feasibility studies and pivotal study launch. Following that and FDA-PMA approval, Endotex was acquired by BSX. In 2001, Jon joined TransMedics as VP of R&D and lead development efforts through the successful completion of the first full venture round. Transmedics recently filed for an IPO and is a pioneering company focused on the normothermic, sanguineous, functional preservation of organs for transplantation.

Since 2002, Jon has led a succession of development and clinical trial efforts in the structural heart and mitral repair fields. First, at Viacor he served as both VP of R&D and CEO; and later at Harpoon, he helped arrange for the spinout of IP and the securement of initial program funding. Now, at MitraSpan he continues to innovate on potential breakthrough structural techniques.

Prior to the Medtech industry, Jon worked for ten years as a consultant and contract engineer in the automotive industry with a focus on manufacturing processes for cooling components. Jon's academic credentials include B.S. and M.S. degrees in Mechanical and Electrical Engineering from Worcester Tech and MIT respectively. Learn more.

Episode’s transcript

Julio Martínez: 0:04

Welcome to the LATAM Medtech Leaders Podcast. This is a weekly conversation with medtech leaders who have succeeded in Latin America today. Today our guest is Zach Selch. Hey Zach, it's great to have you here today. Welcome to the show.

Zach Selch: 0:20

Thanks, Julio. It's great to be here. This is really nice.

Julio Martínez: 0:24

Excellent. Well listeners, today we have an outstanding professional in the medical device world: Zach Selch. Zach is VP of Global Sales for a high tech medical company. He has sold in more than 135 countries and lived in six. At 10, Zach was living in a trailer, at 15 he was left to fend for himself, at 19 he lead men into combat, and at 33 he was the head of sales for South Asia for a Fortune 1000 multinational company and for about 30 years, Zach has built up the international sales of several companies—from start-ups to publicly traded companies— four times growing sales by more than 1000%, three times bringing in the single largest P.O. in a field's history. So with this, he has added hundreds of millions of dollars to the value of mid-market companies by increasing their international footprint. So I'm really, really honored to have Zach today in the show and I look forward to our episode today, Zach.

Zach Selch: 1:33

Thanks for having me. I look forward to discussing a little bit about Latin America.

Julio Martínez: 1:37

Excellent. Zach. So first please give us a description of your journey to Latin America. How do you get involved with the region?

Zach Selch: 1:47

Well, I knew I wanted to be sort of where I am today from a long time ago. I want it to be the head of global sales for a company and what people typically do is they start off as regional manager someplace or a salesman someplace and then they go up through that territory, but they don't get a lot of experience with other parts of the world. That was what I noticed when I was in my early twenties was really common. So what I tried to do on my twenties and thirties was jump around territory is a lot. So, I was a regional manager first in Africa, and then in Eastern Europe, but then what I tried to do was shift horizontally to be a regional manager in different parts of the world, eventually I was regional manager for Latin America, and you know that Latin America for virtually any manufacturing company, certainly in American company, Latin America is going to be one of the better markets. So, having a position, understanding how to sell in Latin America is really important for somebody who's going to be in charge of global sales, in my opinion. So, I got a job with a medical equipment company and actually I took over a position for about a year as acting head of Latin America. There's so many good people out there who speak Spanish and Portuguese and nobody really wanted to give me a job and my Spanish is pretty bad, but as an acting person, I was able to get a job like that and it worked out pretty well. I got to know the market's pretty well and on top of that, my wife is Colombian, so I don't speak Spanish, but I can get by in a taxi, an hotel, you know, I can understand most of what happens in the meeting. So anyway, yeah. So I did that pretty well and that goes back about 15 years and since then I've had responsibility for Latin America pretty much the whole time as part of my overall territory. So, I've hired and managed regional managers for Latin America several times and Latin America's always been a very productive, exciting market for me and aside from everything else, it's a fun place to visit, good developing, producing territory. The food's great, the music's great and most of it's safe. So it's really a good part of my life time as I spend in Latin America.

Julio Martínez: 4:08

Okay. Thank you for that. I mean, as a Latin American, I'm very glad that you have that perception of the region. So, talking about perceptions, I mean, what's your overall perception or opinion about Latin America? Some market to commercialize medical technologies or to conduct clinical research?

