Episode 69

The Pulse of Innovation

with Michael A. Mussallem

June 23, 2022

Michael A. Mussallem
Chairman and Chief Executive Officer, Edwards Lifesciences

Michael A. Mussallem was appointed chairman and chief executive officer of Edwards Lifesciences in 2000, when it became an independent, publicly traded company. Under his leadership, Edwards has established its position as a global leader in patient-focused medical innovations with the introduction of lifesaving and life-sustaining therapies such as transcatheter aortic valve replacement, new resilient surgical valves designed for active patients and non-invasive hemodynamic monitoring. Driven by a passion to help patients, the company collaborates with the world’s leading clinicians and researchers to address unmet healthcare needs, working to improve patient outcomes and enhance lives while delivering value to the healthcare system. Mussallem has not only led the development and successful implementation of the company’s patient-focused innovation strategy, but also established Edwards’ commitment to philanthropy and corporate social responsibility. Since 2004, the company and Edwards Lifesciences Foundation have gifted almost $90 million to non-profit organizations around the world supporting underserved patients and strengthening communities where its employees live and work. In 2014, Edwards Lifesciences Foundation launched Every Heartbeat Matters, which has impacted more than 1.7 million underserved people and aims to improve the lives of 2.5 million additional underserved structural heart and critical care patients by the end of 2025. During Mussallem’s tenure, Edwards has been recognized among the World’s Most Ethical Companies by the Ethisphere Institute, an organization that defines and advances standards of ethical business practices. In 2019, Edwards was named as one of the Management Top 250 by The Wall Street Journal in partnership with the Drucker Institute, and was also cited as one of the 8 “all stars” achieving high marks in five dimensions of corporate performance. Mussallem has been honored by the Harvard Business Review in its annual Best-Performing CEOs in the World list, including, most recently, in 2019. He has received a number of honors including the UC Irvine Medal, a lifetime achievement award from The Phoenix Conference and the Wenger Award for Excellence in Corporate Leadership by WomenHeart. Prior to his current position, Mussallem held a variety of positions at Baxter International from 1979 until 2000, when Edwards was spun off from Baxter. Currently, Mussallem serves on the board of the Advanced Medical Technology Association (AdvaMed) and is an advisory board member for the Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California. He is a trustee of the University of California, Irvine Foundation and the Rose-Hulman Institute of Technology in Terre Haute, Indiana. Mussallem has served as board chairman of both AdvaMed and the California Healthcare Institute (CHI). In 2004, he joined the board of the Edwards Lifesciences Foundation. He received a bachelor’s degree in chemical engineering and an honorary doctorate degree from the Rose-Hulman Institute of Technology.

 

You can't change the practice of medicine unless you put real evidence on the board that says the new way is better than the old way - and do that in a highly credible scientific fashion.

Transcript

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[00:00:06] Gary Bisbee, Ph.D.: Heart disease is the leading cause of death in the US. We sat down with Mike Mussallem, Chairman and CEO of Edwards Lifesciences, a medical technology company leading the way for heart treatments. Mike shares the interesting founding story of Edwards and highlights the advancements they have made in heart valve and critical care technology. Edwards strives to create triple wins, treatments that extends patients’ lives, improve their quality of life, and save money for patients and the health system. One of the ways Edwards accomplishes triple wins is by developing less invasive and higher accuracy treatment options. Edwards is committed to developing evidence of efficacy and they’re currently operating nine clinical trials. Evolving value-based payment models is a goal, and Edwards works closely with CMS in that regard. Edwards encourages a culture of innovation, not just by rewarding innovation, but also respecting failure. In times of crisis, having a strong culture and strategy to fall back upon is paramount. Mike believes that Edwards has a responsibility to the patients they serve, and that mission is baked into their approach to innovation, technology, culture, people, and strategy.

Well, good afternoon, Mike. And welcome.

[00:01:29] Michael A. Mussallem: Thanks, Gary. My pleasure to be with you.

[00:01:32] Dr. Gary Bisbee: Well, we’re pleased to have you at this microphone. As you know, this show is about leadership and how leaders pursue excellence. You’ve been an incredibly successful leader for over 20 years, actually, at Edwards Lifesciences. We’ll get to that in a moment. But first let’s get to know you a bit better. What was your life like growing up, Mike?

