E140 Mark Soliman on SurgeON, Developing a New Social Media App, and Entrepreneurship for Surgeons
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Chad Ball 00:10
Ameer, it's so good to hear your voice. We've been gone for almost 6 weeks from the Cold Steel podcast, and I'm thrilled we're coming back with even more new content and exciting features. Tell the listeners about what's been going on.
Ameer Farooq 00:21
We're really, really excited about the new features that we have coming up, one of which I want to highlight, which is our YouTube channel. We're planning to release a lot more episodes in the upcoming future that will have a video component with them. We just think this is a natural fit for a surgical podcast. So listeners, and now viewers, should head over to our YouTube channel to check out episodes as they're released that will have both an audio component, which we've always had, as well as a video component.
Chad Ball 00:52
That's awesome, Ameer. We're so pleased to bring that to the listening, and now viewing, audience. Today we have an amazing, amazing repeat guest that you're going to tell us about. Welcome back.
Ameer Farooq 01:13
For this episode, we had the opportunity to bring back Dr. Mark Soliman, chief of colorectal surgery at AdventHealth Orlando, to talk about his exciting new venture to develop a social media app for surgeons. The app is called SurgeON. And Dr. Solomon talks to us about entrepreneurship, and what it really takes to build a new social media platform. As always, we'd love to hear your feedback at [email protected], or tweet at us @CanJSurg. Thanks again, Dr. Soliman, for joining us again on the Cold Steel podcast. It's been an absolute pleasure and an honour to have you on our first episode, talking about robotic surgery and innovation and all that good stuff, so I'd highly encourage all of our listeners to go back and listen to that episode. And we're lucky enough to have you again on the second — on round 2. So Dr. Soliman, for anyone who hasn't listened to that first episode, can you tell us a little bit about yourself, where you're currently practising, and what's been going on with you since we last caught up?
Mark Soliman 02:14
It's been an eventful a couple of years. Yeah. Thanks so much, Ameer and Chad, for having me and the Canadian Surgical Society for this privilege. Yeah, so I'm at AdventHealth in Central Florida. I'm the chief of colorectal surgery, and it's a big blessing to be able to take care of the faculty and the hospitals that I do. I actually oversee 17 hospitals, in terms of the administration of colorectal surgery, the expansion, the recruitment, the research, the education, the hiring, and so on. And so it's been a tremendous blessing to be able to serve the community in the capacity that I'm able to.
Ameer Farooq 02:52
That's fantastic. And we're aware of all the many irons that got thrown in the fire. So, you know, one of the big things that we wanted to get you on to talk about today was this new venture that you started — I don't know how you can manage to do something like this on the side, just your side-hustle, as they say — which is this new social media app for surgeons. And, you know, obviously, in the time that we're living in, social media is an incredibly crazy place on many different levels. But can you tell us a little bit about this new social media platform that you're designing for surgeons?
Mark Soliman 03:29
Yeah, so this platform is called SurgeON. It's a play on the word surgeon, of course, and actually, basically it, during the pandemic, and even before that, and certainly afterwards, we've noticed, obviously, a massive benefit to staying connected in all forms of, in all forms of life, whether it's face-to-face events, whether it's in the operating room, whether it's from a personal perspective, and even a professional perspective, it would not come as a surprise to see that, you know, the reason, you know, Ameer, you and I and Chad and all of us have actually, you know, come to know one another through the magic of social media. And there is no doubt that social media has certainly evolved the manner in which we communicate in which we learn and in which we actually take care of our patients. SurgeON actually takes the good of Twitter, the good of Facebook, the good of YouTube, the good of Instagram, and kind of leaves the bad, and amalgamates all that into 1 surgical-centric ecosystem. It's a iOS, Android and web application that launched just over a year ago, August of 2021. And basically, it's our answer to the — let's call them deficiencies — that exist within public social media. It's a big lift. It's a very ambitious endeavour, to say the least, but it is something that myself and my partners that, kind of, bit this project off are deeply inspired by it and think that this is truly the the future of surgical social networking.
Chad Ball 05:15
It sounds so phenomenal, and obviously the potential and I'm sure where you're going to take it, it's super exciting and it's going to be unbelievable. Can you tell us what SurgeON really is, structurally, and then, particularly, what makes it unique? You know, you kind of you kind of hinted at a little bit there, but what really separates it mechanically and in terms of the delivery and the potential from the typical other social media platforms that we all use or don't use?
Mark Soliman 05:43
Yeah, so it's, um, I mean, mechanically and structionally, it is a standalone application. At the crux of it is, it is for surgeons, by surgeons, in that is a completely custom-built application, completely built — a custom-built web application, where the surgeons live at the centre of it. Data is not collected; privacy is of the utmost importance. I don't like my data being sold. I don't like my data being collected. And so that is at the centre — central ethos of us is that personal data is not collected; therefore, it cannot be sold. The differentiators of this, you know, there's multiple Venn diagrams of where the feature sets of Facebook or the feature sets of Twitter, the feature sets of YouTube are — where they excel, is in the ability to curate ads and the ability to monetize themselves, the ability to do all this. But where they fall, they're deficient, is the manner in which they encourage posting from surgeons in an anonymous, encrypted, private, protected manner. So at the central ethos is that privacy is the encryption. It's the idea that we are all in this together. It's all about the idea of advancing surgery as a unit, together. Other — also, we find that there's tremendous capabilities of public social media, but where the same thing is of the deficiencies are. For example, there is no discoverability — not discoverability in a legal sense — but I can't easily discover, for example, what's happening in, as a colorectal surgeon, I can't easily see what's happening in my urologist's operating room, what's happening in my gynecologist's operating room. And just like I want to go to — I want to peek through the window of OR 7 while I'm in OR 9 next door to see what my gynecology colleagues do and how do they handle that ureter, or how do they handle that ovary, for example. We took that same approach in SurgeON, in which it's an open, community-centric approach in which there's 1 colorectal community, there is 1 gynecology community, there's 1 urology community — not a robotic community, not a laparoscopic community, but all the specialty exists in one central community. And it's open, so that a colorectal surgeon can easily wander into an orthopedic surgery community, and learn exactly what's happening and what ideas I can steal and bring to my own specialty. So that's kind of where we feel that the big differentiators are, in that it's open, it's encrypted, there are only verified surgeons in the application. If you're not verified, if you're not a physician, you're not in. We don't want you in that regard. We only want to ensure that we have privacy and protection of the users of the application.
