Health Tech Evolution - The Future of Bio-Electronic Medicine with Dan Goldberger

Hello. Welcome back to the Healthy Enterprise. My guest for this episode is Dan Goldberger. He is the CEO and director of ElektraCore. Dan is a highly accomplished c level executive with over twenty five years of leadership experience in life sciences and health care.

We got a lot to talk about. Welcome, Dan. It's great to have you here with me and

and Thrilled to meet you here. I really appreciate the opportunity.

Absolutely. So tell me about electroCore. I've been I've been on the website, and I'm super fascinated by what's happening there. Yeah. Let explain what you do.

Yeah. So electroCore is a up and coming young company. Like all overnight successes, this has been going this is our twenty twenty year anniversary this year. So

Oh, wow.

My name is Dan Goldberger. I'm the CEO of Electricor, a small publicly traded company. The ticker is e c o r. There's the website is electrocor.com. The company was established to commercialize our invention around noninvasive vagus nerve stimulation.

The products that we sell today are available by prescription for treating headache, for treating migraine headache, and cluster headache. We are working towards a label expansion to treating the symptoms of post traumatic stress disorder. There are variety of other benefits that come from the technology. And and we also have a family of products based on the same technology that are health and wellness products for treating, managing stress, for quality of sleep, for focus and attention, what, what the professionals call cognitive enhancement. That's a smaller part of our business today, but it's been growing disproportionately fast.

And the the future for us is very, very bright.

Yeah. I was looking there. You're tackling some amazing medical issues. I saw in there even opioid use disorder, gastroenterology, Parkinson's disease.

So Yeah. The the pipeline for vagus nerve stimulation is is astounding. Huge. Implanted vagus nerve stimulators have been available since the mid nineteen nineties. I mean, implant is is actually a small surgical procedure.

Right. So you can get an implanted vagus nerve stimulator to treat epilepsy, to treat depression. The founders of this company were actually looking at epilepsy and discovered, a noninvasive way to deliver the same therapy. And in the process of of doing trials, clinical trials, pivoted to work on headache, mostly because it's it's easier and faster to run trials in headache. So the core technology works in epilepsy.

It has a profound anti inflammatory effect, which spans a variety of medical conditions and, and leads to our health and wellness positioning. But we have investigator initiated clinical trials running in post traumatic stress disorder, in substance abuse, in stroke, in Parkinson's disease. There was, last month, there was a publication, about, traumatic brain injury or concussion. So, as we get more data, the it's the the platform technology becomes even more exciting for a variety of indications. And it's an incredibly benign safety profile.

There really are no no profound side effects. We do, from time to time, hear about, skin irritation at the treatment site, which is, you know, may or may not be a contraindication, but it's very rare when it does happen. So that that that's a it's a rare combination of a really benign safety profile, fascinating pipeline of benefit beneficial clinical data. And because this isn't a drug, all of our indications and the things we're working on are stand alone therapies, but also adjunctive. In other words, you can use our device to treat a headache in addition to Botox for headache or triptans for headache Mhmm.

Or the CGRP antibodies that are advertised heavily.

So Right. So it doesn't conflict with other therapies.

Yep. There you go.

Yeah. So let maybe let's explain a little bit how it works. I mean, the vagus nerve is, like, the longest nerve in the in the parasympathetic system. Right?

Yeah.

So how does this device actually work? Like, how do you actually deliver this? And what is it doing? What is it actually

You're you're absolutely right. The vagus nerve, obviously, communicates with the brain, but it interacts with all of the major organ systems in the body, both to collect information and send it to the brain and then to signal to the different organ systems what to do. As it happens anatomically, the vagus nerve travels in the same sheath as the carotid artery through the neck.

Oh, okay.

And so Mhmm. You can find it. You can palpate your neck. You can find the carotid artery. You can feel it pulsing.

Our portable handheld nerve stimulator, this is our gammaCore sapphire. It's our our flagship device. There you can find it on our website as well. There are better pictures of it.

Yeah. I saw it on there. Yeah.

There are two electrodes on the business end of the device. And so we train our our customers to palpate the neck, find the carotid artery, hold the finger there, turn this on, and hold it there like that. It's programmed to deliver a two minute stimulation. So you hold it in place, and it'll shut itself off. You can feel it.

