Melanie (Host): Welcome to UAB MedCast. I'm Melanie Cole, and today we are going beyond the White Coat Entrepreneurship in Academic Medicine. And joining me is Dr. Ashish Shah. He's an orthopedic surgeon and a professor of orthopedics in the Department of Orthopedics at UAB Medicine. Dr. Shah, thank you so much for joining us today.

As I told you off air, I love this topic. So as we think about. The physician entrepreneurial journey, what was for you, the pivotal moment or specific challenge in your clinical practice that made you realize an entrepreneurial solution was necessary important? How did this idea even first take shape?

Ashish Shah, MD: First of all, thank you for inviting me to this podcast. And we physicians, we don't learn entrepreneurship in the medical school. But practicing either in academic practice or private practice, we see so many problems. There is discontinuity of the care information, the way it's related to the patient's, and as well as like, billing And so many other things that you come across.

So I felt like you know that when I am. Helping, like, you know, 30 to 40 patient's a day by just practicing medicine. But if I can make some changes or if I give the reaction to it, making changes in the system, and if I can give the entrepreneurship like, to that it can make an impact on thousands of millions of lives, not only in my practice.

But other practices all over the world. So it's more of, instead of making difference in thousand lives a year, we can make difference in millions of lives in a year with entrepreneurship.

Melanie (Host): I see the importance of this, and I get that, but as you say, you're. Treating so many patient's a day, how do you reconcile the traditional demands of practicing as a physician and a teaching faculty member with the high stakes, fast-paced world of startup innovation, of doing this entrepreneurial activity?

how do you do that? How do you balance? It's like balancing two very demanding or more. Three, as a teaching faculty member, how do you do that, doctor?

Ashish Shah, MD: If you ask me this five years back or seven years back when I was looking for that answer, you know? But one thing that helped me the most. number one, compartmentalize my life. Like, my clinic, my surgery hours, my routine life and everything. But on top of that, spending some time, like I started spending about half an hour average a day behind whatever I'm trying to fix it.

I started with the white board, like, what is the problem? From my angle, that's one thing. Second, I started asking the same problem. All of my clinic staff member or the OR staff, what do you think about this problem? And I started taking survey of my patient's as well.

What do you think? Like, you know, if we do this or if it could be done, that, that helped me a lot in learning. what's the problem? I don't want to bring the solution from one angle because I might be biased, But when I got 360 degree idea of the problem by talking to so many people at the end of the six months, I got very detailed knowledge of What I'm trying to fix it.

The second task started with like identifying who could be the most helpful. Because one thing you, mentioned you are right as a physician and all this busy practice is impossible to maybe get through the system at your own, but that's where you bring the different stakeholders like. I brought the information technology person on the table.

I brought my wife. She came as my partner, and she's an outstanding management person. I brought her on the table. Third, I brought the expertise of the area. That's me, that's why I started with a very small team and one part-time person working with me and started digging into that.

That's all started with the building, the small team. Initially when I was spending half an hour average, then I realized like, you know, that. I need a little bit more time. So I started spending about an hour an average and long story short, working about one to one and a half years to gather and talking to several people, not only the people that I mentioned, but the different entrepreneurs in the field, medical field, technology field.

I was able to get the grasp of the situa, what I need to do, what I want to do, And then I put the puzzle together and through the UAB innovation like we have through the Bull Harbor Institute, I was able to get the paperwork done and launch my company.

Melanie (Host): Okay, so along those lines, then, as the university environment is notorious, is often seen as slow moving. So when we think of his. Vantages and hurdles to develop and commercialize your healthcare innovations from within a teaching institute. Tell us a little bit about the unique ecosystem you operate in And it's influence on your work, because UAB is fantastic for supporting their clinicians.

Ashish Shah, MD: you are absolutely right. All of my colleagues in the different universities And so has my colleagues at UAB, they're worried about, oh, it would take four hour or number two. University will take away pretty much everything from that idea, but people don't understand until idea is not executed. It still remains idea even There's a fantastic idea.

It's a $0 value. That's number one. Number two, you have to start somewhere When I'm sitting down without sharing the email or idea with the Bull Harbert Institute. Earlier I thought it'll take hour, it'll take four hour, or they will take away more than 50% of my company. But I was surprised that when I started the communication with the team and I just started thinking more like an entrepreneur, not as a physician, and communicating with them in timely manner.

