EPISODE 49: ALEJANDRO BADIA, FOUNDER AT ORTHONOW, LLC & ORTHOPEDIC HAND SURGEON
Alejandro Badia, MD, FACS is a hand and upper extremity surgeon at Badia Hand to Shoulder Center in Doral, Florida. Dr. Badia studied physiology at Cornell University and obtained his medical degree at NYU, where he also trained in orthopedics. A hand fellowship at Alleghany General Hospital in Pittsburgh was followed by an AO trauma fellowship in Freiburg, Germany. He runs an active international hand fellowship, serves on the editorial board of two hand journals, and previously organized a yearly Miami meeting for surgeons /therapists devoted to upper limb arthroscopy and arthroplasty. This international meeting was held at the world-renowned Miami Anatomical Research Center ( M.A.R.C. ), the world’s 2nd largest surgical cadaveric training lab which Dr. Badia co-founded in 2005. He is a founding member of the American Hand Institute, a think tank, and medical device start-up company focused on minimally invasive solutions to hand, wrist, and elbow pathology.
In 2008, Dr. Badia completed the Badia Hand to Shoulder Center, a fully integrated clinical facility for the upper limb also encompassing the Surgery Center at Doral, a rehabilitation center, and an MRI imaging facility. In 2010, Dr. Badia inaugurated OrthoNOW, the first immediate orthopedic care center in South Florida which is staffed by surgeons from the Doral Orthopedic Center (DOC), a group of surgeons from the lower extremity, upper limb, and spine subspecialties who also treat elective orthopedic problems, frequently in international patients. OrthoNOW was officially franchised in early 2013 and is actively engaging healthcare entrepreneurs and surgeons, here and abroad to open orthopedic urgent care facilities nationally and abroad.
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Episode’s transcript
Julio Martinez: 0:00
Welcome to the Latin MedTech Leaders podcast, a conversation with MedTech leaders who have succeeded or plan to succeed in Latin America. Please subscribe on your favorite podcasting platform. Apple Podcast, Spotify, Google Podcast. Amazon Music is teacher. Tune in iHeart Radio, Pandora or Deser . Welcome to the Lata MedTech Leaders Podcast. Today our guest is Dr. Alejandro Badilla . Dr. Badilla , how are you doing today?
Alejandro Badia: 0:29
Terrific. How are you,
Julio Martinez: 0:30
Andre ? I'm fine, thanks. Very excited about our , our episode today and listeners, Dr. Badilla is an internationally respected hand and upper extremity surgeon and the CEO of Badia hand to shoulder center in Royal Florida. Dr. Badia graduated from Cornell University and completed his medical degree at NYU . He served as the worldwide president of the International Society for Sports Dermatology of the Hand , ISS Port Co-founded the globally recognized Miami, an anatomical research and training center, mark , which is the largest private category lab focusing on education, research and patent development. And he also co-founded the Surgery Center, Aral , an elite state of the art Ambulatory Surgery Center. I'm sure I didn't mention other accomplishments that you have, Dr. Badilla , but I'm very thrilled to have you here today on our podcast, and I look forward to our conversation. Welcome to the show. Thanks
Alejandro Badia: 1:29
Very much. Um , yeah , at some point we might have an opportunity to talk about ortho now , which is probably my biggest challenge in terms of things that I, I started, so, so hopefully we'll have a little bit of time for that.
Julio Martinez: 1:41
Excellent. Excellent. Alright , Dr . Badilla , could you please tell , uh, listeners about your journey to Latin America? How do you get acquainted with the region on a personal professional level? Sure.
Alejandro Badia: 1:51
So, so I was born in , in Cuba and immigrated through Madrid where my dad's family is in Valencia. And I grew up in New Jersey, which was , uh, you know, a fairly vibrant Latino population as well. And when I did all of my training in the Northeast, I really felt that I wanted to use my Spanish skills and, and cultural , uh, advantages in a city such as Miami. And so I came here 25 years ago and very quickly realized that Miami was really kind of one of the capitals of Latin America. And I saw this as an advantage in terms of , uh, colleagues being able to share ideas with , uh, other orthopedic surgeons and , um, even in training and then also with patients. So we, you know , gradually become a real referral center for patients from Latin America who maybe wanna get an opinion in the US or maybe even a , a procedure, but realize that they don't necessarily need to go to, you know, a Mayo Clinic or a big hospital in New York, and they could come to a personalized outpatient center very near the airport with somebody and the staff that all speak their language and understand their culture. So that has been an exciting journey for me and something that's grown significantly during the past decade.