[00:01:54] Michael A. Mussallem: Well, thanks, Gary. And thanks for the kind intro. Yeah, you might wonder about my last name. It’s actually Lebanese and all my grandparents immigrated about 120 years ago to this country with this idea of dreaming big about a new future. And they came without much. And that’s a proud part of my heritage. But I grew up in Gary, Indiana, which is a steel mill town. It was a very diverse sort of climate, lots of people just trying to pull themselves up. We were always working. I had just a wonderful home life with spectacular parents who basically dedicated their lives to give their children a better life. I was one of three boys and my older brother actually had born with Down syndrome. And my brother George became just the centerpiece of the family, just such an incredible source of love. As a matter of fact, my mother quit her job just to be able to help him and organize the other moms that were in similar circumstances. So that had a real impact on me. I, learned a lot during those years about people taking advantage of the skills that they had. And I think about all the things that my brother George accomplished, just like reading and writing and handling money. And I think it rivals anything that I’ve done in my life. But anyway one of the things that’s nice about being in a steel mill town is you could get a job in the steel mills, which helped me fund my education because that was a good paying job back in the days. And I also had some of my first business experience of being a paper boy, I know people don’t even know what that is now, but I had responsibility for delivering 72 papers every day. And actually even the more fun part, collecting 35 cents from these 72 people every two weeks. And, you learn a lot about people and about reliability and about showing up every day. And some of the basics that I think were just formative for me.

[00:03:49] Dr. Gary Bisbee: Do you think that your leadership style takes anything from your parents, Mike?

[00:03:54] Michael A. Mussallem: Oh, yeah, absolutely. It did. And my parents were wonderful. They were a little more mature when they got married. And my dad was the total optimist. As a matter of fact, he used to tell me all the time, you can do anything. And my mom was just the strength within her family. She was one of a number of kids and the boys clearly got preferential treatment, but my mother sort of stood out as the true leader of the family and she, in her own quiet and highly credible way, were the ones that people turned to for, what do you think? What should we do? Where do we go? And I learned a lot from just being around my parents.

[00:04:32] Dr. Gary Bisbee: Do you think that growing up with your brother George had anything to do with your ending up in healthcare?

[00:04:39] Michael A. Mussallem: Yeah. I think it probably does. You end up thinking a little deeper about life when you have a brother like that. And so I’m sure that that had impact on me. I can tell you that my wife coincidentally also had a brother with Down syndrome. And so that’s the source of our philanthropy today. And so we think about, okay, how can we make a difference? As a matter of fact, we think about delivering healthcare for those with Downs as being an underserved area that we’ve tried to put a dent in.

[00:05:09] Dr. Gary Bisbee: So you graduated from Rose-Hulman Institute of Technology with a chemical engineering degree. What were your aspirations as you were going through the program, Mike?

[00:05:20] Michael A. Mussallem: Yeah, it’s a good question. I sometimes wonder how I got there. I mean, I liked chemistry and math and I had a high school teacher that said, hey, you might wanna consider engineering. And I chose chemical engineering for, I don’t know, probably pretty shallow reasons, one of ’em being, I heard they made a lot of money when they graduated. And, I was definitely thinking about that back in those days. But it turned out to be an incredible opportunity for me to really learn. Rose was special because it had small class sizes and I was kind of an immature kid, glad to be out of the house, looking to have fun, almost too much fun. It was a good place for me to grow up. It wasn’t all straight up. But along the way here, I developed some maturity and started focusing on actually learning for learning’s sake. And I really grew up going through that experience.

[00:06:11] Dr. Gary Bisbee: Now you’re a board member at Rose and you and your wife, Linda, have been very supportive, facilities and scholarships and so on. Where does that commitment come from, Mike? How do you think about that?

[00:06:24] Michael A. Mussallem: I look back and I’ve been able to, do things and achieve things that I would’ve never imagined. And a, big part of that was my education. And so I look back and say, boy, I would love to give others that same kind of opportunity and how could I help Rose touch even more? And so one of the things we did was to support a new student union there, which was a place where they could relax and unwind a little bit during the stressful engineering career. And then we also support scholarships and especially scholarships from the region that I came from, that Northwest Indiana and south side of Chicago, where you didn’t necessarily have a lot of kids going into engineering. And to be able to offer several scholarships per year that included a leadership experience and an international experience with the idea that maybe some folks are gonna get a shot that I got in life.