Ameer Farooq 08:41
And, Mark, maybe at some point you can actually see — I've seen the little mock-up of the the app itself. Unfortunately, I don't think it's available in Canada yet. Right?
Mark Soliman 08:51
That's right. And so, and one of the reasons — we are soon to launch there, though. One of the reasons is, I'd be happy to walk you guys through it. But one of the reasons is, you know, right now we have, we verify every surgeon in the platform prior to joining by what's called NPI verification, which is National Provider Identifier. It's just an ID number that we have. Those ubiquitous identifying numbers don't exist in many other countries, in the UK, and in South America, Central America and so on. And so as we begin to scale outside of the United States, we want to make sure that the algorithms, that the data privacy policies and everything that we have in the application are solid, which they are, as we then roll out to now the next phase of our verification processes in which there's going to be a — there will be a manual verification process that has to occur once we roll out in the United States, and so stay tuned. It will be coming.
Ameer Farooq 09:52
Yeah, so at some point, I think I'll get the mock up of the video and how the platform works, because I think it helps users a lot. Or even if you want to share it now, that's fine. But we'll, at some point, we'll put it in the YouTube video for our YouTube channel, so people can actually see what the platform looks like. So, like, why not do — why not just attach yourself to Facebook or Twitter? Like I know you, like, you know, I think you and I are both part of the SAGES Facebook colorectal group. That's a very successful group. I don't know, I think it has thousands of members. And people share all sorts of content. Like, what's the downside of having stuff on other social media platforms?
Mark Soliman 10:33
Yeah, so the downside really exists in the — I mean, first of all, there's no doubt there's a tremendous amount of benefits in existing in a common space that's very easy and accessible, like Facebook or Twitter. And this is not necessarily meant to replace all that; it's meant to augment that, in a sense. The challenges occur in — where — in situations where, let's say, for example, I want to post very vulnerable — I want to, I want to post potential complications, I want to post information that could potentially have some legal ramifications to what I'm posting. And the reality is, if I post something today on Facebook, or I post something today on Twitter, I do not own that information anymore. So I can therefore never publish it, or I can therefore never use it for a podium presentation. Because I've actually, I've quote–unquote published it on a public platform like Facebook or Twitter, and they own it at that point. The other thing is, as you know, Facebook and Twitter recently and Instagram and LinkedIn and all these platforms are fraught with criticism about the data privacy and the manner in which they're actually conducting the platforms. There are lots of limitations on the platforms, one of which is the discoverability. There are multimillion-dollar lawsuits that occur because surgeons are tweeting or posting videos of patients or photos on public social platforms, in unverified environments; meaning a potential PHI gets disclosed on a public platform like Facebook or a public platform like Twitter. And these have ultimately turned into multimillion-dollar lawsuits that have taken physicians out of practice, licensure has been seized and hospitals have been censured and lost Medicare, CMS or conditional use here in the United States. So this is a big deal. And there are massive social media policies that have been instituted in multiple institutions because of these lawsuits. And the reality is, there's not much trust at the moment in Big Tech and in Silicon Valley and so on.
Ameer Farooq 12:48
And I think maybe we'll circle back to that, the whole issues with social media in a second, maybe get your thoughts on, like, the future of Twitter and stuff. But what do you think — you know, there have been other, there are other social media platforms for physicians out there, like Doximity. And I even saw something else the other day on Twitter that someone was posting about, but like, you know, I get the sense that none of them have been particularly successful, particularly for surgeons. Like, you know, you think about the American College of Surgeons had this, kind of, communities thing that they had built into their website. I don't think it was particularly successful. What do you think, like, how is your — what's your vision for doing things differently, so that people actually find value in joining hopping off Facebook and Twitter?