Zach Selch: 4:26

Well, again, you got to think about who you're dealing with. For most American small and mid market companies, Latin America to some extent as low hanging fruit. For the most part, you're dealing with two languages and you have a couple of hundred million people with just one language too. So, essentially you have a pretty good market if you're basically saying, okay, I can only really afford one regional manager to start my global expansion, and I don't really want to spend a lot on travel expenses. I want to do this, I want to dip my toe into international expansion. Latin America is in your backyard, right? So, it's some extent the low hanging fruit, a lot of the markets in Latin America, will take American products as is, as long as you know, if you're dealing with the same medical software and there's a language issue, that's another story, but again, if you have to do translation, you can get into Latin America we're translating into one language, right? So, there are some advantages that come with Latin America, just essentially being in our backyard. There's growth in Latin America in some markets, and there's also, you take a look at Latin America so the way I look at it, you have products do your?* Manufacturing company, you might have a high end product, which is really aimed at the very best hospitals, or you might have something that is a relatively inexpensive product that's aimed at mass markets right now in Latin America. You're going to have both of those. You go to some parts of Colombia, Brazil or Panama, and you have the very, very best hospitals in the world. Right? And then, pardon me if I'm excluding some other countries here, but really I can think of six world class hospitals in Colombia. I can think of multiple world class hospitals in Panama, multiple world class hospitals in Brazil that are gonna want the very, very best products. On the other hand, there are places in Latin America that they're going to want the lowest priced products that the world buys. So, really there's a range within Latin America for just about any type of product that you have. There are countries where, again, they're looking at lung transplants and hip transplants, and then there are countries where they're looking at a filtering water to make sure that people have clean water and good sewage and basic trauma medicine. So, Latin America is a very, very wide market with different areas that pretty much any American manufacturer of medical devices should be able to find a relatively receptive market for their product somewhere within Latin America.

Julio Martínez: 7:23

Okay, good. All right, Zach, getting a little deeper, let's speak about the countries or the specific territories where you've had experience in the region?

Zach Selch: 7:32

So, I haven't sold in The Guianas, and I haven't sold in Bolivia, but aside from that, I've pretty much sold in every country in Latin America. So, I've done really well for myself in Argentina, Chile, those are great markets. Certainly Brazil, I've done a lot of business over the past 30 years in Brazil, Colombia, I've even sold in Venezuela, although not in the past couple of years, but you know, Ecuador, Peru, Peru is a fantastic market and then all throughout Central America and Central America is the same type of thing as the rest of Latin America. You have Panama and Costa Rica, which are very high tech markets and then you have some of the other markets which are lower tech, lower value markets. So, it really depends on what you're selling it. Over the years I've sold different medical products, so I've sold into different markets across Latin America, of course I've sold the extensively into Mexico and the Caribbean.

Julio Martínez: 8:28

Very good. Quite an extensive experience. I'm sure you had a lot of fun, eating and seeing places.

Zach Selch: 8:36

Yeah, and you know, it's not like it's hard to get a good cigar i n Latin America.

Julio Martínez: 8:42

I'm making friends as well. I mean, people are very friendly down there.

Zach Selch: 8:45

People are very friendly, yes. I have some really, really good friends. I've had places in Europe, you know, not to name names, but some of the colder places in Europe you do with people for six years and you don't know if they have a wife or children; deal with people in Brazil and the first weekend they take you home and, you know, you're barbecuing on their porch. Sometimes there's a total difference in how people treat you in different countries.

Julio Martínez: 9:11

That's very true. Alright Zach, let's speak about the go to market strategy or market access strategy that you've seen throughout your 30 years of experience. Can you tell us what is the predominant approach that you see companies taking with Latin America? A proactive and well thought out strategy where they create a market access plan for each country where they plan to enter or an opportunistic or reactive approach where they just waiting for distributor to contact them at a trade show or through an email or something?

