How do companies transform? Brett Wall shares lessons learned from past experiences, current leaders

June 30, 2021

In this podcast, Brett Wall, executive vice president and president of Medtronic’s neuroscience portfolio, shares the experiences he’s had working at medtech companies in transformation. Each change brings new lessons that Wall will bring to bear as he leads the company’s neuroscience business. In this interview, Wall shares the advice given to him from former CEO Omar Ishrak and current CEO Geoff Martha. He also explains how Medtronic will work to instill an innovative spirit in employees without sacrificing the power that comes with being a big company.

iTunes    Spotify    Soundcloud    Google


Tom Salemi (00:00):

Hey, everyone, this is Tom Salemi of DeviceTalks. Welcome to our newest member of the DeviceTalks podcast family; it's called MedtronicTalks. Our constant search to find new ways to bring you insights in the MedTech industry led us to the fine, fine folks at Medtronic. They've agreed to make their senior leaders available to us and to you. In each episode, we'll discuss the opportunities and challenges facing one of MedTech's clear leaders so you'll have an inside view on what makes Medtronic go. We'll ask the questions, Medtronic will provide the answers, and our great network of sponsors makes it all possible. So sit back, hop on a treadmill, take the dog for a walk, whatever you do when you listen to a great podcast, and let's listen to how Medtronic is getting the job done. Let's go.

Tom Salemi (00:45):

Hi, everyone. Welcome back to the MedtronicTalks podcast. I am your host, Tom Salemi. I'm also editorial director at DeviceTalks. Thanks for joining us today. We have a great interview with Brett Wall. Brett is an executive vice president at Medtronic. He's part of the senior leadership team. He also leads up the Neuroscience portfolio, he's president of that group. We talked a great deal about Brett's work in the MedTech industry. He's been part of companies, both large and small, and he's been a participant of acquisitions and consolidations and reorganizations, including the one that's been ongoing at Medtronic. Brett's been one of the folks leading the way.

Tom Salemi (01:27):

So we'll talk about how you work hard to ensure that acquisitions go well. Brett was part of Covidien when it was acquired by Medtronic a few years ago. And, prior to that, he was part of ev3, which had been then acquired by Covidien. So Brett has been through different parts of reorganizations and brings some great insights on that. We'll also talk about where Medtronic is headed going forward, and how they're, once again, working to instill a new mindset at the company. So great to talk with Brett. He brings a lot of energy and insight to the conversation.

Tom Salemi (02:04):

And before we start our interview with Brett Wall, I'd like to bring in this episode's sponsor, Chamfr. I'm here with one of its co-founders Katie Karmelek. Katie, tell us about Chamfr.

Katie Karmelek (02:16):

Sure. If you think about polymer and metal tubing that are in all components, electrodes, balloons, these are examples of components that engineers need quick access to when working on their medical device development projects. That's where Chamfr comes in. You can think of us as the Amazon specifically developed for medical device components. With over 2,000 parts from 25 different suppliers, such as Johnson Matthey, Integer, and Teleflex, Chamfr helps design engineers launch products faster by being able to iterate without long lead times and high cost minimum orders. Being able to search among thousands of in stock components and purchase with a click of a button is why R&D engineers at Medtronic and other medical device companies use Chamfr as their first spot to source components today.

Tom Salemi (03:00):

We'll hear more from Katie Karmelek a little later in the podcast. If you'd like to find out some more about Chamfr, go to

Tom Salemi (03:13):

Well, Brett Wall, welcome to the podcast.

Brett Wall (03:15):

Yeah, thanks for having me, Tom.

Tom Salemi (03:17):

It's great to have you here. Lots of changes going on at Medtronic. I know we're going to talk about some of the efforts that have gone into reorganization, but as always, we like to start these conversations learning a little bit about our guests. What was your path into MedTech? What were you looking for by joining this industry?

Brett Wall (03:34):

Well, it was a long time ago, actually a long time, but I started in sales and, quite frankly, it was accidental how I got here.

Tom Salemi (03:44):

Oh, really?

