E23: Josh Landy, Chief Medical Officer at Figure1 – Interview

May 12, 2016


In this interview, Dr. Josh Landy tells us about the current state and future of diagnostic medicine. Josh is the co-Founder and Chief Medical Officer of Figure1, which is a venture backed startup. Figure1 allows the medical community to receive feedback on medical cases they post. This helps to expedite treatment and solve difficult medical cases. It’s an amazing community that Josh and his team have developed. And it’s nice knowing that the medical community has these worldwide resources on their phone.

Josh is a practicing physician and before starting Figure1 explored how technology and community could improve healthcare. This was a great conversation.

Josh also answers these questions:

-How did you get it going, attract cases, healthcare professionals initially?
-Where do you want to take Figure 1 over the next 3-5 years?
-Does Figure1 work with medical students?
-What’s one of your favorite stories how Figure1 helped someone?


Dave Kruse: Hey everyone welcome to another episode of Flyover Labs from Madison Wisconsin, this is of course Dave Kruse and today we get to talk to Dr. Joshua Landy who is the Co-Founder & Chief Medical Officer at Figure 1, which is a VC backed start up. So what Figure 1 does is quite fascinating; it’s an app where doctors and patients can post medical issues and images and then the medical community on Figure 1 can help diagnose the ailments. It seems like it’s definitely where medicine has headed. So, I was excited that Josh was willing to come on to show and talk a little bit more about it, so Josh thanks for joining us today.

Dr. Joshua Landy: Dave thanks for having me.

Dave Kruse: We definitely appreciate it and so maybe lets first talk about your background and then why did you get into medicine and then we can start talking more about Figure 1 but first your background, can you give us a little overview.

Dr. Joshua Landy: Sure absolutely. So, I’m a physician myself. I’m Canadian and I did all my training in Canada and I become an Internal Medicine Specialist in 2009 and a Critical Care Medicine Specialist in 2011. So most of my work even to date is really in the Intensive Care Unit looking after really sick people who want my support who need help and support from lots of different healthcare professionals in lots of different fields. In 2012, I went to Stanford to do some research, I was a visiting scholar there and I had always had a mind to do something in the medical education field. This is something that I liked from the time I was a medical student but always felt like the traditional way medicine was taught was fine, it was standard, it was default but it wasn’t keeping up and I really felt like there was like a lot of opportunities for us to use modern modalities of communication that is essentially the internet and mobile phones to be able to do a better job of creating educational tools, now, that was the spark of the idea and it sort of really came together for me when I was at Stanford doing research because the research question that we’re trying to answer is what do young physicians and students do with their phones when they are trying to learn and so we answered their question with a series of qualitative and quantitative prescriptions and I took that idea home with me, you know the results of that and we ended up founding Figure 1 from that. So that’s sort of my background but a bit of the origin of Figure 1, which I’d be happy to go into detail, if you’d like

Dave Kruse: Yeah definitely and what prompted you to get into Medicine. Did you always want to get into Medicine when your growing up or …

Dr. Joshua Landy: Yeah you know that’s a great question. I don’t think that I have specific memories as a child of dressing up like a physician but always wanted to be one but you know, I think I’ve always had a curiosity for how things work and why things work and those are great questions to ask in Medicine, if you’re curious about how the body works so I sort of followed my curiosity selecting courses and things like that in University and it just sort of became clear that all the people who I knew, who were like me, who had questions like I did, wanted to go to Medicine and when I considered it as a career it seemed like a great choice and a good match for my interest and my aptitude and so I went for it.

Dave Kruse: Interesting and are you still practising Medicine.

Dr. Joshua Landy: That’s right.

Dave Kruse: And a CMO, so you’re busy.

Dr. Joshua Landy: Yeah, so I have a fairly busy schedule these days but I certainly don’t mind, I mean staying busy was one of the reasons why I wanted to start a company even though I had a full time job as an Intensive Care Physician at the time.

Dave Kruse: Interesting and as you have already mentioned you thought of the idea kind of when you’re out in Stanford for Figure 1; how did that kind of evolve and did you establish your network at Stanford and how did you come up with the idea and how did you get Figure 1 going ?