Zach Selch: 9:47

Well, I sort of made my living over the years fixing screw-ups that other people have had before. To be perfectly honest, and I can't tell you how often it is that people take a reactive approach to market access strategy; and I'll tell you, I can even know of a company where the founder went down to Brazil and in conversations with her interpreter, the interpreter said, well, if you don't have a distributor, maybe I could be your distributor. So, the person literally gave a distribution agreement to an interpreter who formed a company and became a distributor and had distribution rights for about four years without producing a penny. People do stuff like that, or you didn't your booth, you go to a trade show or maybe even you don't even go someplace, somebody arrives to you. They see you on the Internet, they write to you and they say, hey, if you don't have a distributor in Brazil, can I be your distributor in Brazil? And people think: oh, well, you know, I don't have a distributor, any distributor is better than no distributor, I should let them be my distributor and getting out of those is really difficult because if you give somebody distribution rights in most of these countries, obviously the government of Brazil is going to protect the Brazilian company more than they're going to protect in American manufacturer, right? So they have rights. That makes it very difficult for you to get out of this. Now, the way I like to do things, I typically say I'd never want to work with somebody who contacts me randomly. What I like to do is basically take a look at the market and say, okay, I'm selling a product, they get sold to a certain end user. Now that could be in the private sector, could be in the public sector, and those are very different markets in Latin America. Let's say the private sector in Colombia is going to be totally different than the public sector in Argentina. There are very different price points, very different needs, etc, but let's say I'm looking for a distributor who is going to have existing relationships as well as the knowledge in how to sell to the end users I want to sell to, he's comfortable with my price point, he's comfortable with the type of sales process idea with and, I'm going to build myself a profile and then I'm going to go looking for those distributors and they're going to be selling a different product. I don't want to find somebody who's selling a competing product, but if you think about it, you say, okay, I sell ventilators the ICU and I want them to go into a midrange private hospitals. So, what I'm looking for is somebody who sells monitors to ICU in the same price point, the same, you know, mid-range type hospitals and that country can I find distributor for those types of products. Once he defined a thought way, it's not that difficult to find them. Then you say, okay, there are three potential distributors in Peru, but I want to work with, I'm going to go down and talk to them or I'll reach out to them at one of the big trade shows like FEMA*? or hospital are at, I'll meet with them and I'll talk to them, I'll interview them, I'll see if they're interested; I'll pitch to them, etc. So, that's the way I like to do it myself. Personally in Latin America, I've only dealt through channels. There are other markets where I've sold direct, but in Latin America I've only dealt with channels just because of the nature of the companies I've been with when I've had responsibility for Latin America. So, typically I'm going to find the right distributors, I'm going to be working in parallel to find somebody who can do the registration for me and the regulatory affairs for me and what I like to do is pay somebody per hour for that and by that I mean somebody will say to you: Hey, I'll do the registration for you, but I'm going to hold onto the registration site of documents saying that you've given me the rights to your registration in Brazil for 10 years and I'll do it for you, and then you saved yourself$5,000 or$10,000 but somebody else now is holding you hostage for the next 10 years because you can't sell without them, and you see that a lot. So personally, I rather own the registration for these markets. Now obviously when you're with a small company, you might not be able to afford to do that in every country, but that's my preference and then typically there are trade shows, there're probably half the countries in Latin America have a local medical device trade show. I know that Chile, Peru, Colombia, Argentina does, and then there are also ones that are specific for the respiratory care, for a hospitals, safety, whatever, depending on your field. There are little conferences like that. Then there are the big conferences. Sometimes I'll show in the little conferences sometimes I'll show on the big conferences. Typically I prefer the big conferences and I prefer to have my distributors show at the little local ones that, but it really depends on where I am at the process of market access at that point and really a lot of it is footwork. You have to go and you have to train your distributors, you have to go with them the first few times you have to work with them to localize your marketing material and make sure that they get the messaging right in Spanish and Portuguese. I've done a lot of videos. It's sort of funny. I've got a lot of videos which I then had dubbed into Spanish and Portuguese of me presenting. I know I don't speak Portuguese, but boy it looks like I do, you know, putting together those tools to help your sales people sell, make sure you do your training. In my last company I had a really nice, really professional quality group of distributors, and we did an annual sales meeting of a Latin American distributors to get them together for additional training and to get them to exchange ideas and share contacts and stuff like that. So those are the type of things I do with market access and those have been very successful, couple of times I've grown Latin American territory for my company by well over a thousand percent in a few years, and my last company, they had been selling in Latin America for about 30 years and within three years I was able to increase sales by about 400% with existing distributors because what we were doing was we were hitting them with methodology, we were giving them better training material. We were pushing them to use our messaging and giving them better sales enablement tools and that type of thing and it really showed results in the sales.