Brett Wall (03:44):

Yeah. And I would like to say I had this planned from university, but I went to work for Coca-Cola and what happened is they sold our unit, our part of the business. And the new owners were going a different direction, and somebody called me and said that there was a medical device job out there and I should consider that. And I interviewed and discovered as I interviewed that I had a real passion for this and it was really interesting. My mother had been involved as an X-ray technologist for years and all these other things. And so as I got into it, I thought, "Well, that's a job I could get passionate and go do." And so I started in sales for a company called Bard, which is now owned by Becton, Dickinson, and moved through a variety of different positions. And then joined a startup, and that startup, ultimately, was acquired by Covidien and then Medtronic. So that's how I got here.

Tom Salemi (04:36):

That's amazing. So Coca-Cola, that would've been an interesting... Quite a different path.

Brett Wall (04:40):

Well, you realize when you get into the medical technical world, or MedTech in general, that the world doesn't need another sugary soft drink. Maybe as bad as the executives might think that they need one... I was in the coffee business, but still you probably don't need that either. What we're doing is actually amazing and beneficial for the planet. And that's what was exciting for me.

Tom Salemi (05:01):

That's fantastic. And I do need coffee so I'll take exception of that. But the world has enough, you're right. Let's then talk about how you found your way to Covidien. The company was acquired. What was the company you were with, the startup that you mentioned?

Brett Wall (05:14):

Well, I was with ev3. Prior to that, it was a company called MTI. And when ev3 got started by Dale Spencer, Stacy Enxing Seng, as you mentioned, was employee number one. They were looking at some other spaces. And I had already joined this startup called Micro Therapeutics, which was in Southern California, and we were looking at neurovascular. But what happened is those companies joined together. We had a private equity funder that we put those companies together, and that became ev3. And ev3 then got acquired by Covidien.

Brett Wall (05:44):

And it was interesting Dale Spencer, who you probably know from... He's passed away now, but Dale always gave great advice. I called him up after Covidien bought us. And I thought Dale was going to say, "Great job, go do another one." Of course, that wouldn't be Dale Spencer. What Dale said to me was, "What you should do is you should make this the best acquisition Covidien's ever made, and you should stick around and help all the other people that made you successful have great careers in this new company." And so I took his advice and that's how I ended up staying at Covidien and running the neurovascular business. And that's why I stayed on.

Tom Salemi (06:22):

That's interesting. Yeah, and Warburg Pincus was the investor of ev3, right?

Brett Wall (06:25):

They were, correct, yeah.

Tom Salemi (06:26):


Brett Wall (06:27):

Yeah, they were, yeah.

Tom Salemi (06:28):

Do you understand, and do you still feel, the allure of a startup? Does it bring some energy that a larger company doesn't? Or do they different types of positive feelings? What are the two experiences like?

Brett Wall (06:41):

I think it's a different kind of energy, but I think what was always intriguing to me, if you could combine the two. One of the things I learned at the startup was that the wolves were at the door every day, from the standpoint of your survival, it was existential. And so you had to make decisions, you had to take actions that were going to differentiate your company. And those things were really intriguing and exciting to me. And then what was exciting to me about the larger company, because at the time we were acquired by Covidien, we were looking straight down at the stroke opportunity. And one of the things that we had the opportunity to do there, was to invest in the trials. Now, we had to make a lot of trade offs to go do that, but we could invest the $25 million it took to run these clinical trials that actually proved that doing thrombectomy for stroke actually works. And we were able to get that done and get those papers published in the New England Journal with our partners.

Brett Wall (07:40):

So the intriguing part to me was take the idea that if you don't make the right kind of decisions, you might cease to exist. So take that, and then marry it with the resources that you could have, and then put those two things together and make it work. And that was the exciting part of it because stroke was burning a hole in us and we couldn't do anything other than think about that. And we had the opportunity at that time then to go after that. And that to me was the fun part. That was thrilling. If you could put those two things together, that's great.