It's not uncomfortable, but you can definitely feel that it's tingling, the nerve and energizing the nerve. And for

Is a pulse or anything or just a constant? It's The pulse or is it constant?

Feels like a constant like, if if you put your fingers across a battery. Right? You'll feel that constant.

Right. Little tiny buzz. Yeah. Okay.

And two basic modalities for acute treatment of headache. I'm very fortunate. I I do get migraine headaches, but very occasionally. When I feel like I have a headache coming on and I take it out of my pocket, I treat myself, I can usually abort that headache with with one or two Great. Stimulations.

Right.

And so that acute treatment of I feel like something's coming on, I can treat it

Right.

Is one of our indications. The other protocol is prevention. And

Mhmm.

In prevention, we suggest that our customers use this twice a day. So think morning and evening, like brushing your teeth. And the pivotal data showed a statistically significant reduction in the number of headache days for people who were compliant with, you know, using it regularly every two days, every twice

a consistent.

So two minutes in the morning, two minutes in the evening. You know, I'd love to say that I'm a I do it consistently, but I don't brush my teeth every day either. So but, you know, there's human nature sorta fits in there.

Absolutely. Yeah. For those of us that know people that experience those kinds of headaches, those migraines, it's devastating. Like, it takes them out for the day. I have a friend that has them, and it's like, when they start coming on, she just she abandons everything, and she heads home.

She closes the curtains. She shuts the doors, and no one can talk to her for hours. And it's devastating. I mean, it's something like it would be a

miracle for someone like that. And and not only is the headache debilitating, but the drugs, the, you know, triptans, for example, are the first line therapy for migraine. Right. They have their own side effects. They make you drowsy.

Yeah. Yeah.

There's a warning about, you know, driving and operating heavy equipment. And and so people are left with that, you know, that that that choice of do I take the drugs that make me feel less than, or do I suffer through the headache and not have the side effects? It it's, it's not a, it's an unpleasant trade off.

Yeah. This is a liberating alternative for sure. Wow.

So that must be Are you using that liberating alternative language? That's good.

Well, yeah. Like, there's a freedom to pull it out of your pocket and and and treat something like that. I mean, amazing. And then, you know, issues like PTSD are obviously deeper rooted and have it have their own sort of they have their own

But it said, like, you can use it in the same way. Right? For

Right.

You know, for people who feel that that stress building and that panic attack coming on, they can get immediate relief. And prophylactically, that same twice a day program has been shown to reduce the number of PTSD episodes. Same

Wow.

Wow. Similar to

what we've Mhmm. Yeah. Yeah. That's incredible. Think so.

So it doesn't surprise me what attracted you to this company when you were when you were looking to make your move to electric core. I mean, this is a pretty intriguing and exciting place to be, I would imagine.

Yes. Yeah. For you know, I've been I'm not a young man any longer. I've been in general management of, of, medical technology businesses, for a long time. And one of

us years, I think.

Pretty special. So Yeah. I'm Yeah. Very fortunate to be here.

That's a good segue into a couple of my questions, and and one of them is, like, share with me some pivotal moments for you that helped shape your leadership style in in your career? I mean, now you you've started in Mhmm. In this work thirty five years ago. You must have learned a few things along the way. Is there anything you could share about what helped pivot you and and and give you the tools you needed?

Yeah. That's a big question. I learned a lot of things that I didn't wanna do

Yeah.

Along the way. So, yeah, two very important findings. One is people, and the other is access to capital. And on people, you know, look. At the end of the day, when you're trying to build a business, you are completely and totally reliant on the people that that you surround yourself with.

And

Yeah.

There's there's never been a good way to evaluate people and attract people. It's not just money. It's shared values. It's work ethic. Right.

The money has to be fair. But, you know, from thirty, forty years ago let's see. When did I start? In the late late seventies. You know?

So fifty years ago now. It was all about in person interviews, and we've gone through a variety of semi automation ways of of semi automated ways of getting to know people, but I think it still comes down to one on one and and and networks as opposed to, you know, throwing resumes across the across the ether. Mhmm. And on the access to capital side, that's always hard. You know?

Yeah. When when it feels like the stock market is going up, it's hard to find money for small businesses. And when the stock market goes down, it's even harder to find money for small businesses. But

Mhmm.

