According to the U.S. Center for Disease Control and Prevention, nearly 1.7 million hopsital-acquired infections occur every year. The result: 100,000 unnecessary deaths and an extra $6.5 billion in healthcare costs per year. In this interview with Dr. Charles Kinder, we learn how his company, Doc Froc, is trying to reduce those numbers through unique antibacterial lab coats and scrubs.
Hello everyone. It’s Scott Nelson, and welcome to Medsider, home of the free medical device MBA. Did you know that according to the US Center for Disease Control and Prevention nearly 1.7 million hospital-acquired infections occur every single year? The result? One hundred thousand unnecessary deaths and an extra $6.5 billion in healthcare cost per year. Yeah, that’s B with a billion. In this interview with Dr. Charles Kinder, we learn how his company, DocFroc, is trying to reduce those numbers through unique antibacterial lab coats and scrubs. Here are a few of the things that we’re going to cover: How Dr. Kinder’s personal experience with one of his patients led to the concept behind DocFroc. Dr. Kinder is going to lay out the three keys to implementing change within a hospital setting. Here’s your hint: Clinical, legal and marketing. Okay, so why aren’t scrubs and lab coats banned in hospitals? The stats are downright shocking. What will it take for antibacterial lab coats and scrubs to become the gold standard of care within the hospital setting? And Dr. Kinder’s advice for would-be physician inventors that want to follow in his footsteps. Of course, we’re going to cover much more, but before we dive into the interview, I have to get some attention to our sponsor, Covasc. The guys over at Covasc are doing some interesting things as it relates to launching and selling medical devices within the vascular arena. You see, if you’re a medical device company, you probably realize that paying direct reps is often worth it but definitely comes at a high cost – big salary, company car, expensive insurancee The list goes on and on. Well, Covasc is creating something different. They have a unique network of affiliates that don’t require salaries or cars. These affiliates excel clinically and have existing physician relationships at the local level. What’s the end result? Increased market penetration, less cost and higher margins. Go check out covasc.com if you’re interested. That’s C-O- V as in Victor- A- S- C dot com. And if you’re interested in joining the Covasc network of affiliates on the sales side, go to the same website, covasc.com, for more information. That’s C-O- V as in Victor- A- S- C dot com. Now, here’s your program.
Scott Nelson: Hello, everyone. It’s Scott Nelson, and welcome to Medsider, home of the free medical device MBA, and on today’s call we have Dr. Charles Kinder. He is the founder of DocFroc, which is a unique company that is manufacturing antibacterial lab coats and scrubs. He is also a practicing electrophysiologist in the Chicago, Illinois area as well. So without further ado, welcome to the call, Dr. Kinder. Appreciate you coming on.
Charles Kinder: Scott, thanks for asking me to be a part of Medsider. It’s a privilege to be part of the call and on the program. It’s important to understand as you’ve pointed out that I’m a full-time practicing heart rhythm specialist. I had never fancied myself necessarily going into business, let alone this type of business, but unfortunately, now about three years ago I had a patient come in for an elective operation where I implanted a defibrillator. And the mechanical parts of the surgery went perfectly fine, in fact the patient went home the very next day feeling fine, and unfortunately the patient came back to the emergency room three days later with a bad case of severe diarrhea due to a bacteria, and unfortunately this became so severe it damaged the patient’s intestines so severely that he actually died from this infection with a perfectly normally-functioning defibrillator and no complications from the surgery I did.
And in hospitals when this sort of thing happens, we investigate so we can make sure it never happens again, and unfortunately we found out that the nurse taking care of him was taking care of a patient with the same type of bacterial infection. Inasmuch as we’re convinced that this nurse was washing her hands, she was probably not changing her clothes, which is obviously impractical for nurses to do between the care of each patient.
Around that same time, the American Medical Association, which meets in Chicago every summer had proposed banning the doctor’s white lab coat because of the mounting evidence that the doctor’s white lab coat carries bacteria, and there have now been a number of studies that show that our lab coats and scrubs carry very dangerous bacteria. A study done by Perry et al. and Journey of Hospital Infection show that 92% of nurses’ scrubs after a single shift are carrying either MRSA, VRE or C. diff. C. diff happens to be the bacteria that my patient died from.
Scott Nelson: Okay.