Julio Martinez: 3:08
Excellent, Dr. Padilla, so moving along here, one of the questions that I usually ask my guest , um, Alejandro, is what trends do you see happening in Latin America that are, that represent an opportunity for medical device companies to do business in the region? I mean , uh, let's talk about the economic, epidemiological, political or social trends that you see happening in Latin America now.
Alejandro Badia: 3:31
Sure. Well, as we all know , um, there's often seismic , uh, changes in government which affect the business community, but we all know that healthcare is necessary. So I think that most companies who wanna do business there probably have to work with the government , uh, to some degree because there are , uh, uh, hospitals and healthcare systems that are largely run by the government. But there is a very vibrant , uh, private sector in most of the countries. I think the bigger challenges are regulatory, and I see that as improving. My understanding is even in , in Brazil, you're working now with a sort of abed kind of , um, network to be able to allow and foster innovation. And I think that American companies need to have their, their foot in the door early on because I think there's a , a huge , uh, benefit, certainly geographic, I mean, it's, it's nearby and in many of these countries there are folks who have family or , or come here frequently. So there , whereas unlike maybe other markets where you don't see as much of that, and in Doral , I mean, 80% of the people here are , have family in Latin America, and you know, in this case of Venezuela, Colombia , Brazil. And that's a real advantage. So I think companies that recognize that have a , a lot to gain.
Julio Martinez: 4:47
Excellent. So, Alejandro, I'm not sure if you are in close contact with the industry , um, because , uh, the next question is about how do you see companies doing first in human clinical trials in Latin America or commercial large in their innovations? I mean, do you have examples of companies in the industry that you're dealing with or you have dealt in the past are doing trials or have done trials or planning to do trials or planning to commercialize their innovations in Latin America?
Alejandro Badia: 5:15
Well, I know a lot are, are being done in Columbia specifically because the infrastructure, you know, some countries I think are, are better set up for that. I don't have a lot of , uh, personal knowledge of sort of the trials because I'm dealing simply with the, the orthopedic implants and my experiences. A lot of those are started in Europe or even some are in Asia. But I believe that , um, again, because of the geography, that there is a big opportunity , uh, to do this in Latin America. I have, for example, tomorrow I have a , a big arthroscopy companies coming to visit our center because they're looking at a particular technology that I'll be using in the operating room. So I think besides the actual trials, they can be networking with us clinicians here and , and be able to actually see some of the products being used, you know, because it's already, these products are already approved in the us but we're able to help , uh, the clinicians I think are able to help stimulate the utilization of this by our colleagues that we're constantly in touch. I mean, not a day goes by where I'm not getting a WhatsApp group from Brazil, for example. We have a big conference upcoming in August, and uh, just yesterday my colleague from , uh, Argentina was asking me for some videos of procedures , uh, because they're gonna be doing a almost like a , a video book. So this is something that's just expanding very rapidly,
Julio Martinez: 6:38
I guess the industry sees you or , uh, physicians , uh, like you as a bridge to the region. So you are able to connect industry with Filipino leaders in each country in Latin America. And that's a great position to be in, right, <laugh> ?
Alejandro Badia: 6:53
It is . And , and you know, they come here and they see these , uh, products being used and then they want to bring, you know, bring 'em back to their home country. And I think it starts with either the patient demand or the clinician demand. And , uh, again, the fact that we have this, you know, Puente is bridge here is very powerful.
Julio Martinez: 7:10
Yeah, yeah. Fantastic. All right , so this is a general question. Um, you travel extensively all over Latin America, from what I understand. I've seen your pictures and videos in different congresses events in the region. What do you think about Latin America as a place to do business in journal ? Is it fun? Is it boring? <laugh> ? Yeah.
Alejandro Badia: 7:30
No, no, it's definitely fun. I , I think you have to understand the culture. Latinos, we , uh, we're often very family oriented. We like to mix business and pleasure, and I , I don't think there's anything wrong with that , um, at all. Uh, you know, life is short and <laugh> , you need to enjoy it. So I think it's fine . I think it's important for companies to understand that you go there , people wanna know you as a person before they do business with you. They're not gonna just look at the numbers. And one thing that people need to understand if they don't not familiar with Latin America is , even though most of us speak Spanish, right, except for really , uh, Brazil, that the , each culture is very different. Even the Spanish language can be markedly different in terms of the vocabulary and the slang. And so I think it's important for companies start to realize that and to know each culture. And I've always been really impressed with friends. I have , uh, I have a friend who works with Arthrex and you know, he lived in Brazil for a while, and he speaks Portuguese, he speaks Spanish, he understands the nuances culturally of different countries. Uh , and that's an amazing thing because I think there's just huge, huge growth potential there.