Brett Wall (08:11):

And the last thing I'll say about that, Tom, it's so funny, when you're at a large company like this, everyone talks about resources and they think money's the problem. Money's not the problem. We have the money we need to make the right investments. What no one has is time. You can't buy time. I can't bank it. I can't save it for later. I can't stop the world from moving forward while we figure it out. Time's the resource. So if you can figure that out, choose wisely what to spend your time on. A company like Medtronic, we have the resources then to go after those opportunities. And if you're not getting funded, the idea's probably not that good. That's how I look at.

Tom Salemi (08:47):

That's a good lesson. I do just want to back up to Dale Spencer's advice about committing, what did you do personally, to make sure that was such a great investment for Covidien? And how do you impact an organization that large, and ensure that something this big is moving in a positive fashion?

Brett Wall (09:04):

Sure, sure. I think one of the things you have to do is decide what market, what opportunity, you're going to choose and go after. And then you have to do everything in your power to execute against that. And what we were was a fast growing asset within the Covidien universe. And we found ways that we could grow faster. One of them was stroke. By investing in that, we would unlock a market opportunity to be able to go do that. I think you can never lose sight of... First of all, they acquired the company. I think what sometimes people do is you run this romanticized version of, "Well, when we were small, we were like this." And, "This was so great when we were small." Parts of it were great when we were small, parts of it were not great. I think you have to know the difference. Respect the fact that you've been acquired, and then you make your value proposition to the organization of what you're going to do within the larger organization to drive value, so they get the full of value that they, frankly, paid for.

Brett Wall (09:57):

What our ability was at that point is we were in a fast-growing market. We made some good bets. We had a few more bets that we wanted to make that we thought would be good ones. Some of those paid off, some of them didn't. But what we were able to drive was very significant double-digit growth, year in and year out, for a decade. If you commit to that, not only commit to that, but then commit to, "I'm going to make it work in the new structure." And part of making it work in the new structure is letting go of the old one.

Brett Wall (10:24):

So one of the first things I did, which was very symbolic, when Covidien bought us, is I went to the facility I was in charge of in Southern California, and I ordered the signs removed immediately. And I had the Covidien sign put up. We did the same thing with Medtronic. We trained everyone answering the phone, "This is no longer ev3, this is Covidien." We changed all of that as rapidly as we could. And not that that would change the culture of the company when you're doing that stuff, but it was a symbolic thing that, "Okay, you know what? This was a great experience. We should treasure that. We're moving forward." And one thing I heard once, a long time ago, is, "When you're driving, don't look in the rear view mirror, because it's pretty small, and you only see what happened in the past. Look out the window, it's much larger, and you can see the future and you can see what's out there for you."

Brett Wall (11:13):

And I think if you do that, you kind of embrace that. It won't be for everybody. And not everyone will take that journey with you, but the company will survive. And more importantly, it'll thrive. I wanted that business to thrive and go on after it's acquired, I didn't want it to be something that was acquired and then collapsed under the weight of the acquisition. That was really important to me. The results have shown. It's a billion dollar business today. It's more than doubled in size since Medtronic took it over. It doubled in size after Covidien took it over. That's been a successful transaction for each of these parties.

Tom Salemi (11:48):

That's great. Now seems like a good time to talk about where... Let's look out the windshield and see where Medtronic is headed and the changes you're making.

Tom Salemi (11:59):

We'll take a quick break from this conversation with Brett Wall to hear, once again, from our sponsor Chamfr. I'm speaking with Katie Karmelek, one of the co-founders. Katie, share some of the advantages of Chamfr.

Katie Karmelek (12:11):

Chamfr offers a few things that other online stores don't. For one, we're a one-stop shop with thousands of components, we've got dozens of sellers, all in one spot and with one checkout experience. Everything is in stock and ships within 24 to 48 hours. We have more components, more sellers, all in one shopping experience. And that's the biggest difference than any other single e-commerce store from others in the industry. We also really value transparency. So on Chamfr, you always know who you're buying from. When it's time to source that long term supply, you know exactly where to go and be confident that you have the material traceability for your DHF.