Having having a cash balance covers a lot of difficulties and gives you the time and the breathing room to to make good decisions for the long term.

And I'm glad you brought up the concept of people because you know, reading your background, you know, you stated that culture is really important to you. And so Mhmm. The fact that you brought up people and that, you know, somehow you had to find a way in whichever organization you were at, but you find a way to approach that and building a a strong, healthy culture within those organizations. So how do you, what were some of the key, you know, tech techniques you used to do that?

Wow. So a lot of it is leading by example. I've earlier in my career, I've personally been in most of the functional roles. Right? I started off in product development.

I did quite a bit of my time in operations, both manufacturing and supply chain. I've been a CFO, and the the vast majority of my tenure has been in sales, whether I've been running a sales organization or in senior management. In senior management, a 20% of what you do is still sales. Either you're selling product to customers, you're selling projects, an internal project to various constituents, or you're marketing the company. Right?

You're selling stock

Right.

Supporting the stock. So so sales become very, very important. And, you know, and people leading by example, I think, is the most powerful tool. Right? There's you can you can talk a lot, but people really read into, your team, your staff really reads into, your actions more than your words.

Right. And

Right. And that's how, you know, how you get them to buy into the mission or the vision or the goals that you've set. Yep. Yep. Makes sense.

So I try to I try to walk the talk walk the walk and rely less on talking the talk. And and, you know, morality and ethics and how you treat everybody up and down the organization, I keep discovering it it's that that it it makes more of an impression than you realize in the moment. Try not to get too upset when things go bad and Right. And celebrate when things go well and make sure everybody recognizes that things are going well, and you gotta appreciate when they're going well because they're gonna go bad sooner or later.

That's right. One thing we can rely on is nothing stays the same for long. It always fluctuates and shifts and dips and dives and and peaks. Right?

Right. And embrace the change because change

Right.

The change is gonna happen. Nobody Yeah. Change is never gonna stay the same.

It's where we grow the most is during the change. Right? And that's where we learn more and and fail more, unfortunately. And, I mean, I mean, you're no stranger to tough decisions. That's part of your job.

Mhmm. Tough decisions, hard conversations.

Right.

You know, if you were, you know, talking to somebody who's, you know, halfway through their career and they're kind of climbing the corporate ladder and they're getting to that point where what kinds of, you know, what kind of skills does someone need to know to kind of enter those conversations? Does it just come with practice? The more you do it, the the easier it gets or the or the just maybe not easier, but it just becomes more innate.

So I know that's true for me. Right? I I learn by doing. I learn by screwing up. I'm I'm not very good at book learning or learning from others.

I have I have to make my own mistakes, and and my wife tells me about it. And listening is is an is an underrated skill. Right? Listening for meaning is becomes I just can't under under yep. You can't listen enough.

You learn something from from everybody you interact with, your customers, your suppliers, and and certainly

Right.

Your employees and your peers. Patience. Right? It's never as bad as you think it is, and it's probably never as good as you think it is. And, and and try it's very hard to separate out the, you know, the the day to day annoyances from your long term goals and visions, and we all have to balance that.

What the right balance for any particular person is is a moving target. And I'd I'd also come back to that earlier point of, embrace the change. Right? The changes are gonna happen. President Trump is gonna do something that comes out of left field.

Your dog is gonna do something that distracts you for an hour. And and and it's a mindset thing, but if if you can if a if an executive can thrive in a changing environment, that's a culture that becomes far more resilient over the long haul.

That's good advice, actually. Yeah. Things have changed a lot over the time in your your career in life sciences. And so, you know, what are you most excited about what's coming up, you know, in the in the world of you would call it electro a bioelectric electronic.

Yeah. So we are heavily invested in what we call what others call bioelectronic medicine. Peter Stotts is our chief medical officer, cofounder of the company. He's had a incredible academic career in pain management. And, you know, what he points out is that in in American in Western medicine, we are overwhelmingly relying on pharmaceuticals, which are biochemical.

But the human body is really an electrical machine. Right? The heart is an electric motor. The brain

That's all energy.