Julio Martínez: 16:41

That takes me to my next questions. You're bringing up a very good point, which is a hands off management approach where you just sell products or ship products to a local distributor, let them do the rest or a hybrid approach where you had a local clinical sales agent or somebody at the head office focus on the success of the distributor; working side by side with him to generate demand. What do you think about this?

Zach Selch: 17:14

Well, again, this is something I'm very passionate about and I think this is the difference between really bringing in sales numbers and not right? Is that some people they say, and I know people like this, they go once a year to a trade show. They meet their distributors, they get a forecast from a distributor. The distributor puts in a purchase order, and that's all the involvement they have in the market. And this is a just for Latin America, this is all international sales. There are people who do business this way, right? And what I can say is, look, they have virtually no cost for this. They're basically go to a trade show for a couple of days. They pay for our hotel and the flight, and then they get$1 million or$2 million of purchase orders over the course of the year. And they're happy with it. Good for them. Right. I'm looking at my distributors as part of my sales organization and it's my job to manage them. It's my job to train them. It's my job to coach them. It's my job to push them, basically. I'm going to try and push them and get the best results I possibly can out of them. And if not, I'll replace them. Right. And I'm also going to be very careful about how I recruit them. And it was funny, I was talking to somebody awhile that, and I said, well, what did you put? What type of activities did you put in your um, distributor agreement? And he goes, well, what do you mean you can't tell them? And then the agreement what you want them to do, their private company, they're your customer. I said, well, I said, I put about five pages in my distribution agreement of who they're going to hire. I put a job description of who I want them to hire. I put the training schedule, I put all the different activities as part of the agreement because here's the thing. Let's say you sign an agreement with a distributor and that distributor agrees to buy a half a million dollars worth of product from you during 2020 okay. Now what's your remedy if they don't buy it? You can't go to the courts of Brazil and say, Hey, we had an agreement he didn't buy. I want half a million dollars. It doesn't work that way. Right? If he doesn't buy, you fire him. On the other hand, if you say to him, within 90 days of signing this agreement, I want you to have hired somebody who fits this profile within a 180 days of signing this agreement, this person will have come to Chicago for a sales training. Now, if he doesn't hit those milestones, you have grounds to terminate him. So at least maybe you don't want to terminate them. Maybe you'd give him a little push, give them a little coaching. But if he isn't doing what he needs to do to get sales, you're going to see it early on and you have a remedy. You don't wait for the end of the year to say, Oh, you know, we didn't get a penny out of Colombia this year, so I like to do it that way. I travel a lot. Now here's the thing, you need somebody. You need to regional manager. You need somebody to go down and work with the distributors. If you, if you do it this way, so your travel expenses are high. But on the other hand, if your sales are five or 600% or 1000% higher than they would have been working reactively, then all those expenses disappear there. Drop in the bucket. That's the way I look at it is it's not about just signing the first guy who contacts you and says he wants to be your distributor and you go, Hey, this is great. Now I have a distributor in Colombia, he'll hopefully, he'll send me a purchase order every now and again, right? What you want this to find the right person on the train them. You want to manage them, you want to get them sales enablement tools. You want to move this forward the right way. And that's where sales growth comes in. And it isn't just for Latin America, but you know, we're talking about Latin America. This is for every export market.

Julio Martínez: 21:07

Very well said. Zach, and I hear the word the sooner is customer all the time. I don't like that.