Julio Martinez: 8:33
Excellent. I'm very glad that you think that way. So Alejandro, let's , um, move along in terms of needs that you see in Latin America, what pressing needs you see , uh, in the region in terms of devices , uh, newer technologies, talent?
Alejandro Badia: 8:49
Yeah, I think, you know, one thing is you need really affordable , uh, implants. I mean , um, you know, some of the economies are really moving along, but there's no question that, you know, most of the countries are , are , don't have , uh, you know, it's not Japan, it's not Germany, it's not the us but there is a lot of potential there. So I think it's important that companies price their products , uh, accordingly. And I see a lot of potential in internal fixation. Uh , a lot of companies have started looking in terms of, you know, plates and screws, and I think there's a huge growth for an area I'm interested in in terms of arthroscopy, small joint arthroscopy, right? I think that most of my Latin colleagues are very on par with a knee arthroscopy, for example. But an area that, that I'm passionate about with the wrist , for example, that's that conference I'm going to in Brazil in August, that's gonna be a big theme. But most , uh, hospitals don't have access to these say, smaller arthroscopes and smaller devices. So I think that that is a possibility there, that needs to be, needs to be recognized, and the market needs to be serviced because there definitely are clinicians there who are either skilled or very quickly will be skilled, but they need to have a product. And , uh, the other thing is that we have to be ready for growth in outpatient surgery centers. It's starting, you know, in Brazil , uh, they have some in , in Argentina and , and in Columbia . And I think we're gonna see more of that. That has to also be priced accordingly. But I think there's huge potential as we start realizing with this pandemic that things can move away from the hospital. You know, not everything has to be done in a big hospital, which can be expensive, can be inefficient, can be often in personal , uh, smaller centers. I think we're gonna see in the future.
Julio Martinez: 10:32
Yeah. Yeah. Very good. Well said. So Alejandro, what's your take on the Mexican market? What do you think about the talent available in Mexico? What do you think about the sector, the medical device sector, et cetera ?
Alejandro Badia: 10:46
Well, certainly there's some challenges with Mexico with what's happening right now on the border. And I think that the current government may lead to some challenges. Certainly it's important again, in this particular case to work with the public sector because right now it's gonna be , uh, perhaps dominated. But because of that, there also is opportunity privately because there are gonna be there . I mean, there is a , a huge affluent population in Mexico, and they're gonna be seeking to get that care delivered. I know of a number of sort of standalone hospitals started by entrepreneurial , uh, surgeons and um , you know, we all know the, the big hospitals in , uh, Mexico City , uh, the a, b, C hospitals, et cetera. Mm-hmm . <affirmative> is that they all have a huge opportunity. But the problem is, is that American companies need to learn more about them and realize that that is a , uh, a market. I mean, Mexico is a really a favored , uh, trading partner with the US and geographically they're right there. So , uh, I think we need to really, really pay attention to them.
Julio Martinez: 11:49
Okay. So what about Columbia ? Any comments on that?
Alejandro Badia: 11:55
Yeah, you know, I think Columbia, you know , has gone through a rough patch, right? But one , one thing I've noticed when I've gone to lecture in Columbia is it , it's , uh, extremely , uh, organized compared to maybe some of our neighbors. I find that culturally that Colombians , um, can be very, very serious. That can be very good for American businesses because they may have misperceptions about that. So , uh, in Columbia , there is a very vibrant orthopedic sector. Now, again, I can't speak about other areas, but even my friends who are in general and vascular surgery have made similar comments. So I , I think , uh, Columbia, there is a huge potential.
Julio Martinez: 12:32
I guess trauma is a big business in Columbia <laugh> with all these motorcycle accidents and the war and everything <laugh>.
Alejandro Badia: 12:39
Yeah. But, you know, well , fortunately that's , uh, calmed down a bit. I don't know what's to store as , uh, for the next government, but certainly , uh, right now I think that there is huge potential. We have to realize that population is also aging. So degenerative problems. We we're seeing that in any sort of more industrialized country. And, and I think that , uh, we're gonna see that the age of the elderly have to be taken care of. That's a growing sector. That's also a , a big opportunity.
Julio Martinez: 13:07
Mm-Hmm, <affirmative>. Absolutely. Alright , so moving along, let's talk about Brazil the biggest market. What do you think about , uh, the Brazilian economy and the sector and the talent available in Brazil?
