Q&A with Zachary Edmonds, MD, Palo Alto Medical Foundation Hospitalist; Fogarty Institute Mentor

Zach Edmonds shares his view on the intersection between medical practice and innovation

On the surface, you may not realize how many traits clinicians and entrepreneurs share, but Zachary (Zach) Edmonds, MD, has been able to successfully pursue both fields. While he was intrigued by the human body and its ability to heal and adapt,

he was simultaneously enchanted by the unique aspects of the patient-clinician relationship. These dual interests led him to pursue both his MD and MBA from the University of California, Los Angeles.

While completing his internal medicine residency at Stanford University Medical Center, he became fascinated by the entrepreneurial environment on campus and throughout Silicon Valley, which instilled a deep interest in developing medical device technology to improve patient care.

He decided to apply to the Stanford Biodesign Fellowship program where he and his team focused on muscle loss prevention in hospitalized patients. The team eventually formed Niveus Medical, becoming one of the Institute’s first companies-in-residence. At the same time, Zach began his career as a hospitalist for the Palo Alto Medical Foundation (PAMF) at El Camino Hospital. His involvement with both El Camino Hospital and Niveus initiated what is now a long-term relationship between Zach and the Fogarty Institute.

Today, Zach continues his practice as a successful hospitalist at El Camino Hospital as a site director for PAMF; while retaining strong ties with the Fogarty Institute, where he mentors entrepreneurs and helps select incoming companies-in-residence. In addition, he spearheads the Lefteroff internship’s physician shadowing program, further cementing the collaborative relationship between the hospital and Institute.

We recently had the pleasure of catching up with Zach to seek advice for interns interested in a medical path and entrepreneurs in the early phases of developing medical devices.

Q. Given your involvement with the Lefteroff internship, what do you see as its chief value for those interested in pursuing a career in life sciences?
The program is a great opportunity to expose young, passionate, open-minded individuals to innovation; not just as a concept in a classroom setting, but in a real-life, hands-on situation where they work with startups. It also gives them great exposure to healthcare and the problems we face on the frontlines of acute care delivery. This kind of experience is hard to come by even in medical school.

Last year, I was thrilled to have the opportunity to expand the shadowing element of the existing curriculum. With the most recent class, each intern spent two to three days with a variety of clinicians in the hospital with the option to choose between 10 different specialties, including anesthesia, neurosurgery, orthopedics, cardiac surgery, hospital medicine, emergency room, cardiology, obstetrics and interventional radiology. The response from both the interns and the clinicians was so positive that we are expanding the program to include many more physicians this year.

Q. What advice would you give to students/interns interested in becoming physicians?
Focus on the investment it takes to become a physician to help you determine if it is the right path for you. It’s easy to take the default route of going from college straight into med school, without confirming that it is truly a passion and mission.

You need to do some soul searching aimed at what the “costs” are – medical training is so involved and requires a great deal of sacrifice. While your friends are graduating and entering the job market, you will still have years ahead of you in medical training. You need to understand what day-to-day life is like both during training and as a physician.

The best way to gain insight is to seek exposure to as many different physicians as you can and ask what they like and don’t like and what they would have done differently. That time spent upfront is very valuable. It’s wise to explore other options that may seem equally rewarding, even if you eventually end up going back to med school.

Q. What advice would you give to entrepreneurs in the early phases of developing medical devices?
Never underestimate the importance of identifying the unmet clinical need. Don’t get too excited early on about the solution and technology – you need to first fully understand the problem you are trying to solve. Moreover, you need to make sure it’s a problem that people truly care about and is worth solving.

When observing physicians to find a significant unmet clinical need, the key word is “observe;” don’t ask the clinician what the pain points are. It’s best to watch and see where they struggle and where it is possible to improve the process.

Once you fully understand the problem from all angles and identify a solution that promises to deliver high clinical value, you also need to consider cost-effectiveness. Improving outcomes is no longer enough for the FDA and investors: You need to improve care and do so less expensively. Our system is too expensive and we continue along a path of decreased sustainability. We need to apply the “green” thinking to healthcare: Do more and do better with fewer resources.

Q. What is the best way to engage clinicians?
Learn as much as you can about a physician’s specialty. If you are prepared and have done your homework ahead of time, you can spend your time focusing on what is not efficient and effective when you go observe a case, rather than needing to absorb everything.

In addition, I cannot stress enough the importance of focusing on the clinical need. By nature, the physician will want to talk about solutions. While this may be tempting, it will take you away from fully understanding the need and give you a biased view of the problem, and also gets you into the murky area of intellectual property development without the proper structure and protections in place. Remember that you are there to observe and NDAs have not been signed, so stay focused on the need and avoid jumping into solutions and ideations.

Q. How did the Stanford Biodesign program help you in your career?
While I eventually chose to pursue a clinical medicine path versus an entrepreneurial career, the program and its method of innovation training installed life-long skills that I still use in my daily professional and personal life. We are always solving problems, and the fellowship helps provide the right mindset to do so effectively. It helped me understand the value of fully understanding a problem, and then trying a solution that might not be perfect, but taking the lessons learned to quickly improve on it and try again. This iterative mindset is invaluable to me.

Q. What is the most rewarding aspect of your job?
The connection and relationship I have with my patients and their family members.

I feel tremendously honored and blessed to have the ability to diagnose and treat an individual with an acute illness or help them walk through what is often challenging news, such as a new cancer diagnosis or end-of-life care.

I also like to stay involved with innovation by supporting the Institute, such as helping entrepreneurs understand why physicians act and think the way they do, and in turn, connecting our physicians with entrepreneurs so they stay abreast of new technologies and engaged with fresh ways of solving clinical problems.

I feel I have the best of both worlds: As a physician, I have the opportunity to focus on and improve the life of one person at a time and enjoy that special relationship. And by being involved in innovation, I can help impact more lives.

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