I was able to narrow down the whole process within three to four months, which is not unusual. Okay. And I had to share, very low single digit equity with the university. So. The one advice I give it to anybody or everybody in the academic institute. Number one, don't fear that university will not support, or They will take away their idea.

Now they're there to support. it's a little lengthy process, but you have to start somewhere. And when you start talking, when you sit down at the table, you can negotiate. Depending upon the resources you are using or the help they're going to provide you.

Melanie (Host): That is so interesting. This is just a fascinating topic And so needed at this juncture. So in your experience, and along those lines, you mentioned at the beginning Dr. Shah, that these kinds of things are not taught in medical school. What is the single most important skill a physician needs to acquire?

In your opinion, to succeed in this world of medical entrepreneurship.

Ashish Shah, MD: You are right. We are not taught this in medical school but at the same time we go through the longest schooling or education to become a doctor. We are a little resistance in learning. In terms of entrepreneurship, but at the same time, we have all this intellectual property or intelligence level.

So I would suggest like start thinking from the different angle that instead of complaining about the problem, start thinking how can I solve this problem? When I'm in the surgery, there are certain nails, certain plates, it doesn't work At the same time, I know how to fix that, but I'm not putting the process together or I'm not meeting the right people to wise my questions or the solution.

So what advices. Start looking at from different angle. Number two, start thinking about who could be helpful in this area. If you talk to 10 people, I bet you'll find one or two names through the connectivity who could be helpful in taking you from point A to point B And then point B to point C. Then it itself.

So much motivating. Now you already bought into that and you will continue this journey.

Melanie (Host): So now Dr. Shah, I'd like some. Specific examples and concrete evidence. How has your innovation specifically improved patient care or the educational experience at UAB? What quantitative metrics, if you can share them best, demonstrate that impact. Speak a little bit specifically about what it means. What is entrepreneurship in medical science?

What are you talking about?

Ashish Shah, MD: So I am fortunate to start several startups through UAB, but I will talk about one which is very close to my field in all of the physicians. who are practicing procedure based medicine? They face this every day. So it's called Periop ortho. I found it at UAB. So in the last five years, or last seven years, I noticed there are more than eight person cancellations and no shows for the surgery, and there are about eight.

To 20 persons of readmission And the ER visits after the surgery. Now I'm just talking about orthopedics only right now. And when I look into this and dig into the data or research from the national database and all the different databases, including UAB, I noticed the biggest problem was communication.

And second, all this problem could have been resolved just by teaching or proactive preparedness. So when I start looking into this and I brought my research team on the table. And in the last five years, I published about 10 to 15 publications myself and learned a lot. And I say, you know, I'm just publishing and doing the data only, but how can I fix this?

Why shouldn't I start fixing this thing, you know? So I dig into more than a hundred publications published from the different subspecialty of the orthopedics. I put it on the paper. What are the problems? What could be the solution? The solution is already been published in the literature. I try to put it on the paper.

Then I brought the more of the Gen Z working with me. I say, Hey, This is the problem. How would you fix it? They say, you know, we leave it the world. our attention span has gone so low. So why don't you create wide size information through the videos and.

We can do that. I said, perfect. I started turning everything into the animated videos. Now instead of giving big lectures or paper copy and those things, I brought the technology team together. I brought the social media team together, and I put everything together here, and I was able to launch this into three clinical practices.

Before the end of 2025 and I started getting so much feedback from the physician, from the patient's, from the system, and fortunately I'm launching the study on this at UAB itself in the next couple of weeks. So our basic idea is reducing healthcare dollars spent and inconvenience. Increase in confidence on the patient And the treating healthcare system.

That's what we want to pursue from this. And if I just mentioned in the last sentence, This is applicable to cardiology, GI, each and every procedure, specific subspecialty. And we already started working in that direction.

Melanie (Host): Yeah. Wow. The broader implications are just so interesting. And if we were to look ahead three to five years, what's the next big thing you believe will fundamentally. Affect or disrupt your specific area of orthopedic medicine, how is your venture positioning itself to be a leader in that change?