Alejandro Badia: 13:17
The talent, you know, medically, maybe in some areas, maybe second to none in the area. I mean, I witnessed, I was in visiting at , uh, U Speed , the University of Sao Paulo , and , uh, I was there when , uh, they flew in. A lady who had a bit , who had had both , uh, thumbs , uh, amputated in an industrial accident. It was quite amazing to watch, you know, two teams, you know, one preparing the thumb on the back table for the , um, the vessels, the quality of the microscope that came in. Certainly technically the Brazilian surgeons are really second to none in many cases. So I , I think it's very advanced. Uh , I think the challenge with Brazil is just the , uh, bureaucracy is very high. I kind of was hopeful with the current administration that tends to kind of, you know, suppress kind of big government that that would get better. But there is talk of that improving. So I, it's hard to say, you know, right now there's just a big , uh, dilemma right now with the Amazon , uh, rainforest. So there's a lot of tension, I think. Uh, but at the same time, you know, all these ecological things sometimes cause countries to work together and , uh, there can be a downstream effect from that in business, certainly in medical business. But it , it'll be interesting what happens in the next few years in Brazil because I , I just think there's huge potential and I don't think , um, a lot of Americans realize how many people live in, I mean, that's just a huge country and it's a leader in several , uh, sectors including , uh, aviation. A lot of people dunno that. So I think the problem sometimes with Brazil is, you know, same thing you might see in China is sometimes there are some knockoff companies. So I think that companies need to be wary of that, you know, hopefully the regulatory environment will reign that in. But there's huge potential and , and Brazilians from my experience, really love American product. They are very pro us as opposed to some other countries. So I , I think that's a real positive.
Julio Martinez: 15:05
Would you agree that the opportunity in Brazil is probably with higher end products because they have a very mature, you know, lower end mid-range medical device, manufacturing economy or sector? They even export to many countries around the world, their medical devices , products?
Alejandro Badia: 15:21
Yeah, there are , um, a number of areas still where the physicians are sort of trained, but they don't necessarily have access to the product. And um , again, a lot of that might be that the companies realize that it's kind of tough to get your product in to that country. And I'm really hoping that changes and, and you know, maybe this discussion will be a catalyst to have , uh, talk with some of the, the government leaders because I think we all stand to benefit if we can cut down some of those barriers.
Julio Martinez: 15:50
Yeah, it's really about the patient, Alejandro. I mean, patients have delayed access to medical innovation. I mean, by the time a product gets approved , uh, by the FDA or Ima in Europe, it will probably take 10 years <laugh> , if not more, before it gets available .
Alejandro Badia: 16:05
Well, but you know, what the pandemic has has a lot of silver linings, I believe. And uh, certainly that's another one we saw how quickly the vaccines can cut through some of the, the red tape when you really , uh, are are committed to do that. And uh , like you said, it's all about the patient. As long as we can, you know, demonstrate that there's no harm, a lot of the other , uh, regulatory bureaucratic hurdles are just fluff and we need to figure out how to cut through that. I think that the current world crisis is showing us that we need to be a little bit more streamlined.
Julio Martinez: 16:37
Yeah, yeah. Alright . Uh , Alejandro moving along here throughout the region, <laugh> , we're doing a journey. Let's talk about Argentina, one of my favorite countries. What do you think about it, <laugh> ?
Alejandro Badia: 16:48
Well , I think, yeah, I mean , uh, you know, at least in the area of hand surgery, Argentina has been a leader for the past 40, 50 years. A lot of people don't realize that. I mean , certainly in other areas of orthopedics, but in what I do, you know, Argentinians are known for being real experts in anatomy. So anything anatomic, they can really teach a a lot of us. So they are , uh, uh, very much academicians. I think the challenge there is the government, just when we thought maybe we would move forward, I think there are huge challenges and the economy is really suffering, which is unfortunate because there's so much potential there. I mean, at the turn of the century, it was a world's breadbasket, you know , most of the soy in the world came from Argentina, so it was very affluent. And I think that they still have that culture, you know, the , we always tease them as being that , so do the Europeans in Latin America, but it's very true. And now I think that people are realizing that what a large country it is and how diversity in different areas and there is huge potential there. It's another market where traditionally medical education has been very, very high. So if you can get product into their hands, you're really gonna have a lot of skilled users.