Katie Karmelek (12:50):

And lastly, we're really focused on the diversity and breadth of our product offering. We're not a single company trying to push out our products. Our entire goal is to consolidate all of the items an engineer may find in one place. Our online store showcases dozens of companies' products, which ultimately give engineers the most diverse selection to choose from. And it's because it's a marketplace that it's all in one place versus going to 25 different online stores. Most R&D engineers start with Chamfr, and then when they can't find what they're looking for, then they go out and start searching other places.

Tom Salemi (13:25):

So if I'm understanding you correctly, Katie, you're helping to connect buyers and sellers with your online store or marketplace.

Katie Karmelek (13:31):

Yes, that's correct. We facilitate the online order between the buyers and the sellers. Each seller on our site has in stock inventory and ships from their facility to maintain quality control. All sellers are also ISO certified and include CFCs in every shipment.

Tom Salemi (13:48):

And I know you have a diverse offering, what types of components do you sell? Are there specific markets that you're targeting?

Katie Karmelek (13:55):

Absolutely, Tom. Using Chamfr, engineers and supply chain professionals can quickly source a range of sizes and materials for any medical device application. We strive to sell the most diversified offering of components, ranging from small diameter microcatheter sized extrusions and mandrels, which serve the neurovascular market, to large metal tubing for the orthopedic space. And even some more complex components such as electrodes for brain stimulation or lasercut hypotubes for advanced catheter shaft development. These are just a few examples of the wide range of components and applications we support today. And we have only just begun to scratch the surface, improving accessibility of so many impressive component technologies.

Tom Salemi (14:36):

And finally, I'd love to hear, what are some of the recent industry trends that you're seeing? And how does that impact or influence Chamfr in the future?

Katie Karmelek (14:43):

In a way, we got lucky with building Chamfr when we did, because digital supply chains are the future. While some are starting to get back into their pre-pandemic routines, there's one clear aspect of life that is reemerging differently. Digital is more important now than ever. Regardless of where you live in the world, or what industry you're in, your life has in some way centered around digital over the last year. It's how we've shopped, stayed connected to friends and family, and done our jobs. Our future direction is based on the same principles as our initial foundation, getting engineers quicker access to products, to speed product development. Our technology roadmap supports this by focusing on streamlining the buyer's workflow and simplifying the purchasing journey. People expect the Amazon experience across all of their digital engagements and we plan to give them just that and more.

Tom Salemi (15:32):

It was great to hear from Katie Karmelek. It's great to have Chamfr as a sponsor of this episode of MedtronicTalks. For more information, go to That's Now, let's get back into our conversation with Brett Wall.

Tom Salemi (15:50):

Now seems like a good time to talk about, let's look out the windshield and see where Medtronic is headed and the changes you're making. You joined with the acquisition in 2014, you've been part of the leadership under Omar [Ishrak]. Now Geoff [Martha]'s in charge and you've got the sort of... I feel like this is the next chapter that Medtronic is taking after the Covidien acquisition. You need a few years to digest that. Now, you're moving forward. So talk a bit about how you are helping through this reorganization? And I know a big part of it is for Medtronic to get a feeling of a startup, be innovative, be bold, be competitive. And those are great terms to use, but how do you infuse that in an organization that has resources? Because I do feel that sometimes a lot of that hunger and a lot of that creativity comes from a sense of lack like, "We need to find a new way to do this." You don't have to find a new way to do this. How do you get people to do this?

Brett Wall (16:48):

Yeah, you're exactly right, because I think one of the largest issues is if you're going to continue on and you don't have the threat of imminent non-existence... Which a lot of times you have as a startup company. Okay, that's hard. It's like when you have children and you've been very financially successful, how do you give them a window of what it takes to do well. I got two pieces of advice when I took this role. I'd worked for Geoff when Geoff was effectively in this job, running RTG. And I got to know Omar pretty well through that process, because when I joined, I got to know him. When Geoff elevated to CEO and I took Geoff's role, I got two pieces of advice. It was from two different people.