Dr. Joshua Landy: So the initial idea was sort of around the this idea of using cases for teaching. What we learned from that research in Stanford was that young physicians and students are already using their phones in many ways for medical education. They are using them to looks things up, there are using them to friends, mid-information and communicate ideas about research, studies or techniques and tips to each other and one of the most common behaviours is taking pictures of cases they’re seeing and transmitting them to their colleagues to either ask for advice or demonstrate follow up and often for discussion. So the questions and cases that they exchange between each other are often just on a one-to-one basis and are often not done with patient privacy in mind; sometimes those images can contain private information and so having a tool that lets you collect these types of conversation, make them available to many many more people and preserves them while at the same time removing all of the concerning privacy data that is making the images safe to share on the internet, it was a job that I felt that we could do all in one fell swoop. So we came up with the idea of Figure 1 and immediately we saw that there is this resource where healthcare professionals can share cases, they can discuss them, they don’t have to worry about patient’s privacy being breeched and now those cases are indexable and searchable for many more generations of health care professionals who are going to learn about conditions in the years to come.

Dave Kruse: Yeah it’s a great idea and everyone who has not should download and you can download it even if you’re not medical professional. You can’t necessarily upload cases, medical cases buy you can check it out, it’s pretty fascinating.

Dr. Joshua Landy: Yeah that’s right and I mean the thing that I think you’re referring too with your very flattering commentary, which I definitely appreciate is that, you know, that is the idea we started with, was that we could use those to teach but recognizing that every healthcare professional who works to this day, is learning new things all the time, new approaches to their same case using adaptive approaches to new cases and the idea of becoming more experienced and seeing things that you haven’t seen before, to exercise your brain and deepen you’re curiosity is the mode that expands peoples abilities in Medicine. So making health care professionals more knowledgeable is the same thing as teaching people Medicine, that’s the same thing as practicing Medicine and so by taking this network and this toolset and giving it to people everywhere in the world where there is internet signal means that the knowledge of specialists even if it’s the knowledge of specialists comes from Madison Wisconsin or it comes from New York City, that knowledge can reach providers around the world in places where they don’t have specialists who know these things and now we can start to really shed light to the medical community by providing the information they need in the moment they need it anywhere in the world at any time of day.

Dave Kruse: So you had this idea which you know was a good one, what were the next steps, how did you actually make it happen, you know, creating this type of platform is not easy, when it’s kind of a two sided platform of you know physicians and then… well is the audience mainly physicians, do you see other hospital staff on there or would patient’s be an audience.

Dr. Joshua Landy: I guess I’ll answer that question in two parts; the first is how we turn the idea into a platform and the second question is who is your platform right, who is your platform for?. So the first question of how we reached, or maybe I should answer first who we’re reaching. We are reaching health care professionals and that’s our audience. Our audience is not patient’s but it’s doctors, nurses, pharmacists, paramedics, physiotherapists, speech language pathologists, really anybody who works, you know, licensed health care professionals and the reason is that; there was a time when all health care that was available was delivered through physicians, that’s not true anymore. People see many different types of health care professional through their day and often hospitals will employ physician assistants or nurse practitioner to augment the presence of a physician in many places where there are too many patients for a single physician. So knowing that people gained health care knowledge from specialists who aren’t doctors means that health care is being delivered by these people and that means that their contributions to our community are welcome and just as important as anyone else is. The way we select our audience is essentially by keeping the content on Figure 1 focused on their needs so when you go to Figure 1 you won’t see patient’s conversations and you won’t see conversations about you know how people start care for a disease but you’ll see cases that are in the active phase of treatment or haven’t been diagnosed yet and you’re seeing an inside conversations of what it looks like when healthcare professionals interact in real life. So, you know building something that people will find useful and that is built to suit their communications needs, I think is probably the most important thing that we’ve could have done; essentially treating professionals like professionals.

Dave Kruse: You know that makes sense and how did get the first view of healthcare professionals on the platform and grew out from there.

Dr. Joshua Landy: As a physician myself I work with a lot of physicians and so the initial users were just people who were in my own personal network and you know as people see it they refer it to their colleagues and in fact to this day one of our biggest sources of traffic is, we actually can’t tell where it’s from directly because it’s not from, we don’t get so much traffic from any particular website that draw in or sends traffic to our app but what we see happening probably the most is that when we ask users how their heard about Figure 1, they are telling us that they heard about at work, that means that other people are using it at work and showing it to each other at work and that organic growth has been an enormous driver.

Dave Kruse: That’s powerful.