[00:07:15] Dr. Gary Bisbee: I’m sure you’re very proud to be sitting on the board, but does it ever feel a little bit strange that you’re on the board of the place you actually attended college at?

[00:07:24] Michael A. Mussallem: Oh, boy. It absolutely does. I would’ve never imagined that. I mean, I was always looking up at the professors and the big guys in the school and think that they were at some level that was in the stratosphere compared to what I was thinking about my own aspiration. So yeah, it is kind of strange, but that’s also what’s rewarding here is you have a chance to just be part of creating brighter futures for these folks and give ’em a chance to dream big and do something special in the world.

[00:07:54] Dr. Gary Bisbee: Well, well done, Mike, I think it’s terrific. Why don’t we turn to Edwards Lifesciences, which actually was a spinoff from Baxter, where you were employed at the time. What were the circumstances, Mike, that you became the first CEO of the independent company, Edwards?

[00:08:12] Michael A. Mussallem: Yeah. So this could be a long story or a short story. I’ll compress it a little here, Gary. I spent 20 years at Baxter. It was a great place with a lot of talent. And it was a meritocracy, I would say. It was a place where, if you got something done, they gave you more to do. And I really had a chance to grow up in medical technology at Baxter. And so, by the time I was getting toward the end of that, I had some serious manager responsibility for the cardiovascular business, which ultimately became Edwards, plus some other big businesses in Baxter, like the biopharmaceutical business and what was going on in Asia. And so, we were going through it or doing our strategy planning and the cardiovascular business of Baxter just was underperforming. It was a small part of Baxter was under 10%. And when you analyzed it, it just was performing poorly, which was a contrast to the other cardiovascular technology companies. And when you looked at, what was the problem, my view was the innovation had stopped. This very innovative company that had been created decades before had sort of lost it and had gotten into a grind of just becoming more and more efficient and not really changing healthcare. And we said that has to change. And so we suggested three options to Baxter: either start pumping money in this, buy another company and bolt it on, or exit. And Baxter had success with exits. And so I raised my hand and said, I would love to do this. And so, April 3rd, 2000, we rang the bell in New York. And if you had five shares of Baxter, you got one share of this new thing called Edwards Lifesciences. And we were off to the races.

[00:09:53] Dr. Gary Bisbee: Looking back on your 22 years at Edwards, do you think of yourself as an operator or an entrepreneur or both?

[00:10:02] Michael A. Mussallem: Yeah, that’s a good question. I think each of those can get a label that can sometimes be unfair. People can look at an operator as somebody that has their head down and are just grinding to make things more efficient. And sometimes they think of an entrepreneur of somebody who doesn’t have their feet on the ground, and is always jumping to the next idea. But I like to think, and especially, I think it’s true in Edwards, and I think of myself. I was sort of raised in many ways as an operator, but I’ve always had this entrepreneurial mindset of creating something special and dreaming big. And as a matter of fact, we try and run our company that way today, to have a wide variety of people with a lot of skill sets, those that are really great operators and those that are big thinking entrepreneurs. And I think that’s where the magic is, actually, because you can’t really change something like healthcare without both dreaming big, but operating at a very high level of quality.

[00:10:57] Dr. Gary Bisbee: It’s always interesting to hear the CEO describe his her company. So could you describe Edwards for us, Mike?

[00:11:04] Michael A. Mussallem: Sure. So we have evolved over the years and, although we’ve had a rich history in cardiovascular disease, we’ve actually narrowed the focus and we’re very focused now on structural heart disease and critical care. We’re fortunate to be a global leader. We’re just about in the number one position in everything that we do. And our strategy is all about focus, innovation, and leadership. And we like to go first. We like to dream about great, big, ground changing innovations, knowing that we’re gonna have to back it up with big evidence and it’s gonna take years. So there’s a long term nature to what we do. But going for big, bold innovations that are gonna change the practice of medicine. And then it’s all grounded in a common culture and that’s so important to our company. And our ours is built around focusing on patients. But I’m happy to talk more about this, but I’m really proud of where we are today and, as good as things look, I feel like the best is yet to come.