Yeah. It's all electrical energy. And, you know, for whatever reasons, in life sciences, we've put far more emphasis on biochemistry instead of bioelectronics. And there's so much that is possible once you have that understanding that that so much of the functioning and malfunctioning of a human body is around bioelectronic signals. You know, whether it's a pacemaker for the heart, whether it's a nerve stimulator like what we do, a nerve stimulator for managing pain in the spine, I think, you know, we're just starting we're just as a society, beginning to invest in bioelectronics the way that we've been investing in biochemistry for many decades.

Yeah. I remember I was watching one of those videos, and he was talking about, that that the body, the natural state for health is homeostasis, and that gets interrupted. And and that Mhmm. For whatever reason, whether it's trauma or or injury or or something like that, that that's what it's this tries to do that. It tries to reset that reg regular pace or regular flow to bring the body back to homeostasis so that it can actually operate at its peak function.

Right?

That's yeah. That's a lot of what we do. You know, the the vagus nerve is is fundamentally involved in balance between the sympathetic nervous system and the parasympathetic nervous system. Easy. The the sympathetic nervous system is the stuff that you're aware of, the stuff that makes you happy, the stuff that makes you angry.

Parasympathetic nervous system is the stuff that keeps you alive. Right? It keeps the heart beating. It keeps your

Yeah.

You know, tells you to breathe so that you don't have to be conscious of breathing. And and those can get they get out of balance. So we talk about the you know, you're in a a rest and digest state after you've had a nice family meal, or you're in the fight or flight state when you have a car accident. And Right. What stimulating the nervous system does is restore balance.

And so if you're agitated, if you're in that fight or flight state, stimulating the nervous stimulating the vagus nerve will bring you down. Conversely, if you're in rest or digest and you're on the verge of taking a nap, kinda like caffeine, stimulating the vagus nerve will will will bring you back up and return you to homeostasis.

Okay. So you kinda kind of bring them both down. Okay. That's interesting.

Yes. Yeah. And and when you think about it in that context, it's oversimplified. But when you think about it in that context Yeah. You can see how powerful the technology fundamentally is in in both the health and wellness setting, right, for for healthy people who are just getting through the day, I find I use less caffeine than I used to before I had access to the to the vagus nerve stimulator.

And then even more so for medical conditions like like PTSD and and headaches and and some of the other things that we're working on.

And so individuals that are, you know, starting to feel like they're about to experience an episode or or some sort of situation is is stimulating that that feeling. Instead of reaching for a bottle of pills, they're reaching for this device, and they're, you know, getting almost immediate immediate support from that. That's that's that's pretty powerful.

Yeah. And and in fact, the air force US air force has done a surprising amount of research. Most of it hasn't been published, but the story that I I like the best is around a cohort of of ISR specialists, which are the drone pilots and the the the you know, it's generally two people, one flying the vehicle, one managing the guns. Right. They've shown that for that cohort of drone pilots who had access to the vagus nerve stimulator, they were more accurate in in identifying a target and discerning between a target.

You know, the what they used to talk about is telling the difference between a Humvee and a school bus, for example. Discerning between a target and and where it is in a target. And they were also faster at it. And that's that that cognitive enhancement that I mentioned earlier. But

Mhmm.

The knock on effect was that these young men and women were using less stimulants, right, less caffeine when they were on shift. And then when they went off shift, they didn't have to self medicate to come down from the stimulant. Right? So Right. They're not using as much alcohol or whatever we use to self medicate and relax.

And that became a a virtuous cycle of less stimulants to get through the shift, you know, less depressants to come down again, get healthier, have more energy

Right.

Really a fascinating finding. So

Yeah. No kidding.

We're we're excited about making that concept available to consumers.

Right. Yeah. I mean, I guess if you look at the way certain occupations require a certain level of, you know, hype or awareness or injury, like, whether, you know, mostly first responder

or for example.

Yeah. Exactly. Like, I I need one of those right now. Yes. But but I think that's, yeah, that's a great example is that it's somebody in a higher stress environments where they feel they feel that.

I mean, we all feel how that feels like when we get stressed. We're getting anxious, and we're feeling that buildup, and we either go, you know, full anger or rage or whatever whatever direction we go to release. But when you're in situations like that, you don't really have the opportunity to release. Therefore, I guess that's where it gets sort of suppressed and packed away. And then so this is allowing them to push through it, but in a in a in a way that allows it to flow naturally.

Yeah. That's really cool.

Well said. Yep.

