For Trevor Gibbs, MD, inspiration struck in the OR.
“I was doing a difficult rapid-sequence induction and had set my supplies on the patient's chest, as many providers do, but the items fell off just as I needed them. The patient's oxygen levels were going down, and I was frustrated,” he recalled. “I decided then and there to buy an anesthesia stand after that surgery.”
But when Dr. Gibbs sat down to do so, he hit an unexpected roadblock: there was no such thing as an anesthesia stand on the market. Believing he was on to something, he subsequently created the world's first. The Anestand, which launched a year and a half ago, clips onto I.V. poles, operating tables, beds, and gurneys, and steadily holds supplies close by while providers induce anesthesia, nerve blocks, I.V. starts, and arterial lines.
Author Toni Morrison once famously advised, “If there's a book that you want to read, but it hasn't been written yet, then you must write it.” In a similar spirit, anesthesiologists are reaching for practical tools, only to find they haven't been invented yet.
So, they're creating them.
Forging his own path
Dr. Gibbs admitted figuring out the first step was the hardest part; he mulled over the Anestand concept several years before making his move.
He started with a sketch, thinking through ways an anesthesia stand could adapt to various settings and procedures. He sought free guidance from SCORE, which matched him with a retired engineer who had experience in product invention: he advised Dr. Gibbs on filing a patent and directed him to a prototyping lab where a CAD sketch and, subsequently, a prototype of the product could be generated using a 3D printer.
It took months to get the initial prototype right (“I kept calipers in my bag, and I measured the dimensions of everything in our workspace,” mused Dr. Gibbs). In due course, a higher-quality functional prototype was printed. Dr. Gibbs consulted a lawyer and formed a small corporation, obtained product liability insurance from a commercial agent, and hired an independent regulatory agent to obtain required safety clearances from the U.S. Food and Drug Administration.
Once Dr. Gibbs used the stand and was happy with it, the manufacturing process began. Dr. Gibbs produces and warehouses the Anestand near his home in Naperville, Illinois. He stayed directly involved through every step of the marketing process as well, which included hiring a graphic designer to create a product logo, a marketing firm to put together a professional website, and independent sales reps specializing in anesthesia supplies to get his product in hospitals throughout the country (Figure 1).
All in all, it took about three years, a six-figure investment, and continuous self-education to get the Anestand on the market.
“It was a complicated endeavor, but it's been worth it. I've enjoyed learning and figuring out this whole process,” said Dr. Gibbs. “I started all this because I wanted an anesthesia stand, and there wasn't one, so I made one. If it all fails, I still have my stand, so there's no way I can lose.”
Partnering with an established company
Although the invention journey of anesthesiologist Adrian Matioc, MD, started out similarly to that of Dr. Gibbs (an unmet need, in this case for a more ergonomic, asymmetrical face mask, followed by intensive researching, patenting, and prototyping), his path took a different turn when he opted to partner with a medical device company to produce the ErgoMask rather than start his own business (Figure 2).
“When you sign a licensing agreement with a company, you basically sign over your patent for the life of the patent, they produce the product, and from there you receive royalties,” explained Dr. Matioc, who is retired and lives in Madison, Wisconsin.
The route is simpler because it hands over complicated and costly processes, such as regulatory clearances and manufacturing concerns, to a business with experience in those areas. Yet transferring responsibilities comes with a loss of control. A few years after Dr. Matioc signed a licensing agreement with a Midwestern company he enjoyed working with, the company was sold, repeatedly – and ended with an owner that opted not to pursue the ErgoMask.
“We severed ties because they didn't have interest in the face mask,” Dr. Matioc said. “I ended up licensing with a Chinese company, Tuoren Medical, which at this point has sold a fair amount of the face masks in Asia.”
The expertise Dr. Matioc acquired to create the ErgoMask (as well as an advanced oropharyngeal airway mask he has yet to license) yielded other opportunities. Years of research into basic airway management and the history of general anesthesia led to multiple articles in anesthesiology journals, chapters in professional manuals, and even fellowships in the history of anesthesia at the Wood Library-Museum of Anesthesiology, in Schaumburg, Illinois, an experience he especially cherished.
“Clearly, it's been worthwhile. I didn't make a lot of money, but the academic journey has been fantastic,” he said. “Plus, the ErgoMask is out there being used, and that makes me happy.”
Perfecting through collaboration
Brian Cohen, MD, anesthesiologist and co-owner of Miami Anesthesia Services in southern Florida, ventured into product creation after meeting a tech entrepreneur focused on using technology to drive better habits and behaviors.
A visit with a Silicon Valley business incubator, in this case an invitation-only IBM Cloud Garage, helped Dr. Cohen and his partners distill abstract ideas into the primary focus of a new venture, called Adaptrack.
“...anesthesiologists are reaching for practical tools, only to find they haven't been invented yet. So, they're creating them.”
“That experience was a blast,” said Dr. Cohen. “I went from pushing propofol all day to wearing a hoodie in San Francisco. It was a different world, and it was incredible to see how we went in with 50 ideas of what we could do and left three days later with a single focus: risk management for physicians.”
The next two years were spent developing, demoing, and improving the Adaptrack digital risk awareness tool, which launched in June 2020 (Figure 3). The app uses short statements of content, or “nudges,” to present information about behaviors and risk factors proven to lead to medical malpractice claims, practice inefficiencies, or burnout. Users who engage with the content are rewarded with CME credits and malpractice insurance discounts.
Thanks to his partners' experience in tech creation and business, Dr. Cohen – who has experience in the field of medical malpractice – has been free to focus his efforts on ensuring the tone and quality of the Adaptrack content is right for physician users.
During a recent visit with a prospective customer, Dr. Cohen was taken aback when asked if he was an anesthesiologist.
“He said, ‘More and more, the products and teams I meet with, the physician driver behind is usually an anesthesiologist.’ I found that interesting,” Dr. Cohen said. “Like when you buy a certain kind of car and start noticing more of them on the road, everywhere I looked, I started seeing anesthesia leaders playing in that space of product development.”
The strengths built through clinical practice lend themselves to the work, Dr. Gibbs observed.
“Anesthesiologists are trained to solve problems, and that is a huge part of entrepreneurship,” he said. “Those skills cross over very well.”
Jolynn Tumolo is an award-winning writer with more than 20 years of experience covering the health care field. She graduated summa cum laude from West Chester University, where she earned a BA in English with a concentration in journalism.