Mark Soliman 13:34
Yeah. I think that, for one, to think that a mass migration of a very confident population, like surgeons, overnight [from] something familiar to something new. First, to think that's going to happen overnight is laughable, to a certain extent. And so we have to be 10x better than what the other platforms offer. And one of the many reasons that we feel like we are 10x better — actually, we've seen exponential growth of the platform over just the short year that we've been actually out, is the feature set that exists and the, kind of, the totality of the community. I'll give you a quick example, and I'll show you this if we have an opportunity for me to demo the application, but let's say right now, I have a robotic case in the morning that I need to review for, and there's not really a good — I mean, where do I go to review that? I'm going to go to Facebook. I mean, Facebook is fantastic, but the problem is you can't pull those posts back out. I may have had a phenomenal conversation on Twitter a week ago, a month ago, a year ago, but there's no prayer of me to get that back out. So one of the manners, or one of the ways, that we're 10x better in those regards, is our ability to catalogue and retrieve posts, and then retrieve specific videos or webinars, or those who have images in it, and rank order them according to the true community vote and not the vote of an algorithm of someone that is not a physician, for example. So I think where some of the other institutions and other organizations that have tried this is, they did it, of course, with the best purposes in mind and, of course, with the best intent at heart. But I think that we're taking a slightly different spin on this, because we're not just for general surgery, we're not just for colorectal, we're not just for 1 specialty, but we're for any procedural specialty. And we've taken it to that level with all the different feature sets that we've, kind of, built in. And, you know, really, what we've done is, we've taken a competitive landscape analysis in which we've looked at what are the really good things about Facebook and what are the problems; same thing for Twitter, same thing for YouTube. And we looked at basically all the problems that exist, and there — a few themes arise when you take that approach. One of the themes is post-categorizability. In other words, you can't really retrieve those posts. One of those is fragmentation; you don't know where to go for a specific specialty. One of those is physician verification. I mean, right now on Twitter, you have no clue if a physician that actually says they are, you know — Dr. Ameer Farooq is actually Dr. Ameer Farooq. You think he is because he kind of looks like, you know — but you don't really, really know, because anyone can spin up an account. So physician verification is also one of those problems, thematically. So when you actually take it, there are 5 pillars of thematic problems that emerge, when you take a true audit of all of the current public social media platforms. And effectively what we've done is, in a very algorithmic and the most scientific manner possible, we have mapped solutions to each one of those thematic problems, and that's basically where the feature set of SurgeON was built. So we hope that these thematic solutions that we've come up with, designed for our colleagues by us, by us surgeons, doing user testing, ensuring that the manner in which we're addressing a specific problem truly solves, truly is the solution, or a solution, to a problem. And we're quick to respond to the feedback of our colleagues. We hope that that actually allows it to be adopted even quicker. And we've seen a tremendous, very, very robust and very heartwarming, kind of, uptick in the utilization of SurgeON.
Chad Ball 17:40
That sounds so exciting. You know, Mark, just listening to you, you've already, you've already taught me, personally, so much about the landscape in the last 15 minutes here. I want to drill down a little bit, if you're willing, on the concept of verification, not only because I think it's probably at the forefront of a lot of people's minds given Twitter and the discussion in general broadly right now, but you know, not to be too personal, in Calgary here, we've had 2 physicians, 2 surgeons actually, commit suicide in the last 6 weeks or so. And when I listened to you, and how you describe this platform, it seems like if you can get the verification piece, and the privacy piece and the security pieces, solid and really different from all the other examples you mentioned, then this could be a really safe space to talk about some of these issues that maybe are beyond the clinical context of what we do every day. I'm curious if you can, sort of, drill down on the verification side of it. And if you see a vision for that sort of sharing, nonclinical, conceptual domain.
Mark Soliman 18:51
Yeah. Actually, Chad, thank you so much for bringing that up. You know, physician verification is a big deal. And right now everyone on the platform has a blue checkmark. We have verified their identity. We know who they are. We know their taxonomy. We know the state they practise in, not because we've, we're collecting this or that information, but we use it for verification, and then it's gone after that. And when we go international, it's going to be a 2-step verification process in which you, you know, obviously a university-type email plus an ID badge to ensure that you are who you say you are, is part of that process, because I want to make sure that if I'm truly opening myself up for — Guys, I had this terrible complication. What do I do? How do I handle this? What would you guys do and what would you guys kind of — How would you handle this? I want to make sure that I'm actually speaking to trusting colleagues that is not going to take it and use it against me as competition, or use it, sell it to the press or leak it to the press or have the press themselves use that for a lawsuit, for example. And so, you know, this is a very, very, very, very, very serious thing that we've thought extensively about, and actually we've gone, we've had multiple health care attorneys, multiple firms, help us out with the best verification process to get through this, we designed, I think, a pretty, pretty robust methodology to do it. And to that point, and Chad, kind of, to your, what you were mentioning, is we actually, we don't just have surgeons on the platform. We actually have psychiatrists, and we have coaches and self-help coaches and psychologists on the platform for self-care communities and also palliative care communities. You know, taking care of surgical patients is not just: cut, you know, cure, move on; it's how do I, as a high-functioning, type-A individual, manage when my surgeries fail and I hurt a patient? Or when I'm not at my best, and I'm very, I'm very vulnerable and I can't show my trainees and I can't show my nurse practitioner. I don't even want to go show my wife how I'm struggling with something. Sometimes the only person who will understand me is another surgeon, who has been through, you know, 7, 8, 10 years of training, just like me; who has been up all night, stressing out about a patient. Sometimes the best person is somebody that has walked in my shoes and walks in my shoes today. And so we take very seriously to ensure that the people that you're talking to are who they say they are, and can truly lend a helping hand. And, you know, we've had, we have had physician-assisted — pardon me — We have had self-care community and depression and PTSD as a surgeon, webinars that have been hosted on the platform already by psychiatrists and self-care coaches. And, you know, those are probably some of our best attended webinar streams that occur and those that are actually consumed in post, because it's such a prevalent issue, because it's sad when anyone takes their life, but it's, it just tears at your heart, when it's a colleague of yours that lost, that lost their lives and, you know, ultimately sacrificed themselves because of a calling that — which we were all called into, medicine and, you know, yeah, it's a sad situation. But I think that, you know, if this offers a scintilla of help for 1 person, then it was all worth it.