Awesome. Cool. That's what we're doing. So let's talk about the changes that you've seen over the years in all your various roles. You know, you talked about sales earlier about and then and that that, you know, right now, you particularly in the health care, I find that you have multiple cost customers or target audiences.

Like you said, you've got investors. You've got end product users. You've got providers who are gonna, you know, recommend the product to their patients. And then Yep. You have other stakeholders and shareholders and everything else.

So over the years, marketing has paid a pivotal role in everything we do when we're selling our product or service. How do you see that has changed now than when you started your career? Obviously, we were in more traditional media, like newspaper, magazine

Right.

Television, radio. How is it for you guys now? Like, how complicated is the marketing space?

It gets more complicated every quarter.

Right.

And, you know, you you said it very well. Right? Fifty years ago, how did you get the how did you build awareness? Right? Well, you talk to people, and and you use, you know, print and telephone.

I remember when fax I remember the first fax machine that I ever saw Fax. In a profession.

I think lawyers still use fax machines, actually.

And so and so do doctors to to

fax it. That's right too. Yeah.

Yeah. So, you know, the Internet, electronic media has vastly multiplied our our productivity and and our ability to build awareness. Along with it comes just a whole lot of noise that everybody in your audience is familiar with. Right? What are you Yeah.

What are you really gonna pay attention to? What are you going to listen to? Yeah. You know, in in our field, we do a little bit of all of it. Right?

To to sell our products, we have to educate the doctors and nurses who are gonna prescribe. We have to, we do what we can to build awareness among end users, you know, men and women who suffer from headache, most specifically.

Right.

Some of our competitors on the pharmaceutical side have very large advertising budgets. You see Botox for headache, you know, advertised on prime time TV. I haven't seen a Super Bowl commercial yet, but they're definitely doing prime time TV advertising, which Yeah. We don't have that kind of a budget. So it's harder for us to compete with that.

And, you know, so we use we don't use print as much anymore, but we do use email and Instagram and Facebook and not as much TikTok. We're not as active on x, but we also use old fashioned people. We have

Right.

A customer service team, which is in person, and they do a lot of Zoom calls like this. Our field salespeople are out knocking on doors, going into hospitals, and talking directly to, to clinicians. We also have to communicate with the the supply chain people, the purchasing agents. We have to be on contract. You know, there's the concept in medicine, in life sciences of the third party payer, and that's a that's also a very important audience.

And how do you reach that audience is even more obscure and and takes even more legwork. Our marketing executive calls it omnichannel. Right?

We've Yep. That's right.

You know, we don't we don't do much with traditional broadcast media. We just can't afford to, but Yeah. Whatever we can afford. And and so much of what we do is just awareness and getting our name out there.

Do are are eight people able to access the devices directly, or do they have to go Yep. Through a doctor? Oh, they they can buy directly.

So you can go to our consumer brand is called Truvega. You can go to Truvega.com, and I think it's $500 now. We have a we call it the Truvega Plus. It's a mobile app enabled version of our technology for health and wellness applications. So it's lower energy, lower strength than our prescription model that we sell for for headache and PTSD.

But, yeah, you can you can go to the website and buy one.

Yeah. That's great. Then that's that's just sort of another direct, more ecommerce version of of what you do too. So that's Exactly. As many.

Yeah. No kidding. Omnichannel. Absolutely. So, you know, with with that, I mean, we've seen a huge increase in AI use of Mhmm.

Automation. How are you guys taking advantage of that? Or are you?

We're dabbling. You know, we're not aggressive. Yeah. We're not moving aggressively. You know, we use it internally to to generate copy, to generate product ideas.

Our some of our constituents in in larger medical practices are collecting collecting data from our mobile app and starting to think about how they could apply AI to the usage patterns that they see through our our back end portal. But we're not it's not a a strategic leg of our our development at this point in time. And, obviously, I'm not closing the door on it. We're just not going there right now.

It's still early days. We're gonna be so much more is coming the way. I don't even think the wave has really hit yet, but, I mean, we're in. It's just rising constantly the the level. I mean, in our industry, it's it's been it's been mind boggling.

It's been devastating. It's been, elevating. You know? It's all those things. It's hit it's hit a some areas really hard and and and and enhanced, more areas in its path.

