Thank you so much for joining us in this interview series. Before we dive into our discussion about disruption, our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?
I came to the ophthalmic industry after taking a “gap-year” from studying to be a physical therapist. My passion in my work lies in improving the lives of patients suffering from injury or handicap. In my 24 years in business, I have spent all this time in the pursuit of improving patients’ lives through improving vision and eye health. I joined Samsara Vision to take that to the next level. We focus on the largest group of “non-preventably blind” patients; late-stage, age-related macular degeneration. These patients have no options and we are changing that trajectory.
What do you think makes your company stand out? Can you share a story?
The simple answer is that Samsara Vision is the only company innovating for patients blinded by late-stage, age-related macular degeneration (AMD), uniquely focused on bringing vision back to those who have lost it. While many companies focus on treatments that potentially slow the progression of AMD, our Smaller-Incision, New Generation Implantable Miniature Telescope (SING IMT™)* has been used in over 300 procedures already. Following the out-patient procedure and required low-vision occupational therapy, patients have returned to activities they love like dancing, painting, reading, and reading closed captions in movies. For instance, we had a Greek patient who loves American movies and can now read the closed captions, which demonstrates how good the quality of vision is that we are returning to those who were blind in their central vision before the implantation.
That small change in circumstance — being able to enjoy a movie — doesn’t sound as impressive as, say, putting a man on the moon. But it’s a remarkable improvement for the individual who was could not see in their straight-ahead vision. Further, it’s impressive technology when you think about being able to see letters against a changing background. While the SING IMT is not a cure for late-stage AMD, it reduces the impact of the scarring on the back of the retina that causes the blind spot in straight ahead vision.
*The SING IMT is approved for use in CE Mark countries for individuals with late-stage, age-related macular degeneration ages 55 years and older who meet specific criteria. It is not FDA approved in the United States and is under investigation for people 65 years and older. The SING IMT will not restore your vision to the level it was before you had AMD, and it will not completely correct your vision loss.
You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
Discipline: As a competitive Ironman triathlete, I’ve learned the importance of making daily progress towards a goal. This discipline is crucial for taking a company from early stage to growth mode, ensuring continuous progress.
Compassion: Several studies describe in the elderly the association between the loss of vision and onset of depression. Anecdotally, we also hear from our patients that they’ve felt alone and isolated as their vision prevented them from leaving their homes. Compassion for our patient population drives me and our team to improve their lives. I’ve been present for many of our 300 surgeries, and each time, I am deeply moved by the impact we have on our patients, knowing the immense potential for that person to experience a positive change in circumstances simply from receiving a tiny implant in their eye.
Experience: I’ve spent my entire career — 24+ years — dedicated to ophthalmology. Before joining Samsara Vision, my roles at Alcon and Johnson & Johnson gave me a diverse background. I’ve managed teams across multiple countries and functions, from sales and marketing to warehouse operations and customer experience. All this extensive experience contributes to my leadership at Samsara Vision.
Leadership often entails making difficult decisions or hard choices between two apparently good paths. Can you share a story with us about a hard decision or choice you had to make as a leader? I’m curious to understand how these challenges have shaped your leadership.
The hardest decision we make on a daily basis inside a growing company that is not yet at cash flow break-even is trade-offs. For example, recently, we had to say no to bringing our technology to a new market due to cost. Instead, we decided that same capital could be used more effectively in countries where we already have or are working towards market approval. While this was a smart, strategic decision, it was difficult because I know there are hundreds of thousands of patients in that other country who could benefit from our technology and by the time we expand there, it might be too late for many of them. Our decision to slow our global growth was the right decision for the business and stakeholders, but it’s not lost on me that we were passing up patients who could benefit.
Ok, thank you for that. Let’s now jump to the primary focus of our interview. Let’s begin with a basic definition so that all of us are on the same page. In the context of a business, what exactly is “Disruption”?
Disruption in business first requires a purpose and the approach requires going against the grain to avoid expected outcomes. Particularly in life sciences, being disruptive requires passion and commitment to ensure you are meeting the needs of patient communities and health providers. Finally, you need the ability to see the big picture and the capacity to put in the hard work necessary to get things to move in desired directions.
How do you perceive the role of ‘disruption’ within your industry, and how have you personally embraced it? Is it a necessity, a strategy, or something else entirely in your view?
In the medical device industry, disruption occurs when introducing new technology to a new patient group and you’re asking surgeons to change their daily practices. I compare it to making a river flow in the opposite direction, like the Chicago River, which took a dozen years and many engineers to reverse for commerce purposes.
At Samsara Vision, we’re disrupting standard, expected age-related macular degeneration treatment approaches. For example, rather than asking patients to take vitamins and repeatedly get injections (which provides little relief when patients progressively reach late-stage disease), we’re asking that patients get referred to corneal surgeons who will take a few minutes longer than standard cataract surgery to instead implant an interocular telescope. This requires significant changes in retina practice, patient recruitment, surgery, and post-operative care, involving low vision occupational therapists.
Consider this — we’re also asking surgeons who typically perform surgery in the front of the eye in the form of 30–40 cataract surgeries a day to adapt their skills to a back of the eye surgery involving the retina.
Therefore, we think disruption is absolutely necessary. In our case, it has a clear purpose: to improve patient lives by restoring lost vision. But to help our patient population, we need to re-educate ophthalmologists, corneal surgeons, care partners (such as spouses and adult children) and patients about what to expect from this new approach to treating late-stage, age-related macular degenerations. This takes hard work and passion to move things in a new direction.
What lessons have you learned from challenging conventional wisdom, and how have those lessons shaped your leadership style?