Chad Ball 22:24
Yeah, I couldn't agree more. You know, you have that sense, I think, like we all do in those situations that if there had just been the right opportunity for, you know, personal disclosure and a safe environment, that perhaps the outcome would have been different. So I, you know, I'm really excited about your platform, and I think it could be not only revolutionary, but really game-changing on the nonclinical side as well. You know, when we — just to switch gears here a little bit, I think when we all listen to you, your passion for this, and the importance of this comes through, but also your language. You sound like an entrepreneur, which is, which is so great, you know, and I mean that in the best sense of that word; some of them here are our best friends in Canada, I would also classify as entrepreneurs, entrepreneurial surgeons. I'm curious where that bug comes from, and what the initial exciting trigger has been for you for this, because it's really exciting.
Mark Soliman 23:20
Yeah, thank you. You know, I think that in each of — in the heart of each surgeon, we fix problems, right? I mean, if something's broken, we fix it. If there's a cancer, we take it out. If there's a bone broken, we set it. Entrepreneurship is not necessarily very different than that. We see a problem, we find a solution for it. And although this is a, you know, this is not as binary, black and white, do — you know, this is broken, put a stitch in it. This is a little more complex, in that it's multiple, multiple complex layers, and there's not 1 single particular solution to this. And I think that the complexity of trying to solve this massive, this massive issue of privacy, encryption, physician verification, categorizability of posts, CME and bullying, and all these things that occur within a certain kind of social media, that that challenge actually kind of brings out the surgeon in me, in which we want to fix it. And I think that that's, that equates very nicely to that entrepreneurial spirit in which we will stop at nothing to help our patients. We will stop at nothing to make sure that we're delivering the best, most evidence-based care. And I think that this doesn't, it's not very much different than that, in that we're going to do — we're going to do research to figure out what the best features are for the platform. We're going to figure out what are the big problems to solve. We're going to distill it down to the common root causes of what are the true issues, and attack it according to that, and you know, I would say we literally take people apart and put them back together for a living — and we do, mostly successfully. And so I think that for us to build a little application like this, and you know, deal with complex issues like we're dealing, is not nearly as complex as surgical decision-making and rectal cancer or whatever, but we can learn it just like many other people do.
Ameer Farooq 25:20
Can you tell us a little bit about what that process was like of building a team? Because it is different in one sense, in that, you know, yes, there's a team in the operating room, and yes, you have to manage that team. But this is very different. This is not something that you can really just drive by pure force of, well, like, you have to build a team, you really have to think about, like, there's a whole process in which you can build a company like this. So can you tell us a little bit about like, what went into developing this company? And how did you go about it? And what was your team like? And all that kind of stuff?
Mark Soliman 25:51
Yeah, thanks for that. And you know, it actually, there was 2 other surgeons and a finance guy; Mario Leybo, who's a general surgeon out of Albuquerque, New Mexico; Jeremy Heffner, who's a trauma surgeon, a robotic surgeon, out of Lima, Ohio; and Joseph Griego, finance guy, CPA, out of Albuquerque, New Mexico. We actually — Mario started the company, and then brought a few people on. And then within a few months there, they contacted me because of some of the surgical video content that they saw online that I had been producing. And they said, we want to build an application centred mostly around videos and, kind of, product descriptions and, you know, surgical products and surgical devices. And, you know, we — it was a fantastic idea, a revolutionary idea — but at the time, it certainly needed a little more thought and research. And we did that. And we, kind of, corralled the team. We corralled the minds and, and that's when we started reading books. And I read and read and read and read and read and watched about, I think a million YouTube videos. I went to YouTube University, and I think about startups, and you know, all the different technological incubators that exist, understanding exactly how a startup is launched, and exactly how they fail and exactly what to learn from failures and from successes. And I feel like it's no different than an M&M. I feel like it's definitely no different than prepping for a case. You see how how you can arrive at success — there's multiple paths to get there; how people have failed. And it really what it comes down to is you just become a student of, a student of the trade. And it's not without failure, it's not without persistence and it's not without truly being bought into it. And I think that any one of us, I think, in surgery — you know, if you go into this profession for money, you will be the most miserable person ever. And I think if you try to go into a startup like this, for the, for the, for the belief that you're going to be, you know, the next, you know, Mark Zuckerberg, or Elon Musk or whoever it is, you're going to be sorely disappointed, because it's never an overnight success. It's a over-10-years success. It's that quiet perseverance, that 10,000 hours, that you have to put into a project that's going to grant success ultimately, and I think that that entrepreneurial spirit really came from residency, in that it's persistent. You're up at 4 in the morning every day. You're working out, you're reading, you're studying, you're just hammering the books, you're showing up, you're doing this, you're failing, you're succeeding, you're failing, you're succeeding, and you hope to succeed more than you fail. And, you know, the team that we built is not dissimilar to any one of our OR teams. It's not dissimilar from the team in our clinic, in that, you know, you become the — the surgeon becomes a captain, if you will. I quickly came — took over as CEO of the company in terms of the directionality of it, because of the, just because of the, I think, the, the sheer will and the sheer muscle, we're trying to just get through it. And, and through that became the idea of building teams playing upon people's strengths, knowing that you can't necessarily build up on someone's weakness, but play up the strength and find someone else to fill in a gap of a weakness that exists on a team. Whether it's on the development team on the marketing team, the finance team, the CME team, the content team, recruiting people to the platform, recruiting key opinion leaders to run each of the communities; each and every one of the team has a key role. And each one of us has a sphere of influence that we've created to ensure the success of the platform. So it's a lot of love, too. So, here we are.