Charles Kinder: So that’s after a single shift.
Scott Nelson: And what was that? Repeat that for me again, what was that percentage?
Charles Kinder: Ninety-two percent of nurses’ scrubs after a single shift on a general medical floor are carrying one of those dangerous bacteria.
Scott Nelson: Wow.
Charles Kinder: In a very interesting study done by Dawn Butler at Virginia Commonwealth University, she actually proved beyond a shadow of a doubt that you can take a doctor’s lab coat and you can squirt onto the lab coat a small amount of MRSA, otherwise known as “mersa,” and many hours later you can swab the bacteria off the coat and glow it on skin, which means that not only our lab coats and scrubs carry bacteria, they can in fact spread from patient to patient.
And so here we are today in the setting of 2 million hospital-acquired infections a year at a cost estimated by the CDC to be about 32 billion over the past five years in cost to treat these hospital-acquired infections, and on top of that we have about 100,000 patients who don’t survive these infections.
Scott Nelson: Okay.
Charles Kinder: So this is a very, very significant problem both from the standpoint of patients suffering, patients dying, and healthcare dollars being spent to take care of these infections. A single infection costs about $30,000 to treat.
Scott Nelson: Sure.
Charles Kinder: So, what we’re left with at the end of the day is that if you happen to be the last patient that the doctor sees that day, you are basically getting exposed to every previous patient’s bacteria that the nurse is taking care of that day. That’s all coming into your house to the room or even as an outpatient into the outpatient examination room if the doctor wore that coat into the hospital that day. So, I found this to be shocking information.
Scott Nelson: Okay, so I want to circle back around to how this goes from idea or alarming stats to idea to your own personal experience to now DocFroc, but before I go there, these are such alarming stats, and I know for most of the audience that’s listening to this call is in some sort of role within the healthcare arena, sometimes it’s easy to get numbed by the statistics. But these are very alarming. So if Joe Patient and I hear some of these stats, I’m thinking, “Why don’t all hospitals everywhere eliminate the lab coat or the scrubs?” or “Why is there not more of a concerted effort to prevent these hospital-acquired infections?”
Charles Kinder: That’s a great question, Scott, and the answer is pretty straightforward. The reason the American Medical Association didn’t ban the doctor’s white lab coat is because they basically said, “Well, we have to wear something, and whatever else we wear is going to have the same problem. It’s going to carry bacteria.” And then they said, “Well, gee, maybe we should just wash our coats more often and wash our scrubs more often.”
But a recent article just published in April of this year by Marisha Burden at the Denver Department of Health showed that basically clean scrubs don’t stay clean. So you can go and get a pair of perfectly clean scrubs from the hospital laundry and she showed that within three hours, those scrubs are already contaminated with dangerous bacteria. So the issue is not a laundry issue. It’s an issue of putting something on the scrubs, putting something on the scrubs that keeps them clean during the entire shift. And so the breakthrough in thinking on this is, once again, it’s not a laundry issue. It’s not cleaning things more often. It’s having something that protects them from getting infected.
Scott Nelson: Sure.
Charles Kinder: And so we have a coating that’s made of three different components that has a utility patent protection on it, the most active component of which is silver, but there are two other components, and basically the coating prevents any splashed bacteria from sticking to this scrubs or lab coats. So that’s the first layer of defense, and any bacteria that overcome that layer of defense are killed by the silver, which is bonded to the fabric itself, and we know that the silver doesn’t leach off the fabric. We know it lasts for more than a hundred washes, and even at a hundred washes it’s 90% effective. So, we know have a reasonable solution to prevent doctors and nurses from carrying bacteria from bed to bed.
And to your question, if you’re a patient who discovers tomorrow that oh my goodness, you need elective knee surgery, it gets down to, would you select the hospital that’s using the standard scrubs and lab coats that we know carry bacteria or would you select the hospital that’s using antibacterial DocFroc lab coats and scrubs? I think you’d clearly choose the facility that uses the antibacterial coats.
And the costs are not unreasonable for what we provide. As I mentioned earlier, $30,000 is the cost to treat one hospital-acquired infection. For $30,000, a hospital could put every single doctor in a facility into one of our antibacterial lab coats. If that hospital over the past year had three hospital-acquired infections, for $90,000, every single worker in that hospital including the nurses in the various areas of the hospital and technicians could all be wearing DocFroc antibacterial scrubs.