Zach Selch: 21:17

I don't like that. I find that when somebody says that, that's almost like him saying, Hey, I'm an idiot and I'm never gonna make any money out of it. When people say that it's a sign that they don't understand what they're doing in business, from my perspective, right. And typically the people who say that, who are they? They're engineers. They're founders, right? And they love their distributors. They want to go out and Latin American distributors, Hay, and they go out drinking with the distributors. They have, you know, visual auto with the distributor, but there's no money at the end of the year, right? The distributor is part of your sales organization in the same way that if you are a direct sales company or your salesman is your employee, he's part of your sales organization with distributors. Now the problem is, I always say almost all the distributors I've ever worked with are pretty rich, right? They didn't start out that way. So you're talking to some guy, you say to them, Hey, here's what I want you to do. I want you to do this, this, this. And he could say to me, Hey, Zach, I have a 45 foot boat. How big is your boat, man? Do I got a boat? You don't have a boat? I'll do things my way. Right? So you're dealing with somebody who has successful, he knows what he's doing, but you're still telling him how you want stuff to do. So this type of selling is one of the hardest jobs in the company because you have to tell people what to do, even though they're very successful and they're richer than you are new. You have to do it the right way to get the right results. Right. But, but that's the part of work. Right? But yeah, they're not my customer. They're part of my sales organization and I have to manage them. I just have to do it in the way that they're gonna do what I say, even though they're successful, intelligent people themselves. Right.

Julio Martínez: 23:06

Excellent Zach. I mean, well, we'll set that think, uh, since I've been having these podcasts as being one of the best descriptions of give his tutor, manufacturer relationship that are hurt really good. Moving along. What about demand generation? Have you ever been involved in activities with you, the shooter, where you have to somehow generate the man directly from invaders?

Zach Selch: 23:33

Oh yeah. So first of all, I like to go on like what I call ride alongs. Right? And there are different reasons for that. Part of that's trading part of that, but the sort of sounds a little funny, but I always say that the end user likes to see a gringo come out. It helps them understand that the distributor really is working with the manufacturer, that we have a good relationship. Yeah. I'll tell you if a hilarious story in a second, but so you go around and you do presentations, you talk now my philosophy is that I want 95% of the sales to be done without me in the room because I want the distributor to be able to do everything without me. I don't want a situation where the distributor is dependent on my coming down to generate demand. But certainly in the beginning I'm perfectly happy to do that. I'm perfectly happy to go out on these calls and help do presentations and get the interest flowing and stuff like that. Let me tell the story. This is one of my favorite and American stories. So I happen to really visualize data and you, you know, fish while they're right, the Brazilian not being, and it's not an easy thing to make. And my wife's Colombian, but she had never been to Brazil as an adult. So one day I decided I want to make or visual Adda. So I bring home a lot of the materials to make visual Ata and you can't make visual out of for two people or five people. And I make visual auto one a Saturday and it's a big thing. I have about 20 friends over. It's really nice and I totally friends over. Well, you know, once you make visual art, you can't make visual either for a couple of people. Right. And I take a bunch of pictures and I send them to my distributor in Brazil at this looks beautiful. Where is that? I go, I made it. That's my visual other, right. So he was impressed. About a year later, we're in a meeting together with this hospital in Brazil and this doctor is saying, you know, I don't like working with American companies. They dip their toe into Brazil. They realize it's difficult and then they leave the market and I'm stuck with their equipment and there's no service and I don't trust the Americans are committed. You know, North Americans are committed to the Brazilian market. Wow. What a comment. It was a very ugly comment. Yeah. So my distributor says, well, uh, if you were convinced that this manufacturer was committed to the Brazilian market, would you buy our system? So the doctor says, well, yeah, you know, if you could convince me that I could trust this manufacturer to have a commitment to the Brazilian market. So my distributor pulls out his phone and he, and he says, take a look at this. What does this look like? And the guy says, that looks like visual art. I goes, do you think that looks like good visual Outta the doctor? Says, yeah, that looks like good visual auto. Where's that from? And my distributor says, if I told you that Zach made that, would you believe that Zach is committed to the Brazilian market? So the doctor looks at me, he goes, did you make that? I said, I baked that. And the doctor says, you know what? If you can make visuals like that, you must be committed to Brazil. So it gives us like a quarter of a million dollar purchase order on the spot because of pictures of fish water. Right.