[00:12:03] Dr. Gary Bisbee: Well, I think we have a general idea of the heart valve technologies, but you’ve done some amazing work there. Could you just share with us kind of the highlights in that space? TAVR obviously comes to mind.

[00:12:19] Michael A. Mussallem: Sure. Well, when you think about it, many of the things that Edwards has done, would’ve been more at the late stage of cardiovascular disease in our early years. More surgical, if you will. And think about, it’s a miracle to see open heart surgery in action, but you’re actually cutting open somebody’s chest, opening their heart, pumping the blood through a heart lung machine for the hours of the procedure, and then fixing the heart and putting you all back together. And that’s a pretty big assault on the body and that still saves save, continues to save, and it will always be an important part of medicine. But the idea is, boy, what if you could do something through a tiny catheter and you could come in through an artery or a vein and do the small miracles at the tip of a catheter that a surgeon does with their hands. And, that’s what we’ve learned to do at Edwards. And being able to replace an aortic valve in an aortic stenose valve has turned out to be our single biggest business. And that’s been a procedure that now is done routinely in under an hour with the patients lightly anesthetized going home in a day or two and has been just a remarkable development for these patients. And so that’s what I’m proud of. And then we dream ahead and we say, okay, what else can we do to start treating the disease at an earlier stage, rather than waiting for it to be so severe and then going through these desperate measures, can we do things to make it much more approachable while the disease is still manageable?

[00:13:50] Dr. Gary Bisbee: I mean, it’s really amazing. What about the critical care technologies? Can you share a bit of that with us, Mike?

[00:13:58] Michael A. Mussallem: Yeah, absolutely. We’re very proud to be a global leader in this space and I would generalize and say, what we do is hemodynamic monitoring. So kind of think of the performance of the heart, which is especially important when you’re going through a really big surgery or you’re in an intensive care unit. And so we’ve always distinguished ourselves as being the most accurate at that. But the evolution that’s going on now in that space is to say, yeah, it’s nice to be accurate, but what more can we do? And our global leader there, Katie Szyman, likes to use the term, to “smartify” those products. And what she means is, can we actually be predictive? Can we look at the past trend that’s happening with this patient and suggest that, hey, there’s an 80% probability that, 15 minutes from now, that this patient is gonna go to a very low blood pressure condition. And those kind of things are gonna be game changers. The opportunity to close the loop on some medicine, like, for example, fluid replacement, those are gonna be really exciting developments for the future of critical care medicine.

[00:15:04] Dr. Gary Bisbee: What percentage of your businesses is outside the US at this point?

[00:15:08] Michael A. Mussallem: So we’re about 60% US, 40% OUS. And some of that depends on the currency movements. Of course, when the dollar just got stronger, like it did, that changes the percentage. But when we look ahead, actually we think, outside the US is gonna grow faster than the US. Just our technologies are not as penetrated outside the US as they are inside the US. And those economies in general are getting bigger and stronger, and they prioritize their spending on health. And so we expect that to grow at even a faster rate than the US in the future.

[00:15:41] Dr. Gary Bisbee: Does a situation like Ukraine, does that cause a disruption at all in your supply chain or your business?

[00:15:50] Michael A. Mussallem: Yeah. So, there were never many surgeries in Ukraine and that was not a major source of supply for our company. So, from a supply chain perspective, not very disruptive. But we have a number of people that have Ukraine heritages, Russian heritages for that matter. We have a pretty good size office in Prague. And so, really caring for our people became a key concern because they were pretty stressed out by what was going on over there. And to be able to be not only just empathetic, but to provide philanthropics to those people that needed it was something that they, I think, really looked to the company to be supportive in.

[00:16:30] Dr. Gary Bisbee: The trend these days on the part of consumers is to spend as much time at home and as little time in a hospital as they can. And a number of your procedures, as you just described them, have substantially cut down hospital length of stay. But as you think about innovation going forward, is part of your calculus figuring out how you can kind of minimize time in a hospital and do more and more at home, or is that impractical with the kind of devices you’ve got?