Brett Wall (17:29):

So Omar gave me the first piece of advice, which I thought was pretty good. He said, "Remember, you're not any smarter today than you were yesterday." And one could argue, you're less smart because you now have more businesses that you're responsible for that you know less about. So you're more dangerous, maybe, in some ways than yesterday. I thought that was good advice. The second advice, Geoff told me, "Don't forget what you disliked about the corporation when you were running the business." So don't perpetuate what you found troubling. And those two pieces of advice, I thought really set the stage for how I wanted to come in and operate my role and run the businesses.

Brett Wall (18:10):

And so when we looked at this change, and Geoff did it in the middle of the pandemic, we had no time to make a change when you're in the midst of a crisis, I think, and that's probably a good utilization of the time we had to look at this and maybe do this all at that time. But there's a couple of things we looked at. One was, the groups probably were making a lot of decisions up here. We had large staffs, we had all of the trappings you'd have of a group. And there was a bit of a force down to the businesses. And then everybody in the businesses reported up through all these different channels.

Brett Wall (18:46):

And I think what happened there was we probably lost a little bit of fidelity on our decision making. I don't want to criticize anyone else. I can just tell you, for me, I probably won't make the best decision for neuromodulation, or the best decision for neurovascular, or the best decision for pelvic health, or cranial spinal, or ENT. We almost looked at it more like a private equity would look at it, "Let's look at this from what are the business units that we can break down? What are the smallest units that we can break down?" And they average about a billion dollars a piece. Some of them are bigger than that. Let's get them at the level of where the customer is so we understand the customer. And let's put someone in charge that understands that market. And we give them a framework to work in, "Here's your revenue, here's your operating margin that you have to deliver. Here's some pre-cash flow. And go to town."

Brett Wall (19:38):

And you make the decisions within that framework to meet the demands of your customers, to delight them, to engage your employees. And if we do those things well, the lagging indicator will be our shareholders will like it. But you put them in charge and able to do it.

Brett Wall (19:53):

My role then goes down to a couple of different things. One, pick really good people that are going to be great operating unit presidents, find people that are comfortable in that role, that will take the accountability, that will work within the framework and pull the levers they need to, to make investments here, to stop investment over here, to choose that market. That's one way to do it. The other thing is, on the talent side, that we've mentioned that. And then on the capital allocation, what are the markets that we could invest more in, that Medtronic could apply its large resources, that'll allow us to grow faster. And what we employ there is, really, a capital allocation strategy where we look at what are the strategic bets, all the way down to the core growth, the maintain, and maybe the managed differently businesses. The businesses that may not quite... If we invested more, they might do something. Or if we decide if we're the best owner of those.

Brett Wall (20:45):

And so, looking at those roles, that was a big change for Medtronic. Because now, I've got the head of pelvic health is basically running that business and they're playing just like a pure play company. They have full P&L responsibility. They make all the decisions on their sales force, their head count, the people that are in there, the market choice, the technologies they go after. But they make those decisions and their P&L is of a size that if they were an independent company, they'd be making those same sets of choices. And that step, along with the accountability for your numbers and running the business, that's a change. And I'm not saying it happens overnight, Tom, you don't snap your fingers and it happens overnight. But as we start holding people accountable to those metrics, share being one of them, growing your business, we start building, I think, a muscle there, that I think Medtronic could use.

Tom Salemi (21:44):

Is anything lost in that exchange? Are you swapping, essentially, an innovation independent spirit, but taking away, perhaps, the strength that comes with being Medtronic, with having the resources, with having the ability to roll through barriers more easily than others might? Is there an exchange or can you have both?

Brett Wall (22:03):

I think you can have both and we're going to learn along the way. Let's give some examples of playing big. I don't really want the OU presidents negotiating a new employee benefits package. We're going to do that all day long at the corporate level, and everyone's fine with that. We're going to deliver that to you. I'm here today by Minneapolis-Saint Paul Airport, at the hotel here, I just had a meeting. And we're not going to negotiate every OU with Delta, the corporation's going to negotiate with Delta, and we'll get the best price for that.