Ameer Farooq 29:52
Was there anything surprising about the process that you didn't know about? You know, like, we've all been, sort of, we've seen Shark Tank. You know, there's The Pitch podcast. Like, there's, we've been exposed to entrepreneurship. But, you know, you wonder how accurate some of these portrayals are. So, was there anything surprising about this whole process that you didn't think about?
Mark Soliman 30:13
Yeah, definitely how hard it is. You know, we figure, you know, we've been through surgical residency, we've, you know, trauma surgery, and all this sort of stuff. And there's no, no doubt, it's hard. But it's that quiet persistence that, that venture capitalists and that, you know, carwash entrepreneurs and, you know, the people on Shark Tank, you know, you know, [Robert] Herjavec and all these people on Shark Tank and Mark Cuban always talk about. I [inaudible] them, because they're not, they're not me, I got this. And sure enough, you realize that it's that quiet, deliberate persistence that absolutely, they're not lying about. You're going to want, you're going to want to quit. You're going to find issues. You're going to find obstacles. You're going to find challenges. And the people and entrepreneurs that succeed, according to them, and what we're seeing, is that those that are able to thrive in different climates and thrive in different obstacles, and truly grow something out of it. And it's not dissimilar to the current health care climate that we have right now. I mean, almost every single hospital system, at least in the United States, many of them are underwater, in the sense that they pulled in less money than they collected. And we're using that, at least in my hospital system, as an opportunity that, we're creating, basically, lemons out of lemonade. We're finding opportunity and chaos. And we're trying to figure out like, okay, in this hurricane, in this tornado, in this storm, in this mess — How can you capitalize on it to improve the care of patients throughout the community? And it's exactly what we're doing in SurgeON, through the chaos that's occurring in Facebook, through the chaos that's occurring in Twitter right now and through all the different issues of social media — How do we capitalize it to ensure that the integrity and trust is at the central centre of this? And it's hard. It's really, really hard. Capital is hard to come by, and a lot of it's bootstrapped, and a lot of it's just, basically, again, by sheer will and muscle to get to where we are. Mark, you know, obviously, this is such an exciting idea. And there's clearly a value proposition here. What, what, how do you envision this becoming self-sustaining? Or, is there an opportunity for, I mean, obviously, I'm not trying to drill down into to business side, but I'm just curious, like, for a fledgling social media company, how do you actually think about building revenue? I hope you're not going to make us all pay $8 for... No, no, no. So, the application is similar. Think of it like a SAGES meeting or ACS meeting. You know, the reason why those meetings are able to be done is by industry grants, by unrestricted educational grants, sponsorships and subscriptions, and, and also, member benefits and whatnot. And so we've taken a very similar approach, in that right now, we're funded a lot by unrestricted educational grants to produce webinars on the application. So we offer regular CME facing webinars — that is our continuing medical education webinars here in the United States — and you guys have similar. And so we basically charge some companies to actually allow us to produce these, and we get back unrestricted educational grants that basically help keep the hosting and the development going. Similarly, there's, there's — so that's one side of it, the educational piece of it. But of course, we have the industry sponsor piece, one of our main industry sponsors at the moment that we collaborate with is Intuitive Surgical. And Intuitive Surgical, actually, we have an integration with them — the first of its kind, and we're super excited about it, in which anyone that has the My Intuitive application on their phone is able to register for SurgeON, and it immediately becomes verified in the platform. And what that does is it pulls in from My Intuitive all their case data, how many numbers they've done, what hospitals that they operate at. It allows, again, just an extension of their ecosystem onto a surgical social platform like this. So that's educational grants, sponsorships, and a few of the things are like what we did here in Orlando, the Orlando Colorectal Congress, and we have many other meetings coming up, in which we actually have a full event application built in. So, for example, you go to a SAGES or ACS or, in our case, the Orlando Colorado Congress, there's a full meeting app in the application in which you see who's speaking at the meeting, who's attending the meeting, you can chat with those participants, you can visit a user's profile and see, alright, Dr. Farooq's speaking at these 3 different meetings across the year. And I can see exactly which lectures he's given, and I can see a history of every lecture you've given. So we've basically been able to weave all of these things together, so that meeting hosting was also an additional vertical revenue source for us. And so, and, you know, and the list goes on as to how these are funded.
Ameer Farooq 35:27
That's so exciting. And if I could just make a comment, you know, like, clearly one of the neat things about this is you've leveraged so many of your connections and the things that you've done in the past, and really integrated that into the app. Right? Like, you know, the connection with Intuitive [Surgical], the connection with, you know, the other broader core community. I know, you know, the virtual colorectal surgery sessions they now host on SurgeON as well, every Sunday. So like, it's pretty, you know, you think about, like, what is all this different work that you've done? How does that play into things? But clearly, you know, all the work that you've done up to this point, it all builds on itself. So that's pretty amazing. I'm curious, just to go off on a tangent for 1 second: What do you think is going happen with Twitter? Like, it's just a great total madhouse. Do you think there's some secret genius plan under all this, or do you think Elon Musk has bitten off more than he can chew? Like, and maybe more specifically, do you think physicians should be getting off Twitter?