[00:17:02] Michael A. Mussallem: It’s a great question, Gary. And when you go big picture, what we constantly strive to do is what we call the triple win. If we can extend people’s lives, if we can give them a better quality of life and we can somehow save the system, okay, now we’ve really done something special. And when it comes to saving the system money, there’s not many things that are more expensive than just the resource utilization that goes by hospital days or even days in the ICU. So when we can create therapies and procedures that don’t have a patient have an extended length of stay or doesn’t cause them to have an ICU stay, or maybe you don’t even need an anesthesiologist in the room, those kind of things are very efficient and allow the system to get better and faster and consume less resources and still give the patient an incredible gift. So it’s a clear direction for us. And we constantly strive to make a difference in that regard.

[00:18:03] Dr. Gary Bisbee: Well, the Edwards credo is interesting. “Helping people is our life’s work and life is now.” I love the last phrase, life is now. Where did that phrase originate from, Mike?

[00:18:16] Michael A. Mussallem: You’re gonna laugh. So, I mean, we are clearly patient focused and it is our life’s work, but “the life is now” more refers to the fact that there’s an urgency to our work and that these patients can’t wait. This is a progressive disease and it’s dangerous. But I have to tell you, while we were forming the company, this goes back to ’98,’99, John Cougar Mellencamp had a song called “Your Life is Now”. And it is funny. I’m a music lover and that phrase probably stuck with me and we really thought it had a lot of relevance to what we planned to do at Edwards. And so, yeah, some day we’re going to have to get John to come out to campus and us.

[00:18:53] Dr. Gary Bisbee: That would be very cool. I’d like the invitation to that event. That would be very cool. Well, going back to when you first took over Edwards, you mentioned that really was important to kind of create the innovation part of Edwards that might have been lost. How do you go about doing that?

[00:19:11] Michael A. Mussallem: So, there’s a few aspects of it. Some of ’em just have to do with the money. You need to be able to invest in this. And so whenever we got some extra capability, we would invest it in R and D. And so that was a big part of it. But the other part of it is cultural. It’s a mindset. And I became a student of innovation and I think we all thought about it very deeply. How do we create a culture that really embraces innovation and part of it was actually simpler than you think. And that is, how well do you deal with failure? Because if you’re gonna reach very high, failure is gonna be a regular part of your life. And especially when we’re trying to do these bold things with medical technology, you’ve gotta be able to stand up, admit your failures, and also come up with suggestions on how to fix it. And that culture of living with failure on a routine basis became really important. And then also just simpler things like, hey, when you get a milestone done, you get more money and you try not to get tied to annual budgets. And actually reward people for innovating, not just reward ’em for selling more or making more.

[00:20:22] Dr. Gary Bisbee: Edwards has been very successful with clinical trials. How many trials do you currently have underway, Mike?

[00:20:28] Michael A. Mussallem: Yeah. It’s humbling for me. In the early days of Edwards, if we had one major pivotal trial going, that was typical. Today, I think we have nine. And these are big, randomized clinical trials that will lead to regulatory approval, lead to guideline changes, lead to adoption changes. And so very proud of that. And then separate from that, we’ve got a handful of what we call early feasibility studies, where the technology’s just early yet. Not ready for a big pivotal clinical trial, but in its early stages. And so it’s an exciting time. We are out collecting a lot of evidence because, if there’s one thing that we know, Gary it’s you really can’t change the practice of medicine, unless you put real evidence on the board that says the new way is better than the old way. And doing that in a highly credible scientific fashion. And that’s a big partnership with the healthcare systems.

[00:21:19] Dr. Gary Bisbee: Building on the old way and thinking about payment models, Mike, DRGs were developed in the 1970s and 1980s. And now life is much different or certainly the sort of innovation that we’re coming to these days. And I would just wonder, is the current payment system adequate given the way things are now? How do you work your way through that, Mike?

[00:21:46] Michael A. Mussallem: Yeah, so it’s a really important point. And in the US, we work very closely with CMS, so we need to make them partners early on in this, in the system. And we specifically try and generate data that will be helpful for them. They’re trying to decide whether something is reasonable and necessary and providing data that supports their system is really important to getting payment. Now we’ve gone through a process we’ve called national coverage determination. So rather than having a patchwork across the country, there would actually be a national policy for procedures like TAVR. And the new things that we’re working on, we tend to work through that process. So we’re able to work with it in a very productive fashion. Now, do we think there’s opportunities for improvement? Absolutely. One of the things about the way the DRG system works right now is it’s always keyed off what was the spending last year. And when you have procedures that are getting better and better and better like ours, it means that the rewards, if you’re a healthcare system, are getting smaller each year. And you’d wonder if you really wouldn’t wanna incent innovation and lower cost and better healthcare rather than incenting the things that tend to be expensive. It’s just one example. Also kind of tough when you do a big value add from a company like Edwards for a procedure like TAVR, it’s tougher for rural hospitals because they don’t get the same reimbursement rate that you might get in a big city hospital.