Because other institutions are looking to UAB to take the lead, and, so think about this forward thinking and exciting segment for listeners. where do you see this going?

Ashish Shah, MD: So I see this going in the field. Pretty much it'll be acceptable and easily adaptable to the different healthcare organization. Doing this at UAB will help me. Number one, to collect enough data to show that, hey, this many cancellation or this many REA admissions, we are able to shrink this number to this much.

We are able to save this many healthcare dollars by treating hundred or thousand to 10,000 patient's, and it's applicable nationwide into any practices. Considering, as I mentioned, we are not doing anything other than proactive preparedness and as well as education, which is the answer to majority of the problems in the world.

Melanie (Host): That is so interesting, Dr. Shah and I think that This is an important question as you're thinking about advice you're giving to residents or junior faculty members who have a promising idea, but struggle with that perceived risk of pursuing it while they're also on the academic trek. I'd like you to speak about securing that funding or institutional support, because I think that's the biggest roadblock or barrier that.

Clinicians would face when they're thinking about starting something up or if they have this great idea, criteria, pitch elements, how do you get to the powers that be and those nonclinical decision makers, the administrators, the investors, how do you get to them? What do you say to them to get them to light up, to buy into this idea and say, yeah, you know, This is something we can really get behind.

Ashish Shah, MD: number one, when the idea coming into your mind, find a mentor first who has done this, and all of the people or physician or not physician who has been successful. They all like to teach. Or partner up with the smarter people. So find a mentor. That's number one. Number two, find a time.

That's the number two. That's a very important thing. Number three, first thousand dollars or $10,000 you need to invest from your money. 'cause it's very important, even as an investor, when I come to you, when I'm looking into your product. My first question comes, who has invested the seed money?

And if it comes from someone else, then I feel like you are not investing in so first thousand or first 5,000, whatever the limit that you can spend, you need to invest that. That's the first. Second thing, when you know you are orthopedic surgeon or cardiac surgeon, when you are facing this problem, all of your colleagues are also facing the same problem.

Talk to all of them, your friends and family. That's the best investment if you believe in your idea. If you believe that you are going to spend enough time to bring the solution. Then you have to start talking. Then you bring friends and family into the picture. Again, with the help of the AI in the world, you can get so many answers.

From ai. Hey, whom can you take the money from? How should you do it? What's the equity? What can you do it? There are simple way you can take the money is a convertible note as well. That A, it'll be turning to the equity And the future type of thing.

You do that, so basically through first 50,000 or a hundred thousand dollars you could collect is just from your friends and family. So that's the next thing. After that, if you're in the Teaching Institute, if a big research department, you can go through the SBIR grants. That could be very helpful.

I know it's a tedious process where it's not impossible. I have several examples that my friends have secure up to $3 million worth of grants for his project. So. This is free money like that, and government is helping to bring the innovation. There are so many smaller grants available when you talk to the research or the business part of your university, and once you have prototype, once you have some data, then there are so many organizations that you can be the part of it.

And you can reach out to them for, regarding the funding, regarding the partnering up or testing the idea. See, by the end of the day, as an orthopedic surgeon or as a physician, I believe in the product, and when I come with the product in the market, I'm bringing a lot of credibility.

So people are looking for this type of opportunity to invest. And then it comes down to the bigger investment locally that I was lucky to get connected through my previous ventures. But once you are doing this for the two years, automatically, people start recognizing you and getting connected with you.

And the last thing into this, create your profile on LinkedIn. Create your company profile on LinkedIn. Create on the social media, which is that you fold, it's appropriate. You'll be amazed to see how many people will start talking to you about this, and they want to come and see you in-person.

Melanie (Host): Wow. Dr. Shah, you have given us so much to think of. About, and you know, we do a lot of these, but this one in particular is so full of ideas and information and I imagine it's going to get other clinicians heads wrapped around this idea and spinning in many different ways.

How can we start, what can we do? And you've given us so much to think about. This is just absolutely fantastic information. I thank you so much for being so clear with us. And so many real-world startup ideas that this has just been so informative. Thank you so much, Dr. S Shah, for joining us today and sharing that incredible expertise.

And for more information, you can visit our website at uabmedicine.org/physician dot org slash physician. That concludes this episode of A B MedCast. I'm Melanie Cole