Dr. Joshua Landy: Really powerful, really powerful, I mean, it not only does it mean that people are using it at work but people are using it to the point where other people are seeing it in a generated discussion. So creating a tool that is going to be relevant to people in their work flow, that was really an important thing, I think that we did. There’s a lot of workflow tools out there for physicians and I’ve been pitched for lot’s of tools that are going to “transform my workflow” and that’s something that I dread, like that’s not something I want, I don’t want you to change or blow up my work, that’s going to make me like irritated, what I want is something that will augment what I am already doing and make what I’m trying to do easier and so if I have a tool like Figure 1 where I need an opinion and I’d like it right now please, I can post a picture, request the advice from an ophthalmologist or a cardiologist and I can have that information in 20 minutes, which is probably as long as it takes for a physician in a hospital to even answer a patient.

Dave Kruse: Oh ! it’s that fast, … it can be.

Dr. Joshua Landy: Oh sure you can re-post a case and you start to hear responses within minutes.

Dave Kruse: So can you walk us through how it works exactly, let’s say a physician is with a patient and is unsure you know about the diagnosis and they’re like, well I’m going to post this to Figure 1, can you walk us through how that whole process works.

Dr. Joshua Landy: Sure.

Dave Kruse: Do they send it to the whole community or can they send it just to like certain people or…

Dr. Joshua Landy: Okay so healthcare professionals on Figure 1 can tap the upload button to start a case. There’s a consent form built in with a prompt that pops right at the beginning, which has a built-in consent form for you to show to your patient or their representative and then you can, in the signature either in the app itself of you can do it offline if that’s what your hospital or jurisdiction demands. Every jurisdiction which might mean city to city, county to county, state to state, or even country to country; the privacy rules, regulations and policies change, so it’s important that all users be aware of what the policies are in their jurisdiction and then after their consent process is done, you simply, you either import a photo from your camera or you take a picture using the app, you can annotate those photos by either cropping things out or marking them up with arrows and there is a reminder there about how to remove private details; so names, numbers, birth dates, tattoos and faces are all things that aren’t allowed on Figure 1, among other things. So removing those pieces of data is what makes these cases sharable. Each doctor will add a caption underneath describing what they’re seeing and asking any questions if they have them and then simply finish uploading their photo after which point, the behind the scenes work begins. The behind the scenes part is that all of the identifying data that’s built into most smart phone cameras; that data gets wiped away so there’s no location or timestamp data on that photo when it’s uploaded to Figure 1 and then the images are reviewed manually by a team of moderators here at Figure 1, who are looking specifically to ensure that privacy is protected and that the images are appropriately educational and that there’s no sensationalistic content there. I mean, the goal was for us to contribute to the community not to shock it.

Dave Kruse: Gotcha and what if the case doesn’t need a photo, is there a photo required ?

Dr. Joshua Landy: So right now every case has a photo attached to it. We do permit people to upload photos of related illnesses or sometimes if you don’t have a picture of the patient, sometimes you can take a picture of the medication if you’re asking a question about the medication that the patient takes. So there is a lot of alternatives if you didn’t snap a picture at the time. The idea is to generate conversation and teach people something about the case you’re seeing or perhaps to learn something depending on what side of the coin you’re on.

Dave Kruse: So after your team at Figure 1 kind of scrubs the photo, makes sure it’s okay, they send it out to the community, does that go out to everyone or can you say just ophthalmologists and it will just go out to ophthalmologists or how do you even target a smaller subset like a certain specialist.

Dr. Joshua Landy: Yeah if you want advice from a particular set of specialists, like an ophthalmologist, you can actually indicate that by using a feature that we call paging. I mean, we named it that because it’s just like paging a specialist from a switchboard and the Figure 1 sort of server has an algorithm that finds a particular population of verified specialists of the type who’ve requested and will send that case to them specifically and they’ll get a push notification letting them know that their opinion’s been requested and those are the cases that have a higher response rate; typically an answer is posted within…, I think 26 minutes, is the average these days.

Dave Kruse: Well that is amazing and they don’t necessarily get compensated, this is just the…

Dr. Joshua Landy: That’s right.

Dave Kruse: Interesting.