[00:23:15] Dr. Gary Bisbee: So a number of our audience are health system executives, Mike. How does Edwards work with health systems?

[00:23:23] Michael A. Mussallem: Yeah. So, I mean, if you think of a company like Edwards, I like to say to some extent, we’re the tool makers for the physicians. So these specialists that we work with, we have a very, very close collaboration. It’s actually where many of our innovations come from, it’s this great partnership between physicians and the technical people in a company like Edwards. And so, making sure that those folks have the opportunity to do fantastic procedures every day and have great results is of key priority for us. And that’s shared by our health system. So the health system actually is the purchaser of our products. And so we work very closely with them in that regard. And they’re also the ones that get the reimbursement from the government. And many of our patients are over 65. So having that math all work is so important. But our collaboration with physicians is essential and it’s central to everything we do. And it goes beyond physicians. It’s actually, it’s all the staffs of the hospitals that try and make it all work.

[00:24:25] Dr. Gary Bisbee: COVID has brought a lot of attention to resilience. And I’m wondering, with a company that’s as focused on innovation as Edwards is, what’s the right balance between innovation and resilience in terms of how you allocate your resources?

[00:24:42] Michael A. Mussallem: When it comes to resilience, I mean, I put that in the category of, we have a responsibility to the people we serve. We’re the market leader. We can’t run out of heart valves. We can’t let people down that are counting on us. When they’re counting on us to be there to support a case, we need to be there. And so having systems that are robust and a culture of people and talent that are committed is so important. And so that culture and having redundancy in our system, not being in a single plant or with a single supplier, but having backup systems, is so important. And we’ve been fortunate to be beneficiaries of some past good strategic planning. But we’ve also been beneficiaries of just a really committed team. I mean, our team just were gonna show up every day. We asked them to please do that and they did it. And so that’s important. When we think ahead, we think about just with some of the dislocations that have happened, we know that if we have facilities in the US that support the US, in Europe that support Europe, in Asia that support Asia and they can back each other up, that we’ve probably come up with the most robust and resilient system. And so that’s the way we think about building our system so that it will withstand these shocks.

[00:26:00] Dr. Gary Bisbee: Over the course of your 22 years at Edwards, the company has grown substantially. How has that affected your leadership approach, your leadership style? Have you had to adjust over this period of time, Mike?

[00:26:16] Michael A. Mussallem: Oh, yeah, boy, I’ve really grown up a lot during that period of time. And I’ve adjusted a lot too, as a person, as a leader. I’m fortunate to be surrounded by just incredible talent at this point. And one of the things that I probably do is do less micromanaging than I used to do. And I find out that instead of getting surprised on the downside, more than not, I’m getting surprised on the upside with the kind of things that people think of and are able to implement. And it’s a real joy to be part of that and sort of realizing what my role is and to help people be their best is the best way that I can be successful and not necessarily being involved in every single decision. And I also have just learned a lot about the importance of culture and emphasizing that culture and having a culture that we all can rely on each other becomes so important, especially when the world gets chaotic.

[00:27:11] Dr. Gary Bisbee: In times of crisis spike as a leader, what special skills, characteristics are important for a leader in a crisis?

[00:27:21] Michael A. Mussallem: Yeah, it’s a good question. And some of it depends on the crisis, of course. But staying calm is really important. Staying kind of humble and really listening and learning the facts about what just happened and what is the impact on the world that we serve and the patients that we serve and thinking about that deeply is important. And having a strategy and a culture that you can rely on that, regardless of the chaos that’s in front of you, that your own team kind of knows what you wanna do and what’s important. And so our group knows, hey, patients come first. No matter what happens, we focus on that. And then we can work our way through the rest of the list later.

[00:28:02] Dr. Gary Bisbee: So given the COVID timeframe that we just went through, what was required on the part of the Edwards management team or leadership team? Was there anything special that you needed to institute there?