Julio Martínez: 26:53

Oh my God. Oh, unbelievable. That's a good story, Zach. Really, really good. All right. I guess that answers my question very clearly. Yeah. All right. Moving along. What about Pricing Jack? I mean, how do you perceive pricing in Latin America? Some people say that these are very price sensitive preaching to what's your take on it?

Zach Selch: 27:18

You go to Colombia and places in Brazil and Palomar, right? You have some very, very high and hospitals that are looking for high end equipment right now. Sure. They're price sensitive because their business model, the medical tourism and muddied and Colombia is based on being order of the price of the same surgery in America. Sure. So they have to keep their prices low, but they're still looking for high end equipment. And I have been able to sell at the same prices that I sell in other parts of the world, in a lot of Latin America. Where do I have more problems? And again, I would say it's not so much, it really depends on the product. It really depends on the benefits you offer. But the biggest problems I've had haven't necessarily been with pricing. They've been with cash flow. So for instance, Argentina, sometimes it's really hard for people to get their money out of the country. So you have to give really good credit terms. Sometimes remember a few years ago there was really bad currency fluctuations in some parts of Latin America, especially Colombia and Brazil. So sometimes you have to take those things into consideration. But my personal experience has been that I've been able to hold the line with pricing relatively well in Latin America, but I can certainly understand where some people would be having a lot of problems with pricing and Latin America.

Julio Martínez: 28:51

Got It. Yeah. All right. What about the reimbursement? Have you ever been involved with government negotiations for insurance company in negotiations to get reimbursed for your products?

Zach Selch: 29:02

I personally haven't gotten into those details so much. I'd rather not voice a strong opinion on that because typically my distributors have dealt with that. I've helped by providing information or that kind of thing. But I really haven't been involved in the reimbursement side direct with governments too much.

Julio Martínez: 29:20

Okay, that's fine. All right. What about the importation process and duties and all that Sec, what's been your experience with this? Is it easier to import? Is there corruption involved? I mean, what's, what's your take

Zach Selch: 29:34

as difficult as any place else in the developing world and typically the uh, developing the more complicated that I once had a shipment that went in for technical training. We shipped about a$100,000 worth of equipment into Peru that was supposed to be shipped out again after a week. It was specifically there for a course for everybody from Latin America and it got sucked up by customs for months and we couldn't get it back. We had to cancel the training, that kind of thing. But it was our fault. We, the person who shipped at this was years ago with different company, the person who shipped it, who did the paperwork, a screwed up the papers, but there was no recovery. I mean, once the customs people saw that we had a mistake in our paperwork, they were sort of, hey, we're going to hold onto this and you can have a hearing in a couple of months and maybe get it back. But it was brutal. But for the most part, I've found that if you're dealing with a reputable shipper who understands how to do paperwork, I haven't had any real problems. But I deal with a lot of countries like this. So when you're shipping to Nigeria and you're shipping to Saudi Arabia and you either you shipping to Brazil, I wouldn't say that Brazil is any more difficult than a lot of other, you know, developing countries to get stuff into or to deal with the shipping into. Now one thing I'll say with Latin America, there's a lot of people I've dealt with. What they'll do is they'll say, ship it to Miami. We're going to consolidate the shipment in Miami and bring it all down together and we'll deal with shipping. And that's much more common with Latin America than any place else in the world that I've seen. I'd say probably 20% of the shipping that I've shipped, uh, Latin America, my distributor, and even in some cases the end user customer has wanted to deal with the shipping themselves and they just wanted us to ship it to Miami and they dealt with it from there. So

Julio Martínez: 31:34

I like that approach a lot because you taught you now very good points, which is the shippers role here. If you don't have an experience for somebody who has shipped to that specific country before, it's very easy to screw it up. So