Scott Nelson: Sure.
Charles Kinder: So the cost burden is not excessive and hospitals are beginning to awaken to this idea that we need to do more than just vigorously wash our hands. I mean, you could think of the other ways in which bacteria are spread. So, the big mover in this area is going to be the January 2012 mandatory Medicare reporting of all postoperative infections.
Scott Nelson: Okay.
Charles Kinder: But up to this point, if you came into the hospital and you got an infection from knee surgery and you went home and came back to get treatment for the infection, that really didn’t get registered anywhere. You couldn’t look that up and say Hospital X has all these infections. Now, starting in January 2012, hospitals have to report all postoperative infections, and if they don’t they get a 2% Medicare reimbursement penalty. So, suddenly this technology is beginning to look a lot less expensive to hospitals who at first would say, “Oh, you want $10 more per lab coat and scrub for yourself. Well, that’s too much. We can’t afford it.” Now, they’re suddenly realizing that they should be doing it, and unfortunately they’re realizing it first for economic reasons and only secondly for patient care reasons.
Scott Nelson: Sure. Okay. So, to that point, looking ahead two, three years, especially considering the financial implications of something like this with that January 2012 mandatory postop reporting of hospital-acquired infections, do you see this almost like becoming the gold standard in the overwhelming majority of hospitals looking out two, three, four, five years?
Charles Kinder: There’s no question about it because again what it gets down to is, why wouldn’t you do it?
Scott Nelson: Sure.
Charles Kinder: I mean, why wouldn’t you do it? The hospitals that are using our stuff, and there are several earlier adopters that basically we sat with their board of directors through our people from the community, and they look at us and they say, “You mean we could be doing something more to prevent infection and we’re not doing it?” My neighbor was at the hospital the other day and they got an infection, and then so and so’s boss’ sister had infection. Everyone knows somebody now who’s had an infection from their time in the hospital.
A recent consumer report survey showed that the patients’ number one fear from being in a hospital is getting an infection. Eighty percent of patients fear that outcome, and so I think hospitals are going to look at this and say, “Well, it’s the right thing to do for patient care.” It’s the right thing from a patient safety standpoint, and guess what? It makes sense financially now because we’re not going to get reimbursed for the treatment of these hospital-acquired infections anymore, so let’s do even more to prevent them from occurring in the first place.
Scott Nelson: Gotcha. Okay. And I would presume, while we’re on this topic, I kind of want to just stay here, I would presume that when—I’m not entirely sure, you know, how you’re selling these, but whoever’s selling the DocFroc scrub into the hospital, I would presume that’s probably the number one issue, is the upfront cost, correct?
Charles Kinder: That’s exactly right.
Scott Nelson: Gotcha.
Charles Kinder: The biggest challenge here is that if you sit down with a purchasing director, the accounting bean counter for lack of a better term, and I don’t mean to be pejorative but that’s what they’re there for. They’re there to put the screws to me and to beat me up over cost.
Scott Nelson: Sure.
Charles Kinder: And they say, “Look, we’re buying our scrubs for $10 apiece and they’re made in Swaziland, which I didn’t know, I had to look on the map, it’s in the southern tip of the African horn, or China or whatever, and if you can’t sell it to us for $9 a pair, then we’re not buying it,” and that’s the end of the conversation and they kick me out of the room. What this takes is an understanding by the chief medical officer at the hospital that it’s a patient safety issue.
Scott Nelson: Gotcha.
Charles Kinder: What it takes is an understanding from the legal counsel of the hospital to understand that if this technology becomes more available, if you have a bad outcome from a hospital-acquired infection, the plaintiff’s attorneys are going to start saying, “Whoa, why aren’t you using these antibacterial lab coats and scrubs? They’re available.” So it’s a liability issue to not use it, and then finally, the marketing people can get on board and say, “Gee, we could use this as part of a patient safety marketing campaign. Come to our hospital. We’re going the extra step to protect you by having antibacterial lab coats and scrubs.” But that sort of a meeting quite frankly takes some time to organize.
Scott Nelson: Yeah.