Dr. Joshua Landy: Yeah, I mean the idea here is that these are professionals asking other professionals and indeed people will sort of like give and take right, this is a short discussion, you’re not asking for much of this person’s time and in fact you’re not even asking them to review the entire case, only to answer the one questions you’ve asked. The mode of consultation in Medicine is that a consultation is based around a question. So you have asked the specialist to review your patient and you have a question about that patient if not just generally help make this patient better. Often if you’re asking an ophthalmologist a questions that’s you now, if you see a patient whose got blindness in one eye, you might say, can you tell what’s causing this person’s blindness, you’re not going to say; you don’t know what’s going on, can you help and then they have to start asking a series of questions right; you try to be as specific as possible so that person knows exactly where to direct their attention and the same is true in the app, people will do that sort of directional questions to help. If you’re a user and you are, say a Cardiologist and you only want to see cardiology images, you can define your own feed of images yourself and select as many or as few specialties as you want.

Dave Kruse: Okay, do you see many cases where your team at Figure 1 might already know that this question has been answered many times before or do you just automatically send it out even though it’s kind of typical question that’s asked.

Dr. Joshua Landy: Yeah I mean, we upload cases even if they seem similar and only because there’s almost never two cases that are exactly the same and there maybe some prevailing piece of information that changes the meaning of one particular case where it wouldn’t be different, you know, even if it’s very similar it may be slightly different. It’s also good to have a different pictures of the same disease because then if somebody comes on wanted to use Figure 1 images as a resource like, they are seeing a picture of skin rash called erythema nodosum and they want to know what is erythema nodosum look like when in its classic pattern and when they search Figure 1 and if they only come up with one example, that sort of doesn’t give you a lot to go on but if you have 50 examples, you sort of get a sense of what it looks like on white skin, what it looks like on dark skin, what does it look like when it’s advanced and what does it look like when its early, you know those sorts of variations is what really gives you a lot more information to give multiple tokens to each type of image.

Dave Kruse: Can the general public search for all this information.

Dr. Joshua Landy: Yeah, I believe they can. I think the non-health care professionals searching the Figure 1 have a search bar in it and so you can access that function just as well. Non-healthcare professionals aren’t able to contribute content so they are not able to discuss or add images but to be honest most of the conversations are fairly high level; are sort of the professional and even at times academic level. So you know it’s a resource certainly and its available certainly but it’s not designed to be specifically helpful to patients at this time.

Dave Kruse: I gotcha, okay. Yeah I remember seeing a search bar and I did some searches, I just didn’t know if it indexed out, you know, most of the cases and it’s not indexed by Google, right now right ?

Dr. Joshua Landy: Yeah not at the moment. We had some concerns about you know, this data is very, it’s sensitive right; these are peoples illnesses and we want to make sure that the data is protected in the appropriate way so at the moment it’s not indexed to search in that way.

Dave Kruse: So do you have one or two good case studies where somebody just could not figure something out. It sounds like the responses are pretty quick, but are they some cases where just no one has an idea what if this might be and then, but over time …

Dr. Joshua Landy: Yeah that’s happened, certainly, and you know, even something we’ve been computing lately is; if there are cases that exists that people know about, like there was a case, a very shocking medical condition in the United Kingdom where a young girl was having these episodes where she would spontaneously bleed from her eyes and ears.

Dave Kruse: Oh my!

Dr. Joshua Landy: Those pictures are just absolutely shocking and this has sort of baffled a lot of physicians that she’s seeing as specialists and so somebody posted on it Figure 1 and we don’t have an answer for her either but certainly; in fact there are lots of those mysteries that don’t get found out, sure; and there’re lots of ones who do but sure there’s some of them.

Dave Kruse: Interesting but I feel a lot better knowing that Figure 1 is out there, in case I come down with something. I feel like you have the power of the network behind you instead of just your doctors whose sitting with you in the room.

Dr. Joshua Landy: Yeah I mean, just think about you know a general practitioner saying I’m not sure I know what disease you have but let me take a picture and I’ll ask five hundred thousand of my colleagues and I’ll be back in five minutes.

Dave Kruse: Yeah I mean it’s amazing and that’s why …

Dr. Joshua Landy: Like connecting the world to medical knowledge is something that is long overdue, right . We see the long times that it takes to get from introduction of a useful therapy to the time when it becomes common place, you know and that length of time is unacceptably wrong, it’s like 10 years to go from an official SSID releasing an official set of guidelines for therapy to the point where those guidelines are routinely used and that type of time span disadvantages 10 years worth of patients. So having a platform like Figure 1 where that information can instantly be transported across borders, you know, in seconds I think it’s something that will meaningfully contribute to the future of medicine.