Mark Soliman 36:27
I mean, of course, I'm, you know, I have a measured approach to Twitter. I think that there's absolute benefit to Twitter. I think that there's so much momentum behind Twitter. It is a massive train that's running 100 miles an hour, it's difficult for 1 specific individual to derail it in its entirety. You may slow it down, there may be obstacles in its way, you may tar and feather it, you may cause issues to it, but I think there's enough momentum behind it and platforms like Facebook, like Reddit, like YouTube, for example, that you're probably never going get rid of it, but you may change the public perception of it and who interacts with it on the daily. I think, you know, what we see, for example, on Facebook is the daily and monthly active users on Facebook are actually declining. They've been declining for some time with a younger age population. And we're seeing it in, now, kind of, our age group is also, kind of, leaving Facebook in droves because of the privacy issues. Twitter right now, we're seeing a massive uptick in the number simply because it's kind of like, I want to see what that car accident's looking like; I want to see the mass chaos that's occurring. I don't know how sustainable it is. Having said all that, I do think that Elon Musk's vision of converting Twitter into that public square, taking that WeChat approach in which it's, yes, it's public conversation, its payments, NFTs, cryptocurrencies, chat, encryption, and all these things, video, monetization. I think he is, I think, conceptually, there's a lot of really great things in that. The methodology by which he's going about it, I think, can be debated. But I mean, listen, he's bought, he's built some insanely successful companies that people thought were basically impossible to do. So I wouldn't count it out. I'm excited to see what he's doing. And just like when you have 1 robotics company, people kind of question the platform, but when you have many more coming to the foray, it tends to validate the technology and validate what's happening. So in this case, I think that there's a lot of validation that's occurring. And I think that the competition is very healthy, to push Twitter, to push Facebook, to push Reddit, to push SurgeON to be even better than they already are.
Chad Ball 39:09
Very, very well said. You know, you've talked about some of the DNA that is synonymous in surgery and building an entrepreneurial endeavour, like you have. Outside of that, do you have any, sort of, Coles notes or general thoughts in terms of advice for surgeons trying to work their way into that entrepreneurial space? Whether it's tech or social media, or whether it's developing a widget, whatever that is, what sort of advice, looking back, in terms of the process you've gone through, would you give others like us?
Mark Soliman 39:47
Yeah, I think there was, there's 1 book I think that probably helped distill this down the best for me. It's called The Lean Product Process. The author's name is escaping me at the moment — it's on my bookshelf back here — but The Lean Product Process. And in that, he talks about, basically, solving a problem. And it comes down to, whether it's an instrument, whether it's a website, whether it's an app, whatever it is, solve a problem big enough to be worthy of solving. And if you're solving problems, then that's, that's a big deal. So, for example, say, hey, you know, I built this website the other day, or I built this instrument the other day, I built whatever the other day — that's actually diving directly into a solution, as opposed to a survey, is this a big enough problem to solve? So really, the way it, kind of, really should flow is figure out what the biggest problems exist are, talk to a bunch of users, users, surgeons, nurses, whoever it is, whoever you think could potentially be that potential user to it — make sure that that user or that user group is a niche enough and target enough audience, and then find out what, again, their biggest problem is and ensure that it's a big enough problem to solve, and then pitch the different types of solutions to said problem. One of those could be, yeah, is this, you know — I need sharper scissors. Well, is it really sharp scissors that you need, or do you need a better methodology to cut that tissue? And maybe it's not scissors, maybe it's harmonic scalpel, maybe it's something we haven't even thought of yet. So instead of diving directly into solution space, truly think outside of the box about how to solve a problem that's big enough and worthy enough to be solved. And I think if you do that, that's really a start of it. And then beyond that, I mean, there's tons of books out there. Like I said, The Lean Product Playbook is probably one of the best ones to get through that product process, that minimally viable product process, and what that means and how to iterate, how to build, how to scale, how to adjust, how to speak to users — which we're obsessed with — how to do that in a in a truly scalable and limber fashion. And then beyond that, I think that in terms of, like, incorporation, in terms of getting legal opinions and trademarks, those are probably out of scope for our conversation, but really do need a good solid team to bounce that stuff off of.
Ameer Farooq 42:25
Mark, it's been an awesome conversation, as always. Where can people go to find the SurgeON app and platform? And if they want to get find out more about it, how do they get a hold of you?
Mark Soliman 42:37
Yeah, so if you just go to surgeon.app — that's surgeon, the word surgeon, dot a-p-p. Now, it'll take you directly to the, kind of the informational website. All about the platform. It'll tell you a little bit about it, what it includes, screenshots, kind of, guided walkthroughs and how it works. And also, you can download the application, just type the word surgeon or SurgeON — it's just a play on the word surgeon — in your Android or iOS app store. Again, it's US-based only at the moment, but we should be — we are imminently launching internationally. In terms of me, contact me [at] [email protected], and on all social media platforms, on Twitter, Instagram, Facebook, and in SurgeON and YouTube at @MarkSoliman. And so you know, definitely look us up, look me up. [I'm] happy to have more conversations about this.
Ameer Farooq 43:31
Fantastic. And if you have a few minutes, Mark, maybe, could you demo the platform?