Zach Selch: 31:49

yeah, and I'll tell you what, I was actually talking about this yesterday with somebody. Let's say you're working with small to mid sized American manufacturer. What I always say, one of the first things you want to do is you want to find yourself a new shipper who can help you internationally and help you with the paperwork internationally and every time, literally every time. For the past 2025 years. The first reaction of the shipping manager of the company is, Zach, you know, I've been doing this for years. I think I can figure this out. And he say, he though what? Um, I really suggest that we talked to a few shippers that do things internationally who could help you with this. I think it's really a good investment and they always push back and they say, Zach, you know, you deal with selling. I'll deal with shipping. I this, you're being a little bit insulting. I think I can figure this out if I can ship to Cleveland than I can ship the Sao Paulo. Yeah. You're like, I don't think you're right on this. Right. And then I probably have lost 20 purchase orders over the years because of a shipper screwing something up and that works out to millions of dollars over the years of business. Because what happens is people will say, and I'll tell you like one example, which is really counter intuitive, the most difficult thing to ship documentation wise, our small orders, demos, trials, samples are very, very difficult to ship from a documentation perspective, but they're very expensive to do the paperwork. You're sending a hundred pounds of samples to somebody and the paperwork might cost you$1,000 to get right. So what happens is the shipping manager says, you know what, I'm just going to send this with ups and I don't mean to insult ups or Fedex or DHL here, but what happens is you basically say, why should I spend extra money on a small package when ups, I'll send it down for$200 but that it gets there without the right paperwork. Customs takes a look at it and they say, okay, this is fishy. I'm going to hold onto this, and that happens a lot. You shipped down to tons of stuff without the right paperwork. Customs is usually going to look at it and say, well, this makes sense, but if you send down five pieces of something and the papers don't make sense, customs is going to, they might hold onto it. That might make it disappear. You'd never know. Right. So I always tell people, one of the first things they want to do with, they see that they're planning on scaling up, they're international sales is get a new shipper and get a shipper who can help you with the documentation.

Julio Martínez: 34:32

Fantastic advice, Zach. I mean, really useful. I mean, this is what I like about speaking with experience executives like yourself because you provide actionable items for listeners and I'm sure people find these very insightful and useful. All right, sack moving along. What about compliance? What's been your experience with corruption or bribery in Latin America in light of the FCPA,

Zach Selch: 34:59

first of all, again, I'm really, really careful with my distributors and with the people I work with because you can't really afford to mess up on this one. Right? I'm really careful. I always tell the distributors lucky that you got to make sure that you comply with this. We get them to sign papers, say they're going to comply with this part of my distributor agreement, that kind of stuff. And I know I've lost deals over the years over it. Honestly. I also sell an Africa and other parts of the world. So I would say Latin America is nowhere near the worst place in the world for this. But you still see it, you gotta just be careful about it. You can't be at the position where you say, you know, okay, I'm just going to wink my eye and pretend it didn't happen. You gotta be pretty careful about it.

Julio Martínez: 35:47

All right, very good. Last question, let's speak about the last area that I have in my list here and before we move on to the closing remarks. What about that regulatory approvals or market clearance in countries in Latin America once you stake on this?

Zach Selch: 36:04

So you got to take into consideration, this is a group of countries, so it's not like Europe where you get CE and boom your cupboard. On the other hand, most of them have a reasonable relationship with the United States. So if you have FDA, it's going to make it relatively easy for you to do it. So if, just going back to what I said before, I like to pay somebody to do this so that I as a manufacturer can own the regulatory approval and the registration and I've never had any problem with getting anything regulatory approved. If it had, if it was a reasonable product and had FDF, it's all a matter of time and money, but it's a lot easier than for instance, CEO. I've had problems with CE where we actually had to make changes to our product to get CE approval and I've had problems with some other places and other developing countries where getting approval was difficult. I've never had a problem with getting regulatory approval in Latin America.

Julio Martínez: 37:05

Yeah, you bring up another good point, which is the fact that there was recognition of CE mark or FDA Market clearances. So as you have either one of those or actually five Canada, Japan,

Zach Selch: 37:20

right, Canada, Japan, CE, FDA, and one other one.

Julio Martínez: 37:23

Yeah, exactly. So you should be said in that the American. All right, Zach. So are there any other areas that we haven't mentioned? I mean, we cover how to obtain regulatory approvals, we cover distributors, we cover pricing, end user demand generation. Again, we cover rotation compliance. Are there any other areas that we haven't covered that you think listeners should be aware of?