Dave Kruse: Definitely and where do you want to take Figure 1, just keep expanding, do you want to get into more areas? I mean, I always pictured; that you’re an ICU doctor and if I was in ICU like, maybe I would want all my vital signs or anything made available to the public for the same reason that maybe somebody would catch something that my own physicians aren’t catching. That’s taking it to the extreme but I think at least I’m very opened about my medical issue or I would be and …

Dr. Joshua Landy: Yeah, I mean the natural extension of this is to think about Figure 1 as the world’s first global digital teaching hospital and that this is a place for medical students and residents can go and see cases and practice and be given advice by experienced clinicians and specialists and help shape their practice and for people who are practicing in the field for them to bring interesting cases forward and have those cases seen without needing to you know take a week off to attend a conference to present a single case amongst 5000 others, right? this is the thing you can do from your office and bring something interesting to light to demonstrate or either the hundreds of thousands of other healthcare professionals who will see it later that day or week.

Dave Kruse: So how do you see this changing how physicians are trained and what type of skill sets are necessary. Theft management’s going to be, you know, it’s different than, you know…

Dr. Joshua Landy: That’s for sure. I guess one of my thoughts on how Figure 1’s going to evolve, which is to say, when you picture medical education, you picture classrooms and you picture wards and groups of students rounding together with their residents and attending physicians and to be honest that mode of medical education hasn’t changed substantially since 1903 that’s when a report called the Flexner Report was published and it basically describes and subsequently quantified the way medical education was being delivered the in the United States. Since then things haven’t really changed a lot, sure! now we have power point so okay there’s more slideshows, but the truth is that when you transport an old format into a new medium you end up with something you don’t recognize and so that’s why a lot of old media, that’s why social media and traditional media look different on the internet right. You can’t just take something that works in real life and try to put it through the internet and expect it to look and feel the same way. So by, you know, creating an app and developing a tool that is designed for the mobile on the go physician who has habits of knowing how to message people on social platforms knowing how to upload photos to social platforms leveraging those behaviours that people already have, I think what we are doing is we’re creating a hybrid model of social and professional, which ideally helps your knowledge stay up to date while at the same time being satisfying to you.

Dave Kruse: Could you see yourself creating essentially training modules, so like an ophthalmologist would essentially could go to the app and be trained on lots of different real cases.

Dr. Joshua Landy: There’s no question that that is something will exist on Figure 1 one day.

Dave Kruse: Interesting.

Dr. Joshua Landy: Creating tools and sort of mini- curricular that will outline and demonstrate the 50 most important cases you will see as an Acute Care Surgeon or you know the 100 different ways that a heart attack can present on an electrocardiogram or different ways to look for a collapsed lung on x-ray, I mean, these things are very easy to collect and collate on Figure 1 and I think it’s just a matter of time before things like that arise naturally.

Dave Kruse: Is there anything else like that that you like to see Figure 1 evolve to overtime.

Dr. Joshua Landy: There are so so many, well it’s just a matter of time, I mean, to take all the tools and resources in technology that we use that costs tens or even hundreds of thousands of dollars and take that infrastructure convert it to something that has a distributed knowledge ferocity like Figure 1 and you can deliver much more value at almost no additional costs. So by taking technology out of the hospitals and putting it in the hands of healthcare professionals, I think that we are going to see a rapid improvement in communication techniques and potentially even interpretation of tests. I don’t think it’s so farfetched to picture Figure 1 having a module where you can shoot a picture of an ECG and it points out to you the things that you need to pay attention to.

Dave Kruse: Yeah I was going to ask what kind of vision ….

Dr. Joshua Landy: __36:33 __ vision and machine learning model, the sky is the limit. For us, we are only limited by our own small recourses right like our company isn’t behemoth, not massive it’s in fact it’s pretty small for a medical technology company so you know we can only build one feature at a time but we are trying, we are trying to build things as fast as we can.

Dave Kruse: Have you ever thought about kind of opening up the platforms so that people could build their own tools on top of it ?

Dr. Joshua Landy: We’ve been asked if we would do that, those requests are infrequent and so it hasn’t been something that we developed very much but it’s not something I am closed to into the future just need to have, I think a sufficient demand and I guess the prevailing belief that, that would be helpful.