Brett Wall (22:39):

But similarly, on the customer side, we also have regional cuts. So our Americas group, if they're dealing with a large hospital organization, they're not going to go around to every 20 OU. What they'll do is they'll negotiate the plan and then the OUs will have to accept that. That's one of the trade offs that we made. But I think that probably works okay, because it allows them to move quickly and decisively, where we need to. And at the same time, we benefit from that as a company when we start thinking about the broad scale of Medtronic, across some of these large IDNs and hospital systems, where we can actually be beneficial. At the same time, it allows our teams to focus on delivering the right technology to the marketplace, having the right sales forces, doing the right things. And frankly, holding the development teams, the product, the selling teams, the marketing teams, accountable for that.

Brett Wall (23:29):

And I think, Tom, we're going to get there. I think these are going to be the 20 best jobs in MedTech. Because you're working for the MedTech leader, you get your full P&L responsibility to actually go manage it and do what it is that you want to do, and operate that business, and choose those markets. That's exciting. I can tell you when I had my first GM job, if an opportunity like that would've come up, I'd be all over that. I think the other thing that's interesting to me is most companies go internal for the CEO search. If I was an operating unit president today, I'd be thinking, "I've got a shot at being CEO here at Medtronic." And if that's something you want to do, perfect role. Perfect role to go out and do that.

Brett Wall (24:11):

So I think we're going to learn a lot. It's not going to be perfect. We're going to make some mistakes, but we're going to learn from those and we're going to adjust and fix it. But I do think that this is exactly what we need to do, on the operating model, to actually make us more competitive, to make us more... People that know me know I'm extremely competitive; I love winning. But you know what? I hate losing more. And I think this organization, the way it's structured today, is set up to go do that. And I think as this develops in the next couple years, it's going to be a pretty formidable group, and I am excited about that.

Tom Salemi (24:46):

I know you're a fan of acting boldly, and you want people to be uncomfortable, so they're moving forward. But how in creating these separate business units, where there is greater accountability and greater risk... And I do think that's all good. How do you still encourage people to take a chance, where if the chance they take doesn't work out, the consequences might be a lot harder to take than if you were just part of a larger number where those things can be countered? I don't want to say covered up, but there's other assets that would make up for it.

Brett Wall (25:19):

Yeah, that's the ideal question, but I'm a big believer that if you don't allow people to take those opportunities, your growth is actually going to be slower. Even with the ultimate failures that you're going to have. And so I think what you have to do is allow people to take those shots. If we fail because we made the wrong decision, or it didn't work out, we'll survive that, and we'll learn something from it, and we'll do something different on the next time. But I think the biggest killer for large companies is not taking those opportunities, trying to protect something that you've kept for a long time and not going after that new opportunity that's really exciting and really thrilling. I think that's where the most damage comes from, and the lack of growth comes from.

Brett Wall (26:03):

So I'm willing to take that calculus and make that exception. And then when somebody makes a mistake, there's simple rules. As long as we had good information, we had maybe some assumptions that didn't play out, but we executed well, we operated compliantly, we followed the law, we did all those things. Okay, it didn't work out. Now let's learn from that. We won't make that same mistake again. Now let's go target the next thing that we need to go do and go do that. You have to make it safe for that. And you have to give people the freedom to make a mistake, if it doesn't work out, and know that their career's not over, and they're going to move on to do that.

Brett Wall (26:39):

And look, I can tell you, I've worked for this company for a while, I've worked for Geoff for a while. I've made a couple of doozies. I've had a couple things that didn't work out. Now, luckily, we've had things that have worked out well, but I don't think we'd get the things that worked out well, if we hadn't have made some of the mistakes. When you accept that, you've got to accept it all, that I'm going to get a lack of private equity. I'm going to get a basket of opportunities here. And some of them are going to work out really well, some of them probably will fail, and some of them be in the middle somewhere. I think that's okay.

Tom Salemi (27:09):

Sure. And mistakes in MedTech, and if you want to speak specifically to yours, is it principally a technology thing, an execution thing? What have you found to be the most vexing thing to overcome in this industry?