Charles Kinder: If you get those different parties in the same conference in the same time, everyone gets it and they’re all…
Scott Nelson: And have you experienced that firsthand? Because I know there are some hospitals there, in doing some of the research for this for our interview I noticed that you’ve got some hospitals especially in the Chicago area that are currently employing the DocFroc scrubs throughout the whole hospital, correct?
Charles Kinder: Correct, yes.
Scott Nelson: Yeah.
Charles Kinder: But the early adopters have been the enlightened ones that really the light bulb’s gone off and they’ve gotten this, and they’re very happy with the results. In fact, we have a clinical study from the University of Arizona Emergency Room where we showed our DocFroc antibacterial scrubs after a single shift in the ER had 90% less bacteria than standard scrubs, and that’s just in an ER in a single shift. So we know the stuff works in bench testing. We know it works clinically. I cannot yet at this point promise that I’m going to cut back on your hospital-acquired infection rates, but it certainly would seem to be the case, and we’re just starting a big intensive care unit study to try and prove that point, but obviously it’ll take some time and money before we have that answer. But again, this gets down to a very basic premise of safety, and if it does no harm and it’s very likely to cause good, why wouldn’t you employ this relatively inexpensive technology?
Scott Nelson: Sure. Sure.
Charles Kinder: And the interesting proof of concept is already there. There were six hospitals in the world, I think one in the United States and five others overseas, that decided to put copper on all of their metal surfaces in the intensive care unit because copper like silver is antibacterial, and sure enough, over the course of the study which was just announced in an international meeting on infection prevention, there was a 40% drop in hospital-acquired infection just from putting copper on the metal surfaces in the intensive care unit.
Scott Nelson: Okay.
Charles Kinder: That is a very expensive thing to do, and so I think, you know, when people talk about what prove it, I think we have proof in concept already that if you decrease the local bacterial burden that patients are exposed to, these would be the copper on the stainless steel surfaces in these sick hospitals or using our antibacterial garments, I think patients are bound to have a low infection rate.
Scott Nelson: Sure.
Charles Kinder: And so we’re very confident that this will become the standard of care. Patients are becoming more aware of this and starting to ask questions about it. I can tell you our logo, which says on the right shoulder of our scrubs and lab coats, says antibacterial, and then in smaller letters DocFroc, every single patient and their families that I see ask me, “Gee, what’s that on your shoulder? What would that mean?” And when I explain it to them, they’re like, “Why didn’t someone start doing this a long time ago? That makes perfect sense.”
Scott Nelson: Right.
Charles Kinder: And so patients really appreciate that their healthcare providers, the doctors and the nurses and technicians, are going the extra mile to protect them.
Scott Nelson: Sure, and in the hospitals there in the Chicago area, the early adopters of the DocFroc scrubs, have they used that as part of their marketing strategy in…?
Charles Kinder: They’re putting together the early draft of the campaign. The early adopters thus far are Provena St. Joe’s and Joliet and the Vanguard Hospital here in the Chicagoland area, of which there’s 27 across the country but the first adopters have been here in Chicago, and the very first was in fact the MacNeal Hospital in Berwyn, and those hospitals are in the early phases of putting together a patient safety campaign that announces that as one of the things they’re doing to help protect patients.
Scott Nelson: Cool. Now that’s good stuff, and I guess before we circle back around the actual antibacterial coating, because I know, for those of you who are listening that want to find out more about these scrubs, it’s www.docfroc.com. It’s D-O-C-F-R-O-C dot com. You can certainly go there and learn more about the other features of the scrubs. But the highlight is that coating, right? The antibacterial coating. Do you have some IP regarding that, some patents for that particular coating then?
Charles Kinder: Yes, yes. So we have a utility patent for that coating, and what I can tell you, Scott, is that the key here is that some other manufacturers have decided to throw some very dilute silver onto their fabrics and call their things antibacterial. But I know from our testing, because we spent a lot of time and money researching this, that if you just put silver onto a garment and you test it, the efficacy is in the ballpark of 60%. When we bind our silver to the other two chemicals in the formula, our efficacy shoots way over 90%.
Scott Nelson: Sure.
Charles Kinder: So because other people realize this is a growing market and a growing concern, there are other people trying to do this, but it seems to be based on the testing we’ve done that when they just put silver on their garment without the two other chemicals we use that the efficacy is not going to be where we are, and we’re very happy to say that we’ve done rigorous testing on our stuff to get the efficacy way over 90%.