Julio Martinez: 17:58
Yeah, I think it's one of the most educated countries in Latin America. So Alejandro, what would you say to the CEO of a medical device company from the US that is just looking at Latin America as a place to do business? What would be your muscles of wisdom to him?
Alejandro Badia: 18:15
Well, I think , uh, you'd have to go down there and , and meet the people, the clinicians. You'd wanna meet the distributors and understand what the market is like. You have to understand the culture, and then you have to see what the opportunity is. I mean, again, there's a lot of regulatory hurdles, but if you can get through those, I think there is huge potential. And I think it's many times underserved. I would be very enthusiastic. There are some countries that are easier than others. So for example, you might not wanna start in Brazil, even though it's such a big market. But for example, we didn't mention , uh, Chile, which really works under the auspices mostly of the FDA . It's a very educated populace. So there is , uh, huge potential to at least get some traction with that product. And then you can kind of expand to neighboring countries. So , uh, I think it's important to recognize that each country is different and you need to, you know, almost do a a a market survey and get to know them.
Julio Martinez: 19:08
Yeah. Yeah. Have you heard about the Pacific Alliance?
Alejandro Badia: 19:12
Yes.
Julio Martinez: 19:13
Would you agree that it is , uh, an opportunity for finally Latin America to get their act together, all these countries to get their act together and work in unison towards a common objective? I mean, I think I would represent a , a paradigm shift in Latin America.
Alejandro Badia: 19:30
Yeah. Again, with culture, there is historically, you know , been tension, say with , uh, with Chile and Peru. I mean, if you go down there to understand the culture, you don't wanna tell the Chile and that Pisco sour is Peruvian, but you , you don't wanna do vice versa. Uh, but I think it's a lot tongue in cheek . I think , uh, a lot of these people really get along very well. Uh, the reality is, I think a lot of times it's a government that creates the , uh, tension. But I think the people are wonderful. And I , conferences I've been to where there's been surgeons from different countries, I think there's , uh, friendly rivalries, whether it be based on soccer, right? So you have to understand it's called football there. It's , it's huge , uh, bigger than in Europe, really. 'cause Europe, there's other sports, but I think in Latin America you have to understand the , the football or soccer culture. Uh, but then there are countries that are , uh, uh, sleepers, for example, Peru. I mean, the government's been fairly stable, so has the economy and huge potential there. Now that is a country that doesn't have the physician base of say a Brazil and Argentina, but there is potential. So there is I think, real opportunity there and an Ecuador , uh, and maybe even Bolivia where a lot of companies are shied away because they thought that their economy wouldn't be able to sustain their product line. But I don't think that's true. Certainly in Peru. I mean, one of the nicest hospitals I have visited anywhere is La Delgado in Lima. You know, they have a helipad. I have a picture with my colleague who's one of my old fellows. I trained him about 15 years ago, and I'm very proud. He's a hand surgeon, but he is also the chairman of the orthopedic department. I did a tour of that hospital, the intensive care unit was to me, second to none. So the , you know , this is what we're seeing in , in a lot of these countries.
Julio Martinez: 21:12
Fantastic. Alejandro. Alright , we're close to the end of the show. How can I get people get in contact with you,
Alejandro Badia: 21:20
<laugh> ? You know, I see a lot of patients from there, and what I tell them is just right me to my website, it's dr badilla.com , DRBA dia.com . It should also know I wrote a book that has, I think, some bearing on , uh, particularly the challenges that we have with the insurance companies, even government. Um, and that's called Healthcare From the Trenches. And that book is on Amazon. You can also find it through my website, but I think my website's the best way to get ahold of me. Uh, right there on the homepage, it just says , uh, ask Dr. Badilla a question and I answer myself. I have an international patient coordinator who , uh, handles the fellows, the visiting fellows, you know, gets them , uh, uh, their code to name tag and sets up a rotation. And we have , uh, visitors from diff from industry as well. So they'll come and spend a day in the OR from different orthopedic , uh, companies and obviously the patients. Uh, every week we have patients who fly up from some of the countries. And I think it's a wonderful relationship. Uh, for me. I, I have to make sure that I have colleagues who can follow them up. And also therapists, we have to talk about the whole , uh, occupational physical therapy world in Latin America. So for my patients, it's important that they have that follow-up care. I'm really very proud to have this relationship. And , uh, you know, one thing I wanna emphasize is I learned as much from them as they do from me. I think it's great when you, you get different points of view, always growing, always learning.
Julio Martinez: 22:42
Excellent. Alejandro, thank you so much for being a guest in our show and look forward to being in touch with you in the future . Thank you .