The biggest lesson I’ve learned from challenging conventional wisdom is that no big problem is unworkable with the right vision, plan, and team. For example, in 2010, I led a group in South Korea to successfully argue against a government pricing challenge for intraocular lenses for cataract surgery, achieving a decade-long impact. Another instance involved resolving a three-month warehouse issue in Canada by identifying the optimal solution and executing a disciplined plan. So, I don’t think any big problem is unworkable. It just takes a vision. It takes a plan, a vision, and the discipline to work the plan.
Disruptive ideas often meet resistance. Could you describe a time when you faced significant pushback for a disruptive idea? How did you navigate the opposition, and what advice would you give to others in a similar situation?
This question is flawed because my belief is that if you view the other side as opposition, you’re already going to lose. Instead, you have to engage with the other side of the conversation, invite them to your side of the fence, and find common ground. Every disagreement or difference in perspective is an opportunity for collaboration to make sure that both parties’ needs are met. For example, in South Korea, we faced pushback from a government agency tasked with lowering prices due to issues in another medical device category where there was some [possible] nefarious business dealings that led to a change in pricing. By working together, we convinced them that drastic price cuts for cataract intraocular lenses weren’t in their best interest.
I often think about author Stephen Covey’s advice: seek to understand the opposition’s point of view before you try to force them to think about it your way. This has helped me achieve goals throughout my career.
What are your “Five Innovative Approaches We Are Using To Disrupt Our Industry”?
1. Smart Geography: We’re agnostic about geography. At Samsara Vision we go where the patients are, instead of where, traditionally, medical devices have launched, first. For example, there is a higher percentage of people living with late-stage, age-related macular degeneration in Europe, so we sought approval their first. We’re also working through regulatory processes in the United States and China.
2. Leverage Digital Technology and AI: We use digital technology and AI to identify and engage with patients in terms of patient recruitment and in follow-up care post-operatively.
3. Embrace Innovation: We are treating a disease located in the back of the eye by using a surgery that was originally designed for the physiology of the front of the eye. Further, our interocular telescope and specially designed delivery system improves upon an earlier generation device, allowing the surgery to be completed more quickly and with fewer sutures.
4. China First: Early on, we targeted China as an important marketplace for the SING IMT. We’re embracing the challenges that come with launching in this country, rather than saving it for future days.
5. Embrace Talent: We identify talent wherever it lives and are not focused on maintaining a huge central office. For example, while we do have a facility in Israel supporting about 20 employees who manage manufacturing, R&D, and regulatory work, we have an additional 35 people in the company who live all over the world. We are using the technology we all learned during the pandemic as the normal way of doing business.
Looking back at your career, in what ways has being disruptive defined or redefined your path? What surprises have you encountered along the way?
I’ve always said yes to opportunities that disrupted my own sense of normalcy. For example, I was doing Asia Pacific work while based in Fort Worth, TX, traveling to Asia Pacific for two weeks every month for three and a half years. That was disruptive in my personal life, but saying yes to that has set the foundation of my current experience in our industry.
As you get comfortable, you must ask yourself if this comfort is a disease, and “do I need to change something quick?” When the days are too similar to the previous days, something has to change.
Beyond professional accomplishments, how has embracing disruption affected you on a personal level?
Currently, my daughter is doing a college internship in the ophthalmology industry, which really excites me. I love that she’s interested in the same field that I’ve devoted so much time to, particularly as she grew up.
I’ll add that she soaked up first business experiences from hearing my conference calls while in the car with me. She said the multiple calls from Japan made her think that ophthalmology might be right for her.
On the other hand, that disruption of our personal time, driving to school during the time that we could connect in Japan, it just made a difference. My young kids have watched my journey and learned from the disruption that I’ve been able to create in business and in my career. They’ve gotten excited about that and maybe they’re a bit fearless, from seeing their dad go out and tackle challenges.
In your role as a C-suite leader, driving innovation and embracing disruption, what thoughts or concerns keep you awake at night? How do these reflections guide your decisions and leadership?
Several thoughts keep me up at night. Delivering for our patients keeps me up at night. How do we get to more people faster?
For my employees, how do I keep this company growing, so that my employees have a place to call home, recruit new people to join the team, and create that culture that can be so special?
For all the other stakeholders, like the investors, I think about how to make sure I’m getting a solid return on what they’ve invested. They believe in the technology and in the leadership team.
We owe it to our employees, and we owe it to our patients, to wake up every day and fight harder to make our goals and objectives a reality.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
So many R&D dollars are focused on new products for an existing treated disease area and/or improvements on products that already exist. I’d like to take a page out of what Mr. Beast is doing. He called attention to preventable blindness and got millions of patients treated for cataracts. Great. There are plenty of treatments for preventable blindness — let’s connect people to those resources.
However, now our industry needs to start investing in areas of non-preventable illness. In ophthalmology, people who are blinded by age-related macular degeneration are considered non-preventably blind. But couldn’t it be preventable if we put enough time, effort, engineering, and invested capital into solving these issues? I don’t like the term non-treatable; we need to challenge ourselves in the industry to focus more on that and less on iterative design changes for products that already improve people’s lives.
How can our readers further follow your work online?
Samsara Vision: https://www.samsaravision.com/
Samsara Vision Europe: https://singimt.samsaravision.com/en
LinkedIn: https://www.linkedin.com/company/samsaravision/?viewAsMember=true
Tom Ruggia LinkedIn: https://www.linkedin.com/in/tom-ruggia-b094014/
Instagram: https://www.instagram.com/samsaravision_us/
Facebook: https://www.facebook.com/SamsaraVision/
Thank you for the time you spent sharing these fantastic insights. We wish you only continued success in your great work!