Brett Wall (27:22):

I think the biggest challenge for established companies, particularly when you've established a technology, when you see a shift coming in that business, sometimes the biggest, most hard thing for a company to do, and an individual to do, is to say, "I've got to reinvent myself. I can't fall prey to the innovator's dilemma." So I'm going to have to figure out how to manage my current business. And I might not be able to grow it, but I've got to invest in this other area over here, because it's going to allow for dramatic growth, once I get that done. That transition fails to happen a lot of times, for a lot of reasons. I think sometimes people are afraid of, "Well, what happens if I go flat for a year, or I have a gap? What happens with that?"

Brett Wall (28:12):

And I think we have to do a better job with our teams too, of always countering that question, and say, "What happens if you don't do it?" Play out the other side. Play out the other side that you just keep investing in your current business. You end up growing a bit, growing a bit, growing a bit, but this other technology comes and eventually takes half your market away from you. What does that world look like? And I think when we understand that, and then we provide opportunities across the capital allocation of the portfolio for us to take those opportunities. And probably, for me, going to other parts of the business where I know they're stronger and saying, "Okay, you're going to have to come up here a little bit, because we're going to invest in this other place." That's where I can help to go do that. But we have to encourage people to take those shots.

Brett Wall (28:58):

I think the other thing, as we look at when you're a GM or you move from a general manager to an operating unit president, time and grade in those roles is also important. We were talking the other day at Ex Comm, our executive committee, and a number of us that are in these portfolio roles, we were general managers for five years, seven years, eight or nine years. And what happens with that, the value of that, instead of moving every two years, the value of that is you get to live through market cycles and you get to live with your own decisions, good and bad. And you get to see those come through on one side or the other.

Brett Wall (29:38):

And that's a really valuable experience because there's opportunities that I've missed, that I had to live through, that I wish I would've taken, but for whatever reason I didn't do it. There's things I've done well that I got to see the benefit of that. And then I've lived through some market cycles where something happened in the marketplace that was beyond our control, and we had to respond to it. And I've had both good and bad experiences there, where something happened to the market that was great and we kind of got a windfall, and then something happened in the market that it wasn't great, and we had to manage through it.

Brett Wall (30:07):

And you go through that and, let's say, it's a five-year window. You get to experience a lot of that stuff in five years. You take those experiences into the operating unit president role. And when you're making all those decisions, and many of these jobs, you have GMs reporting into you. So you can be a good coach and mentor and help developing them. And then also, you become, I think, a lot more sensitized to the challenges of those particular jobs and how hard they can be, but also how rewarding they can be. So that's what's exciting to me, is building the skillset, and frankly respecting it. Because, as I said, these are some of the top, I think they are the top, 20 jobs in MedTech. And so you get that role and boy, that's an exciting job.

Tom Salemi (30:56):

What lessons or experiences are you taking away from neuroscience? You mentioned the success you had there. In your new role now, what stories or examples or lessons might you take from where you'd spent the last five to seven years?

Brett Wall (31:11):

Well, I think I draw on a couple of things. One of the things that I think we've always been good at is developing markets and going out and doing this. I think one of the other areas that we've been challenged on sometimes is defending those when you have competition come in. So I think one of the things you'll see in our Medtronic Mindset is about competing to win, being more competitive. And I think that's just a discipline that we have to continue to focus on and to work on. So I'm highly interested in how we make those decisions, how our team's going to take on competition in the marketplace, and how we think about that. And I think you're going to see a more competitive Medtronic. That's something that's on my mind a lot.

Brett Wall (31:51):

I think the other thing is the decisions we make or don't make. What we choose not to do is probably more important, almost, in some ways, than what we choose to do. And I don't mean to denigrate what we choose to do, but the issue is, is we have... There's an old saying, I think at Medtronic, we can do anything we want, we can't do everything. And I think the trap is, is I'm going to try to do every cover, every base, or parry every punch that I'm going to see in the marketplace.