Mark Soliman 43:36
Yeah, I would love to. Yeah. Alright, so let me share my screen. Alright, so you're in my phone now. And so right now, we're basically in the application — or in the, this is my phone. And you can see it's just like any other social networking application. The icon on the top left is SurgeON. So tap into it. And basically just load your SurgeON feed. And just like you would imagine, it's a social networking application, so you're going to have a feed. And right now, this is my home feed based upon my preferences. So this is, Dr. Leila Rashidi just posted a video on a colostomy reversal, a rectal stump, rectal stump leak and extensive lysis of adhesions. Actually, at SurgeON we now have swag by the way, so this stuff will be going on sale soon. I just got that in the mail the other day. But, so this is what the, this is what the SurgeON feed looks like. And you can see that there's different fees; there's a random fee, there's a billing and coding, rather community, there's a HPB community. And so basically, what it exists is that SurgeON is built specifically around community, and the whole crux and the DNA of the application is around community. So we have, for example, a colorectal surgery community, a trauma community, a cardiothoracic community, a hernia community. And let's say I went into colorectal. You're going to be able to see every post with specific regard to colorectal surgery. We see there's 1800 members, there's 510 posts. The post exists here. You can see all the live webinars that are to be occurring in this community in a couple of days. You also see the list of members here. And let's say I went into one of these videos. I can see Dr. Rashidi here, just about to do this laparoscopic — sorry, robotic colostomy takedown, you also see that she's tagged it with specific tags: colostomy takedown, robotic and colorectal. And I'll show you what that means it looks like in just a second. But what I'm able to do is I'm actually able to give her a scalpel rating — it's kind of a 1-to-5 Likert scale — about the quality of that post. And people that comment, I can also upvote or downvote their comments based upon the quality and the content of that post. Why this is important is, when you back out here just for a moment, is I can come back to the home feed, and I can say, you know what? I'm really interested in doing — I got a case tomorrow. And that case is worrying me. And I really want to watch videos. So I want to watch, I want to watch all the videos on the platform that are in colorectal surgery, for example. And I only want the abdominal cases. And I only want — let's see here — let's go to colostomy takedown. And I only want the robotic colostomy takedown videos. So I can actually filter and show the results. And sure enough, here's Layla's video, there's an intracorporeal course that I ran a while back. And that allows you basically to curate and search. But we can actually take that 1 more step. Let's say I'm actually going to search for transverse colectomy. Now I want to take it down to the individual operative step, I can actually say, you know, I want to look for robotic transverse colectomies with an intracorporeal colo-colonic handsewn anastomosis. And actually, I can do that exact same search and find all the videos relative to a handsewn colorectal robotic anastomosis. And if I wanted to be even more granular, I could say I only want those videos and Crohn's disease, I only want them in the colorectal community, for example, so I just filter only for colorectal. I only want the best videos, I don't want the 1 scalpel rating and up. I only want the 3 scalpel ratings and up. And I only want it within a specific date range. And I only want a specific user's posts to come up. And of course, this is a very tight, narrow criteria. So there's going to be many results in this. But you get the idea that there's a tremendous amount of ability, ability to kind of search for things. And here, these are just the trending posts on the platform based on the number of upvotes and the number of views that a platform — that a specific video has — like, this is a laparoscopic TAP block done by a gynecologist. It has 6600 views in the platform, for example. SurgeON also has, of course, yes, webinars, but we also have this new section called events. And this is super exciting, is because right here, this is a meeting that we just concluded. Now the Orlando Colorectal Congress, which is available now for everyone to view, we will pretty soon have all the information uploaded into the platform. But this is, let's say, for example, I'm attending the meeting. I can see okay, what are the objectives of the meeting, the accreditation statement, who were the sponsors, what things were there to do in the city, who gave us grants? And so on. But I can also say okay, you know what? What is on the full agenda for the meeting? There's a high-resolution anoscopy course on Wednesday, there was a, you know, all the plenary sessions on Thursday, I can go and sit in the malignancy session and see who spoke at the malignancy session. I can read all about the different surgeons that spoke, I can see Dr. Monson here, for example, he moderated all these different sessions at OCC and attend to that, and I can also see exactly which posts that he left on the platform as well, as an example. So this really allows us to interweave the entirety of the platform, from the meeting aspect into the, into the community aspect. And, you know, there's, of course, a lot more to the platform than this but the idea here is truly allowing the totality of surgery to exist in 1 holistic ecosystem that allows for a good encouragement and discussion. So yeah, that's, that's in a very brief nutshell what SurgeON is. I mean, I didn't go into the complexity and, you know, the posts themselves can be as simple as a 280-character tweet, or as complex as a 55,000-character book chapter, with up to 30 gigabytes of videos and media that can exist. And that's kind of what, what this, what this section here is. I can just put, you know, content according to a post. So all this, you know, I'm just randomly putting characters here, but you get the idea. And I can actually place videos and place them in a specific community depending upon what we're actually talking about, and go there. And of course, we also have encrypted private messaging in the application. So that, in a nutshell, is what SurgeON is today. And, you know, we're a year young. And, you know, we've come a long way in just 1 year. I'm excited to see, you know, where we are, and where the community takes us over the next 12-to-18 months and 12-to-18 years moving forward.
Ameer Farooq 51:00
Right. It's amazing. Like, do you, you know, like, I'm particularly intrigued by the tagging of such specific steps, because I think that would have been incredible as a trainee. So do you have someone who's, like, come up with all these tags or filters a priori? Or is that something that's sort of evolving over time?