Scott Nelson: Gotcha. Gotcha. You know, maybe some more bigger players for I guess lack of a better description see the market potential of this and where this technology is going. Do you think that’s what it’s going to come down to, is cheaper coatings, and are they that efficacious?
Charles Kinder: Right. Well, that’s exactly right.
Scott Nelson: Yeah.
Charles Kinder: Well, here’s the basic question. The basic question is if all these big companies really cared about you as the patient, why wouldn’t they have done this a long time ago?
Scott Nelson: Yeah.
Charles Kinder: They clearly have the chemist, the engineers, the money to have done this years ago. Here we are, a small startup company who decided this was the right thing to do for patients, and we got the chemist and the engineers together, pay for that out of our own pocket, out of our own hard-earned savings, and come up with a very fine product. So, we’re proud to say we’re first to market with this sort of thing that’s been rigorously tested, and we’re looking forward to seeing this technology spread. So again, we have less than 100,000 deaths a year from hospital-acquired infection, less than 2 million infections to start with per year, and you cut back on this $34 billion that the CDC estimates we spent over the past three to five years in this country paying for these infections. That would be good everybody.
Scott Nelson: Gotcha. Yup. No doubt. No doubt. So, currently, are you distributing it through scrub distributors or how are you actually selling your product?
Charles Kinder: We sell through our docfroc.com websites. We have a direct e-commerce website.
Scott Nelson: Okay.
Charles Kinder: We are in the final stages of completing paperwork to sell through Amazon. We also are in the process of hiring sales reps. We have a handful of sales reps but need about a dozen more, and we provide at this point very personalized service for any large orders and [00:22:21] large-volume discounts on those orders, so the best way to get through to us is to go email our website, and inquiries we get back to you within 24 hours. We do personal service to make sure you get the color that you want, the embroidery that you want, and make sure the sizing is correct for you.
Scott Nelson: Gotcha. Okay. Are your customers primarily within the hospital setting right now or is it other areas of healthcare?
Charles Kinder: Well, Scott, the market is very diverse, so even within the hospital there are about 16 million people who buy their own lab coats and scrubs online because they’re not provided by the hospital. So there are 16 million people who work as nurses or techs but don’t work in a sterile area of the hospital. They work up on the regular nursing units and they have to buy their own. So those people come to our website as individual purchasers.
Scott Nelson: Gotcha.
Charles Kinder: Then, there are other hospitals that are starting to go to a color-coded notion where each unit wears a different color of scrubs with the hospital logo on it, and those hospitals are starting to take a look at what we can do for them. And then, finally, we have several dentists and dental offices using our stuff, and I suspect there’s more room to grow into other areas, chiropractic offices, dermatology offices, spas, etc. Look, we know you can get MRSA just going down the street to your health club to exercise. This would be the kind of thing you could put on exercise clothing as well. So the sky’s the limit, but right now as a small company we are focusing on our main mission, which is in the standard hospital.
Scott Nelson: Gotcha, and you funded this entirely, you know, basically bootstrapped it?
Charles Kinder: Right. Yeah. My wife and I have funded this entirely out of her own savings. We will be coming to the market probably in the next 9 to 12 months to seek funding, but right now we’re trying to build the value of the company before we do that, because if you go try and get venture capital funding too soon, some of the terms tend to be a little bit onerous, so we’re trying to continue to build our book of business and get our regular customers built up. We have a decent shot at some government contracts, too, and once we have those I think we’ll really be in much better shape to seek funding.
Scott Nelson: Gotcha. Okay. Very cool, and one other question in regard to kind of the marketing and sales aspect, your sales reps right now, are they solely focusing on your product or it is something that they’re carrying other products and they’re kind of adding this to the bag for?
Charles Kinder: For now, we’re open to any interest from independent reps who are carrying other products, because from a simple business standpoint, we’re trying to avoid having direct employees because of all the implications. So anybody who is an independent rep, certainly send their résumé to our website and we can take a look.