Brett Wall (32:20):

When I think we have to make those decisions of saying, "Look, some markets we're going to maintain with our existing product set. Some markets we may not choose to compete in." But the markets we choose to compete in, we're going to choose them because they're strategically important. They have high growth, we could make a difference. We can actually be, probably, the best group of people to go in and make that change. We're going to invest heavily there, and we're going to drive a lot of growth, and a lot of great things for patients and people, and go do that.

Brett Wall (32:50):

And making those decisions early is really important. And continuing to create the environment for the teams where they can make those decisions early. Because, Tom, one of the hardest things is to see a threat coming at you, or an opportunity. Sometimes they're the same thing. People mistake them, but sometimes they're exactly the same thing. And sometimes you got to get in the mud puddle and you just got to get dirty. You know what I mean? You got to just experience like, "Okay, how bad is this going to be if we don't do it?" And sometimes I've seen a tendency to, "Oh, okay. I don't want to talk about that right now. Three years from now. And I'm busy." No, we need to talk about it because in our field and the work that we do with a regulated industry, it's going to take us three years to get there. So we've got to decide now what we're going to do. And that means whatever we decide to do now, we probably have to make some trade offs of what we think we're going to do today, in order to invest for that future.

Brett Wall (33:52):

But I try to paint that picture. I try to ask people to live with that, to be in the middle of that, to experience it, and then to really talk about it. And usually, once you do it, it's a little less traumatic than you think it might be. And what you're able to do then, I think, is make some really good decisions, and then you face the trade offs. And the benefit that comes from that, I always tell people this, the benefit that comes from that is, once you make that decision then, as hard as it might be to maybe stop doing this and do a lot more of this, then you can actually get your team very focused. Everyone's happier actually, because they know what they're supposed to do. They know their role, they're off on the journey. It ends up being a lot better decision for the long haul. Those are the experiences that I'll draw from.

Brett Wall (34:41):

And I think lastly, what I've been really humbled by in this space are the patients. When we did the stroke trials, they were randomized prospective trials. But what we've learned now is some people didn't do very well in the control arm that could have benefited from the therapies and the technology. So you always have to have the respect for why we're doing it, who we're doing it for. And frankly, the sacrifices that a lot of people have made in order for these therapies, or these miracles, or these things to come true. And we've got to keep that level of respect, and understanding, and conscious caring for the patients and the people that are going to benefit from this. And if you lose that, then I think you're... I talk a lot about competition and growth and all that stuff, and I love all that stuff. But at the end of the day, it comes down to those individual people and what we're doing for them. And that's the part that we have to maintain and keep us to be motivated to do what we need to do.

Tom Salemi (35:39):

I think that's the difference between MedTech and selling a soft drink or something. I think you're right. I think take it back to there, that's what sums up what makes this industry special. So that's it. Great conversation, Brett. Thanks for joining us on the podcast.

Brett Wall (35:54):

Good seeing you again. Thank you.

Tom Salemi (35:54):

Well, that is a wrap. Thank you so much for joining us on this episode of the MedtronicTalks podcast. Thanks again to Brett Wall, our guest. And thanks again to our sponsor Chamfr, appreciate your being part of this podcast.

Tom Salemi (36:13):

If you would, please subscribe to the podcast so you don't miss any future podcast. You can find these podcast episodes on all major podcast channels, including Apple, Amazon, Spotify, Google. We are out there. You can also find episodes of this podcast and our DeviceTalks weekly podcast at You can find the DeviceTalks weekly podcast on those podcast channels as well.

Tom Salemi (36:39):

While you're on, you can check out our DeviceTalks Tuesdays program, and our upcoming schedule of DeviceTalks in person events, which we'll be rolling out in 2022. Very excited to be bringing the energy and insights from these podcasts out onto the road again. So again, go to to find episodes of the MedtronicTalks Podcast, DeviceTalks weekly podcast, DeviceTalks Tuesdays, and our DeviceTalks meetings. Please do consider sharing this episode on your social media channels, and please do connect with me on social media. I am on Twitter @MedTechTom, and I'm on LinkedIn at Tom Salemi, S-A-L-E-M-I. Be great to be part of your MedTech conversation. Tune in next time. We'll have another great episode of the MedtronicTalks podcast waiting for you.