Tom Feiden remembers the moment when he knew he wanted to start his own surgical laser rental business—and how he actually thought “uh-oh” before “aha.”
It was in 1995, and Feiden was a sales rep for a surgical laser company in Kansas City. His job regularly put him in regional doctors’ offices and operating rooms, where he programmed the laser technology that physicians used during procedures.
“My forte was going into the operating room and creating the desire for the surgeon to continue to use the product,” Feiden recalled. “Once you were used to it, the OR was literally your office.”
The company Feiden worked for had recently implemented a laser rental service for hospitals and clinics with test markets in Miami, New York and Los Angeles. The ambitious Feiden implored his employer to add a fourth test market in Wichita.
“Wichita was part of my territory,” Feiden said. “And I had doctors down there who I knew had an interest in using a laser, but their hospitals weren’t going to spend the $80,000 to buy one.”
Feiden convinced his bosses to add Wichita to the test program, and within four months, it was far and away the company’s top market for surgical lasers rented by the procedure.
Feiden felt he was onto something, but his entrepreneurial epiphany didn’t occur until the morning he was waiting for an appointment in the purchasing office at Shawnee Mission Medical Center. He looked at the other sales reps gathered there and saw only younger faces.
“Everybody was in their mid-20s, and I’m the old guy at 38,” Feiden said. “I’m thinking, ‘Where are the 50-year-olds? What happens to them?’”
Then it hit him: Companies can pay a 25-year-old less than they can pay a 50-year-old, and it was only a matter of time before his medical sales career would be in jeopardy.
“I loved Kansas City and didn’t want to leave,” Feiden said. “My wife was from this area, and she didn’t want to leave. And I thought, ‘OK, what can I do to ensure that I have a job, that we never have to leave Kansas City and I’m not just constantly switching jobs every two or three years?”
Feiden’s answer was to start his own medical laser rental company, On Call Surgical, which began with just himself, a single laser and two hospitals in Wichita as his only customers.
Nearly 20 years later, Feiden employs 20 technicians who work with about 50 company-owned lasers and the doctors who rent them for mostly urological procedures. In all, Feiden and his team are annually involved in 4,000 to 5,000 procedures in up to 150 hospitals in more than 10 states, with hubs in Kansas City; Fort Wayne, Ind.; and Tulsa, Okla.
With revenues of $4.8 million in 2013, On Call Surgical has seen double-digit growth in the last three years, including 20 percent growth in each of the last two years. Despite any lingering symptoms of the economic downturn, sick people always need to be made well, so the business is “basically recession proof,” Feiden said.
Additionally, the health care industry’s handling of Obamacare is likely to benefit On Call Surgical, Feiden said.
“We are really well positioned as a rental business,” Feiden said. “Hospitals are even more hesitant to invest in capital equipment,
because of uncertainty over the Affordable Care Act. Nobody knows what’s going to happen. Uncertainty should be good for us.
“Hospitals don’t want to be in the equipment-owning business. They want to be in the technology-providing business. And we can have an experienced person there for every procedure.”
‘This Will Not Beat Us’
Long before On Call Surgical showed any sign of sustainable success, Feiden had to survive his fledgling company’s troublesome first week.
After honoring a six-month non-compete agreement with his former employer, Feiden resumed a working relationship with his two previous Wichita hospital accounts. But the new tabletop laser he purchased for his company’s first procedure malfunctioned in the operating room. He had the laser repaired and tried it with the same doctor for another procedure, and it failed again.
“Now I’m 0-for-2, and I’m just getting restarted at this hospital after being gone six months,” Feiden said. “I’m panicking, because this is my new company. This is my first week.
“And so the OR director came into the room, and she said to me, ‘I’ve got another rental company on the phone. The doctor has one of these cases tomorrow. Are you going to have a laser here? I need to know.’ I said, ‘Oh, yeah, it’ll be fine.’”
Feiden wasn’t sure if he was telling the truth or not. He called a friend at Shawnee Mission Medical Center, who agreed to lend him a laser for the next day —an older, 300-pound model. He had no idea if he could get the monster into his minivan, but he raced to a hardware store to buy plywood and, with his wife Ellen’s help, built a makeshift ramp that he hoped would let him get the machine into his vehicle.
“By this time, it’s 9 o’clock at night and we’re finishing up this ramp and we’re sawing,” Feiden said. “And I’m going: ‘This will not beat us! This will not beat us! We will win!’”
Feiden picked up the borrowed laser that night from Shawnee Mission Medical Center, loaded it into his van—precariously strapping it to the back of the passenger seat—and drove straight to Wichita, where he was able to grab a few winks in the doctors’ lounge prior to the 7:30 a.m. procedure. But to his astonishment, there was a problem with this laser, too.
“I took the cover off the thing and I found that this little button kept popping out every time the doctor would activate the laser,” Feiden said. “But as long as the button was in, it was fine. So I’m sitting on the floor in the urology room while he’s firing this 220-volt laser, and I’ve got my finger on the button.”
The procedure concluded without a hitch, but On Call Surgical almost died before it had a chance to live. His own resourcefulness aside, the thing that sticks with Feiden is how his wife was there for him.
“It was a moment when I knew I had a wife that was really supportive,” Feiden said. “She said, ‘You can do this.’ There were some other choice words, but she was like, ‘If you can get through that, then you can get through anything.’”
Although never officially part of On Call Surgical, Ellen took care of paying the bills early on, Feiden said, because it would stress him out when the business had more going out than coming in.
“But she never worried about it after that,” he said. “She just basically believed in me. And that was the key to the whole thing. I get emotional even talking about it. But we got going and we didn’t ever really look back.”
Rapid Growth, Valued Partner
After a lean first year, improvements in surgical lasers and Feiden’s ability to identify a winning technology allowed On Call Surgical to steadily grow. Even so, the company’s revenue stream appeared to plateau until 2004, when a new generation of lasers was introduced to treat benign enlargement of the prostate.
“All I had to do was see five minutes of video on this new laser, and I called the company and said, ‘I want two of these,’” Feiden recalled. “They said, ‘We’ll have a salesman call you.’ And I told them, ‘Well, you can have them call me if you want to, but I want two of these.’”
Feiden’s cost for the two prostatectomy lasers was $240,000, but 18 months later, he had purchased a total of six to keep up with rental demand.
“That’s how fast it grew,” he said. “We went from $500,000 in revenue in ’03 to $3 million in two years. It was a good feeling.”
Technological advancements and their savvy adoption continue to drive the profits of On Call Surgical. But as much as anything, Feiden said, the achievement of his company comes down to the relationships forged between its technicians and the doctors, nurses and staff members they assist with the utmost patient care in mind.
“If you’re doing it right, you really and truly are part of that OR team,” Feiden said. “And you become a valued partner, as opposed to somebody in there trying to sell something. You have one goal in mind, and that’s a successful outcome for that patient. We think of that patient as a loved one, as your father or mother on the table. How would you conduct yourself in that room? What decisions would you make or not make?
“We hear all the time from our customers: ‘Your people just get it. They understand what we’re doing. They understand the equipment, but they also understand how to handle themselves in this setting, how to talk to people, how to be professional, how to help.’ And that’s a huge part of why we’re successful, because our people understand the service aspect of this better than anybody in this industry. It’s not even close.
“We didn’t set out to be the most profitable company,” he said. “We set out to be the best at what we do. ‘Profits’ is not a bad word. It’s just that they’re an offshoot of providing this great service.”