Zach Selch: 37:47

Nope. But can I give a quick pitch, Julio?

Julio Martínez: 37:50

Absolutely. Yeah, go ahead.

Zach Selch: 37:52

So yeah, I have a day job. I'm a VP of sales for a company, but I also do a training program and a coaching program for international sales managers. So please look me up on linkedin. I also have a website called global sales mentor.com and uh, I, the training programs and coaching and mentoring for people who are getting into, well not just people who are getting into it, but if you're a global sales manager or an export sales manager, a regional sales manager, and you think that you could use some, uh, additional training, some additional support, some additional coaching, that kind of thing, please do reach out to me. Cause that's, that's my, uh, my side Gig.

Julio Martínez: 38:38

Excellent. Yeah, I like that. Alright. What about before we close the shows Two things. One is your thoughts on trends in Latin America. Do you see anything coming to the region that will make the medical device business better or, or something?

Zach Selch: 38:58

I would say there is a worldwide trend. Health care is very expensive in the United States. Right? And as people become more comfortable, why shouldn't they hop on a plane and go down to Columbia or Mexico to do hip replacement or that kind of thing. And it started out with cosmetic surgery or for dental stuff. But now really, I mean there is some fantastic surgery available and fantastic procedures available in parts of Latin America at a fraction of the cost of what you'd get in North America. Right. And I think we're gonna see more and more of that because there's also a pressure on people, less people in America or maybe not less, but certainly the numbers of people insured and America isn't going up. It might be going down, but it's certainly not going up. People need to get healthcare coverage someplace. So I think we're going to see more and more medical tourism of high pretty serious stuff in Latin America. So that's, that's one thing I always say, I keep my eye on the growing middle class. So again, we're seeing growing middleclass of different parts of Latin America. Yeah. You take a look at the places like Brazil where somebody's grandfather might have lived in essentially a hut, right. And eaten beans and rice and bread a couple of times a day. And now that same person has a little car and he lives in a high rise apartment and he has to television and you know, he's middle class and he also wants better health care. Right. His grandfather was perfectly happy going to the clinic. I'm waiting in line for her, you know, now this guy wants to go to a nicer place. He's willing to pay a little bit more for it. So you're seeing in a lot of these markets, more private medicine, medicine with a better patient experience, those types of things. So I'd say those are in my mind, the big trends that I've been watching and I've been involved in.

Julio Martínez: 41:00

Okay. Very good, Zach. All right. So before we close, any final thoughts to our listeners? In other words, what would you say to a small or midsize medtech company, they haven't looked at Latin America or it is just starting to explore the region. What would you say to that CEO about the region, about the potential?

Zach Selch: 41:22

I would say, look, the single best way to grow the value of a company is to expand your international footprint. And the best to start, I mean the low hanging fruit is Latin America. So if you're in Cleveland and you're selling, you know, a couple of million bucks a year and you have a really nice market position with your product in America, the next step is probably to go into, you know, Mexico, Brazil, Colombia, right? And then you leverage that to go into Europe and Asia. But if you're only selling in America, even if you have a great market position, there's a really a ceiling on the value of your company. But if you're selling in 28 countries internationally, you're probably gonna triple the value of your company. So if you're looking at this and you're the CEO, the person you were talking about, Julio, you're the CEO of a company that makes some type of medical product. You make a quality product. You're based in, you know, and I throw out the word Cleveland or Pittsburgh, or the way you're going to grow, the value of your company to pass on instead of passing on a$20 million company to your family, you pass on$100 million company to your family is to grow your international footprint. And the first step for that is to reach over to Mexico or Colombia or Brazil. That's my opinion.

Julio Martínez: 42:45

Well said. I like that approach. All right. Excellent, Zach. It was a true pleasure to have you here. Well, nowhere AP episode.

Zach Selch: 42:55

Thank you. Thank you for having me, Julio.

Julio Martínez: 42:58

And much success with your training program. It sounds like a very appealing value proposition for new leaders that wanted to expand their footprint in that thing America.

Zach Selch: 43:07

Great. Well thanks for your time.

Julio Martínez: 43:09

Okay. Bye Bye. Take care.