[00:28:18] Michael A. Mussallem: Yeah, it’s a good question. I mean, especially the early days of COVID, every day was a school day. We were just learning so much about this disease. We knew very little about it and how it affected people and it was humbling, right? And you had to admit that you really didn’t know what tomorrow was gonna bring. And overall, one of the things that we learn, especially as being a global company, that instead of tightening our grip on the steering wheel, we probably felt that our best bet was to loosen our grip on the steering wheel and to let our local leaders make decisions that were in harmony with their local situation. And we just tried to give ’em some big ground rules, which says, please take care of your patients. Please keep your people safe, follow all the rules in your own locale, and make it work. And could we really support hospitals every day when they needed us? This became our goal. And it worked out great. And again, we were able to lean on our culture in a big way when we went through COVID and actually there was less direction from the top and more just empowering people to do what they knew was the right thing to do.

[00:29:25] Dr. Gary Bisbee: So you speak about leaning on your culture. Do you have to do anything special about reinforcing that culture over time or does it just kind of take care of itself?

[00:29:36] Michael A. Mussallem: No, it definitely doesn’t take care of itself. I think, personally, you heard the old expression, I think there’s a book, that “culture eats strategy for breakfast”. We’re kind of a believer in that, that culture is so important. And for us, the centerpiece of the culture is patients and helping patients. It’s why we say our company exists. And trying to bring that to life for people every day through storytelling, through real life examples. And we’re actually pretty good at making short vignettes, little movies that we routinely show at pretty much every time we have an employee meeting of any sort, where it’ll tell somebody’s life story, a little bit of who they are and where they come from. And then they ssuffered with some ldebilitating set of circumstances, able to go through a procedure, come out the other side, and get their life back together, and the impact on their family and their life. And, just to have them say, hey, thank you, team at Edwards for your role in this just means so much. And we constantly try and remind our folks of that. And one of the things I’m most proud of is we do surveys like other companies do as well. And one of the questions we ask is, do you think about patients each day when you make decisions? And over 90% of our workforce says yes. And so it’s so gratifying to say that it’s front and center for our team.

[00:30:59] Dr. Gary Bisbee: Mike, this has been a terrific interview. We appreciate your time. I’ve got two wrap up questions if I could. And I’m sure you’re asked both of these questions as you go through your life as a leader. But first one. For a young person who’s interested in innovation and interested in medical devices, what advice would you have for that person?

[00:31:21] Michael A. Mussallem: Yeah. My pleasure. I don’t call it medical devices. I call it medical technology. I think we’ve grown out of devices at this point. And the broad point is, do we think that we can improve healthcare through technology? I just absolutely believe that there’s so much for us to do and we’ve made great advances. I like to say that, you compare the treatments that our grandparents had or our parents had to what we have, and it’s dramatically different. We’ll look back at 2022 and we’ll smile at how primitive we were when we think about the things that are possible. And you could enter this industry and absolutely change the way that medicine is practiced and do so much for these patients that I think it’s a very rewarding way to spend your life.

[00:32:08] Dr. Gary Bisbee: Final question, somewhat similar, but for up and coming leaders, not necessarily in medical technology, but for up and coming leaders, what advice would you have for them, Mike?

[00:32:19] Michael A. Mussallem: Yeah. And I assume that most of the leaders that we’re talking to Gary are those in healthcare. And boy, if there’s one thing that we got reminded of as we went through the pandemic ,it’s the value of health. And if you don’t have health, I’m not sure what ground you’re really standing on. It’s such an important part of all of us and our families. And to be able to be in a career where you’re actually improving health, I mean, I don’t know what is more rewarding than that. And it’s much more complicated than people think, and you get pulled in so many directions. Healthcare’s fragmented, as we know, and it’s complex. And there aren’t always clear answers. But, just stay focused on the people that we’re serving and the patients we’re serving and allowing yourself to bask in the glow of knowing that you made lives better and you made families happier is an incredibly rewarding way to live a life.

[00:33:12] Dr. Gary Bisbee: Great advice. Thanks Mike. And thanks again for your time today. And congratulations on such a terrific career at Edwards. Very impressive.

[00:33:22] Michael A. Mussallem: Thank you, Gary.

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