You know? It's like, I mean, I learned I became a photographer in 1991. That was my first first coming out of school, and Mhmm. I learned on paper and chemicals. And and in 02/2004, I had to decide if I was going to, shift to the digital era.

And I remember many didn't. Many didn't make the shift. They said, no. I'm not going that way.

I'm I'm seeing still a a certain magic to have in the tray of chemicals and seeing the image kind of

Yeah. It's magic. Yeah. And people and a lot of people have never seen that seen that actually happen, but it, reminds me of of of going through many different eras of of digital transformation. You know?

I

mean Right.

There was no Internet for me growing up. Right? Or for us, it's like, we've made so many pro so much progress in the last twenty five years.

Yep. And photography is a brilliant example. Right? It

Yeah.

It it took a lot of work to get one image, and now you get a thousand images, and you don't know which one is the best. So you've

That's right. And the cost to get one image too. The image. You you can just fire off, you know, 400 pictures like we do today if you're a wedding photographer or whatever Because every frame, every snap was a cha ching.

It's a cha ching. Right.

It ate into your profits.

It used it was a substantial pay per click. Yeah.

Yes. Exact was the original pay per click. Yep. So looking back twenty five years, if you were standing in front of Dan who just walked out the door of Stanford, what advice would you give him moving into the career that he's going into, what would you tell him? What would you say?

What to avoid? What to what to jump? What to do better or do worse?

Or first of all, was Do

less of?

It was more like forty five years ago, but I'll take the twenty five.

Hey. I didn't wanna, like

Thanks for that. Yeah. So I think that most of it would be stay the course, you know, stick to your ethics. Morality is important. Treat people the way that you wanna be treated.

Don't sweat the small stuff. You know, especially when you're young, everything seems so monumental and so important. And

Right.

You get to the other end of your life. It's the vast majority of what I did at work, I don't remember. But, you know, I I do remember the the family times, the laughs, the camaraderie, that kind of stuff is what's really important in the grand scheme of things.

Right. That is good advice. Do you think instincts have played a big role in in your in your growth?

Is it luck or instincts? Right? It's you know?

Is it your gut? Yeah. Your gut or luck. Right? Or luck.

Yeah.

And, you know, right place at the right time. You know, somebody opens the door, do you walk through it? Who knows? But

Yeah. I'll

Yeah. I'll take luck over all of the others any day.

Right. Right. I hear that often is when people are thinking about, you know, where they're at and, in their careers, or whether they're younger, or more mature. It is it's a reset, particularly in in in health care and health tech and is that Mhmm. The original the original vision was to help others, to help people be better, feel better, do better, survive more, you know, and live longer, whatever that is.

And and that, you know, business does there are things about business that kinda get in the way of that. And a lot of people have said, well, you know, I just gotta keep reminding myself why I'm doing this and why we're here and why I joined this company or why I started this company, and it was to help people and and make people's lives better. And and it seems to be a very

consistent Yeah. You know, you gotta make a living. You gotta provide for your family. But all things being equal, I would rather do something where the end product is gonna relieve suffering or improve quality of life.

Awesome. Well, I am excite I'm I'm really excited that I I learned about electric electroCore. Great. And I'm going to I'm gonna tell my friend about it who's got migraines. She's gonna be really excited because she suffered immensely.

Please do. Send her to to trudega dot com.

I'm excited to see where you go, and maybe we'll have you on another episode sometime if you're into it.

Love to continue the conversation. Appreciate your time, Heath.

Alright. Thank you so much, Dan, and it's been a pleasure to meet you. I really enjoyed my conversation with Dan. You know, I I can see how he has led large numbers of teams through various transitions in business, multimillion dollar corporations, because he chooses to lead by example and let his actions speak louder than words. It's easier to follow somebody when you see how they're how they want you to behave as opposed to just telling them.

So, anyways, great advice. And he wanted me to pass on that anybody who is interested in trying out one of the products, the devices, particularly those with migraine headaches, that you can go over to truvaga.com, t r u v a g a Com. And there is a discount code for anybody who has been listening to this podcast and would like to take advantage of, using one of their devices, the code that you would type in for your discount is health ten, h e a l t h ten. So if you suffer from migraines, go check it out. I hope it works, and thank you again for listening to another episode.

Stay tuned.