Mark Soliman 51:24
Yeah, very good question. So we, initially, it was myself and a few of the founders just coming up with all the most common tags. And let me show you what they look like. This is what the tagging index looks like. So basically, if I choose the specialty — let's say I choose colorectal, for example. It's going to then give me, for example, what domain. This is like, is it, am I operating in the domain of the abdomen, the inner rectum or the lumen? So let's say I just picked the lumen, for example. Then it's going to give me only those specific tags of the lumen, which is going to be a anoscopy, colonoscopy, ESD, EMRs, Zenker's and TAMIS. And so I can tag it as a TAMIS operation, for example. And then it's also going to give me what's the approach. Did I use a robotic, a hand-assist, a lap, for example? And which operative step did I — is relevant to that one, to this one operation, for example. And then I can also give the diagnosis that goes to that specific operation. So in a roundabout way, to answer your question, initially, these were created by the founders of the company. But now we have many of our KOLs, our key opinion leaders, that exist in the application, bariatric surgeons, trauma surgeons, breast surgeons, residents, and colorectal, we have all sorts of different people that are helping contribute to this library, because, you know, to think that we can think of every single named operation is kind of a joke. And so, you know, if I were to change this to abdominal, for example, you're going to see that the list grows tremendously. And these are just the ones that we thought of. So the point is, there's a lot more to grow, and we continue to add operations to this. And the idea here is to truly centralize, and as the company's name is, to unify surgery. I mean, our company name is Surgery Unified Inc. The idea is we want to unify service, we want everything in the application. We want anything that has to do with surgery in the platform, and that's kind of the idea behind this.
Chad Ball 53:40
Absolutely incredible. Wow.
Mark Soliman 53:44
So let's see. Yeah, so they have chest for breast approach. And all the different operations that we've — whoops — all the different operations that we've attached to breast surgery, for example. So anyway, there's a lot more to it. Yeah.
Ameer Farooq 54:00
So, Mark, do you have moderators as well, too? Like, I know, we didn't really touch on this as much. But you know, occasionally people do get into, kind of, arguments, even surgeons. Should I say even surgeons? Especially surgeons. So do you have moderators and stuff that kind of say, like, "Hey, calm down"?
Mark Soliman 54:18
Yeah, for sure, for sure. Yeah. So let's say, for example, that like, this image here is offensive or whatever. I can actually come up here, I can report the user or I can report the post. And I say this is a HIPAA privacy violation, it's spam, it's nudity of sexual activity. And this is important, that, you know, sometimes nudity is actually completely, very appropriate. Obviously, there's an anus or a breast or a genital in the surgical context, just will be immediately vetted, immediately filtered out on, like, Facebook or Twitter, when some of it's very relevant to have here. So if I were to report someone or something that immediately goes to our team of moderators on the back end for us to moderate that content. So absolutely. And then we are very quick to act upon this stuff here, if you will, and very quick to — I mean, we are hyperfocused on the, on the integrity and the protection and the safety of the community. Hyperfocused. So while we don't moderate voice, we absolutely do monitor to ensure that the platform remains safe, remains protected and remains professional at all times.
Ameer Farooq 55:40
And folks who want to take this stuff and, like, whatever they post on here, they can still submit it to, let's say, a journal or whatever. Like, that's not, that's not considered an issue, right?
Mark Soliman 55:53
No, not whatsoever. In fact, we're very — we're not implicit, we are explicit, SurgeON does not own any content; we only want to be a platform. And this is very different from some of our competitors, because they want to own all the content, so they, you know, it's no longer yours. But we are explicit in that you retain ownership, so you never have to worry about, can I repost this somewhere else? Or, can I publish it elsewhere? And so, it's not published here. You own it, you're just kind of getting feedback, if you will. And so, many of us will actually post abstracts and manuscripts and research ideas just to get feedback from the community, and then even get help with, for example, just iterating and ideating around a project, and even a video, before we publish it and before we send it out. And it's, again, because of that express, that express data ownership that exists and stays with the surgeon and with the surgical society at all times.
Ameer Farooq 56:52
Is there any thoughts, Mark, about, for journal articles? Or, like, it's so hard to keep track of papers, and that was one nice thing about Twitter, was being able to really, like, keep on top of new papers and stuff. I know — so, beyond people, let's say, posting about it, or, or is there any specific, like — I'm intrigued by your vision of, like, having everything on the app. Right? Like, having everything that's related to surgery on the app. Is there any thoughts about, specifically, partnering with journals or even textbooks and things like that?
Mark Soliman 57:28
Absolutely. Yeah. So if I were to just type rectal, let's say rectal cancer, what we are in the process of doing is studying our users. And we've done several — whoops, that's spelled wrong — but basically, where eventually come here is a — there, yes, there definitely is a desire to partner formally with more journals — with more medical journals and surgical journals in the application. But also we have, on our roadmap, an integration directly with PubMed. And what that PubMed integration would look like is actually, you type in the search field, you can actually search PubMed directly from your application — from the application here, so you no longer have to go to pubmed.gov, you can just search it here, and then do that entire PubMed search. You can chat about the articles, the abstracts, the manuscripts, and so on from within the application — that's on our roadmap to build. And we hope that that becomes a value add to the user base as it is. But yes, we absolutely want and really, really desire to have a growing partnership with more and more medical journals, podcasts and so on, so that way, we can even centralize podcasts into 1 central area.
Ameer Farooq 58:56
Well, thanks so much again for joining us. It's been an absolute pleasure.
Mark Soliman 59:04
Likewise. Thank you for the privilege and honour. I really do appreciate it. And you know, that's, you know, you know, it's not a small project. It's a massive and monumental lift, but I feel like, you know, as surgeons we find something broken, we fix it. There's an issue; there's no challenge where that's too big for us to kind of go after. And I think as a community of very strong and innovative surgeons like all of us are here and you are on the Cold Steel podcast, I feel like we can we can truly move the needle in unifying surgery, and we want to be a part of that conversation.
Ameer Farooq 59:52
You've been listening to Cold Steel, the official podcast of the Canadian Journal of Surgery. If you liked what you've heard, please leave us a review on iTunes. We'd love to hear your thoughts, comments or feedback, so send us an email at [email protected] or tweet at us @CanJSurg. Thanks again.