Scott Nelson: Gotcha. Very cool. And I know we’re running short on time, but I did want to ask you, I wanted to kind of circle back around and ask you, after you had this patient experience, you see these alarming stats, what’s that first step that causes you to sort of pull the trigger on this idea? Because everyone has ideas, and I think the more important thing is the execution of the ideas. Anyone in kind of a startup capacity would probably believe in that sort of framework. But you personally, how do you pull the trigger? How do you take the first step and say, “Okay, I’m going to do this. I’m going to go after this idea and see what we have here.”
Charles Kinder: I would say that this was meant to be, and believe when I say that it’s because of the health club I go to in downtown Chicago, there happened to be a guy in my same locker room who is already in the government business who is a retired United States Marine, and he runs a very successful family business out of North Carolina, and he helped us with a lot of the resourcing to help us get to market.
Scott Nelson: Gotcha. Okay. And you just met him at your health club there in Chicago?
Charles Kinder: You got it.
Scott Nelson: No kidding. No kidding. That’s an interesting story. And he sort of partnered with you and helps you kind of someone to execute a go-to-market strategy?
Charles Kinder: He helped a great deal with the actual product. We now have a CEO named Evan Goldberg who’s actually our full-time CEO who runs the company, and he’s really the one helping us with the business side of things. As a doctor, I certainly am not going to pretend I know enough about business to become successful, but it’s important to admit that and then go get the right people to help you, and Evan Goldberg is in this outstanding job and I’d be happy to provide his contact information if you have any followup questions.
Scott Nelson: Gotcha. Gotcha. Very cool. Do you see a bigger player acquiring your company at some point or do you see DocFroc becoming the big player in this market?
Charles Kinder: We are prepared to become a vertically integrated company and stand on our own and make our products, all made in the USA, and continue to do business that way. But if this becomes the tidal wave we think it is, we’re already in the rolodex of several of the big companies and certainly we’d be open to being acquired by them, but I would put my foot down and insist that I be able to stay involved and review their quality, because I don’t want them to take what we’re doing and make a poor-quality product. We send samples of every run across our production line off our chemical testing to make sure the quality is good, and I get worried with some of these big players that they may not do that.
Scott Nelson: Okay. Gotcha. Gotcha. Very cool. This is kind of one of my last questions here. I know there are quite a few physicians that actually will probably listen to this interview. What advice would you give them that, you know, for those doctors and physicians, whatever specialty they may be in, that have these ideas kind of floating around in their head, had a personal experience just like you did, what advice would you give them if they’re interested in maybe sort of emulating your business instincts?
Charles Kinder: My best advice is to go slow, do all your homework, do your due diligence, because even with the help of the fellow at my health club who had experience in this marketplace, we still made a lot of costly errors early in the going. So, go slow, do your homework, and at the end of the day if you’re not passionate about what you’re doing, you likely will give it up before you’re successful. There have been many dark hours where I thought this is never going to work and I’ve wanted to give up, but then at the end I thought that this is the right thing to do for patients and I have to keep going.
Scott Nelson: Gotcha. Very good. So go slow, do your due diligence, make sure you do your homework, and…
Charles Kinder: Be passionate about it because if you’re not passionate about it you’re likely going to give up before it succeeds.
Scott Nelson: Gotcha. Very cool.
Charles Kinder: You have to take something you really believe in.
Scott Nelson: Right, right. The other three points probably won’t follow if you’re not passionate about that. That’s for sure.
Charles Kinder: Right.
Scott Nelson: So, very good, Dr. Kinder. I really appreciate you coming on. Is there anything else that you’d like to mention before we conclude this conversation?
Charles Kinder: Now, what I would say is if you’re a doc out there or a nurse or a management person and you would like to provide this do-no-harm DocFroc antibacterial lab coats and scrubs for your practice or your hospital, get a hold of us through the website, docfroc.com, and we’ll give you a great deal, and it’s the right thing to do for your patients. We’ll get you set up.
Scott Nelson: Gotcha. Docfroc.com, that’s www dot D-O-C-F-R-O-C dot com, docfroc.com. So, very good. Well, thanks a lot for your time today, Dr. Kinder. I really appreciate it.
Charles Kinder: Thank you so much for the privilege to be on Medsider. Thanks.
Scott Nelson: Alright, and I’ll ask you to hold on the line real quick, but anyway, that’s it for now folks. Thanks everyone for listening and take care. (Music Plays)
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