Stanford University
Paul G. Yock, M.D. is the Martha Meier Weiland Professor of Medicine and Professor of Mechanical Engineering, by courtesy. Dr. Yock is Co-Chair of Stanford's new Department of Bioengineering and Director of the Stanford Program in Biodesign. Dr. Yock is a Stanford cardiologist internationally known for his work in inventing, developing and testing new devices, including the Rapid Exchange balloon angioplasty system, which is the dominant angioplasty system in use worldwide. Yock also invented a Doppler-guided hypodermic needle system, the Smart Needle and P-D Access. Dr. Yock is Director of the Center for Research in Cardiovascular Interventions, a Stanford facility that develops and tests new technologies in cardiovascular medicine. The focus of Dr. Yock's research program is the field of intravascular ultrasound. He authored the fundamental patents for intravascular ultrasound imaging and founded Cardiovascular Imaging Systems, now a division of Boston Scientific resulting from a 1994 acquisition for over $100M. In 1998 Dr. Yock developed a new interdepartmental and inter-school program at Stanford, the Medical Device Network (MDN). MDN helps stimulate and guide the process of biomedical technology innovation within the University. Recently MDN has been expanded under Dr. Yock's leadership into a broader research and educational initiative, the Stanford Program in Biodesign. MDN is now BDN, the Biodesign Network. The primary mission of Biodesign is to promote the invention and implementation of new health technologies through interdisciplinary research and education at the frontiers of engineering and the biomedical sciences.
Related Links: med.stanford.edu
Last Updated: Wed, Feb 28, 2007
Yock talks about the attributes of a successful entrepreneur. The key is being able to find needs and to frame them well, he says.
Yock tells the story of how less invasive cardiac techniques got started. He shares a video clip from Charles Dotter, better known as crazy Charlie
Yock talks about the interface between the universities and the industry. He talks about the rich MedTech environment at Stanford and other universities.
Yock talks about the Biotech bay - the other Silicon Valley, and how the products offered are based on the science of genetics. Medtech focuses on instruments, equipments, and is not a trivial market sector, he says. The Bay has titans like J&J, Guidant, and Boston scientific, for example. There is significant start up funding into the Medtech sector. Half to two thirds of venture funding for Medtech goes into Northern California, he adds.
Yock focuses on cardio vascular disease, which is a very profound disease - it is the # 1 killer in the western world. About half of all Medtech companies have to deal with cardio vascular diseases, he says.
Yock addresses the question: Where else is convergence happening between biology and devices? He believes that outside of the cardiovascular area, convergence is happening in local drug deliveries for many uses. The combination of sensing some condition and delivering and optimizing drugs is something that will be seen in the future, he says.
Yock talks about the fundamental problem of applying the balloon technology to dilating the heart narrowing. The balloon was too compliant. He talks about the development of a balloon that actually worked.
Yock talks about the costs versus the charges of medical stents. A cynical approach is that the actual metal stents themselves cost 80-90 cents to make and their charge is about $1200. However, there is an enormous amount of R&D effort to get it approved, he says. For example, a clinical trial can cost as much as 10 millon dollars.
Yock's final suggestion comes from Wayne Gretzky. How is he so successful? Gretzky knows how to go where the puck will be, he says.
Yock emphasizes that in MedTech, there are two forces that can make your life miserable-- the FDA and Medicare. He emphasizes the importance of understanding how medicare will handle new technology. Same with the FDA; there are different pathways through the FDA and sometimes it takes longer than a year and that can be a problem in getting a technology through.
Yock discusses the future of minimally invasive robotic surgery. He says it is very exciting and Stanford actually has a lot of expertise in this area.
John Simpson, a Stanford trainee in cardiology, thought the catheter system didn't work so he worked in his kitchen in Menlo Park to develop a catheter that is easier to use. He used a guidewire to travel down into the coronary artery . With money from Fogarty and Ray Williams, an angel investor, he started a company called ACS, which grew into Guidant.
Yock continues the story about a non-invasive cardiac technique and how it quickly had a Stanford connection. Thomas Fogarty, a surgeon at Stanford, worked with Charles Dotter and soon developed another technology - the Balloon Angioplasty Catheter.
Yock talks about how the hospitals make money on cardiac surgery, but they are concerned that the stents will take away the nice margins they have in cardiac surgery. This would mean loss of revenue for the hospital, he says.
Yock declares that the key is to identify needs correctly. He suggests that one finds an area of strong consensus among thought leaders--and then do something different.
Yock talks about next generation of Medtech and biotech innovation at Stanford. The idea behind the Clark Center is to put something physically at the interface between school of engineering, school of medicine and H&S and draw people in to start interdisciplinary collaboration between the sciences. The new department of Bio-engineering, under both school of engineering and medicine, will be housed here. Yock also talks about the BioX program at Stanford.
Yock sees tremendous theoretical progress for nanotechnology. However, he does not see the first hand hold at least in the cardio vascular area.
According to Yock, physicians characterize needs. Half of the medical inventions depend upon characterizing needs well, he says.
Yock states that the most important thing he learned in his in whole career was that in medtech, you have to keep it simple. The reason is that people in MedTech seem to have less skill, and even less patience than a typical kid in an 8th grade shop class.
Yock comments about what is going on in the region and at Stanford in the Medtech sector. Things that make up regional advantage in this sector are very similar with what is being studied in different industries, he says. A network of expertise has now been setup in this area.