Dave Kruse: So we’re coming to the end, or near the end, I’ve got a couple more questions. One is, I liked to ask most folks as you know lessons learned through this process; have you learned some lessons that you would maybe do differently next if you did it again .

Dr. Joshua Landy: There’s lessons learned that I sort of like learned and applied hopefully many of them in time. I am sure if I had learned these things earlier you know our company would be further along the way where we are now but there is a very, and I think it’s a very natural inclination for you to picture how your products will evolve, you know you sort of think, we are going to add this feature, then like, we’re going to add a feed, that would be first then we’ll add a search and then we’ll add a browse function, then we’ll add a profile and you’re sort of like grow it just like any other, and you’re sort of goal directed about how you want to deliver new pieces of your product but you now within the past year we really really changed the way we think about, what the next steps are, you know we are a company that has you know a mission and values but what we want to do is keep those in mind as we develop new features but have the features be not just there because they are supposed to be but have them serve a purpose and have users give us feedback on what they want to see in it and so by learning what engages healthcare professionals really on a product, learning what engages your users and letting them guide you is not a natural or automatic sort right, like that is something that has to be very deliberate for you to say, we are going to plan to interview a hundred or a thousand users, we are going to ask them how they find this useful. We are going to ask them what they want and we are going to find out if they use it and then we are going to build that but sort of doing it from the beginning and saying, alright I know what are first ten steps are, No you don’t, you don’t know anything, you don’t know anything until you’ve talked to your users.

Dave Kruse: That’s good advice, that’s good okay. Last question is, right now is it free for everyone and I know you’ve raised, I mean you’ve guys raised about $30 million from some pretty significant venture capital firms, I know you’re small but for a start up you’re doing quite well.

Dr. Joshua Landy: Yeah we’ve raised just over $10 million dollars from a number of investors, chief of which is the most recent lead investor on our series A which is Union Square Ventures, Union Squares is well known for being you know one of the first investors in Twitter and Tumblr, Etsy, Kickstarter, and sound cloud.

Dave Kruse: Yep, they’re pretty brilliant.

Dr. Joshua Landy: They brilliant and they know and they really really have an appreciation for how people build networks and how those networks effect the product and so having their guidance has just been absolutely marvellous. So you know, you asked or you sort of hinted that the app is currently free maybe perhaps wondering if one day it won’t be but I think if we are trying to engage a worldwide network of healthcare professionals there is no question that this app has to stay free for those people to use at anytime. When it comes to making money we are currently conducting a series of experiments with various types of revenue streams so we’ve experimented with sponsored content sort of like made-up advertising type of thing. We were experimenting with market research information and there’s a bunch of more tests that we haven’t done yet but are planning to do later this year and really the goal is to find out which of these monetization experiments will lead to adding value to the network because of course you know our investors and board is expecting that this company is going to be successful financially and indeed I am sure that we will be but the only thing that matters is if users are using your service. So if you’re going to try and make money from somebody who doesn’t want to do what you’re trying to get them to do they will leave and you will not make money. So if you can figure out something that will add value to that user’s experience, they’ll stick around . So by making sure that we balance those two things carefully as we move forward and we discover more I am hopeful that we’ll be able to strike a balance that makes sense for our company.

Dave Kruse: Yeah that makes sense and you probably wouldn’t necessarily open up to consumers, like consumers asks the community questions for like, you know, parents are…, I’m a parent, we’re fairly psycho, you know we’d pay $250 to have access to all of these different physicians but that would change the model.

Dr. Joshua Landy: It would.

Dave Kruse: That would definitely change the model.

Dr. Joshua Landy: It would also change the way that the community extracts with itself. You know, and it’s still fairly early, I mean if that was something that would happen, I couldn’t see that happening for a very long time.

Dave Kruse: It makes sense.

Dr. Joshua Landy: And if I did do it, I don’t think it would be a __42:45 __ it might be a market based things so people could potentially bid on things but to be honest that’s just not on top of my head, and this isn’t something that we meaningfully thinking about taking up right now.

Dave Kruse: Fair enough. Well I think we have come to end now. Definitely appreciate Josh, it’s inspiring what you guys are doing and like I said I feel safer knowing it’s out there.

Dr. Joshua Landy: Thanks so if anybody is listening and you’re in your doctor’s office today, don’t forget to mention…, ask your doctor if there are using Figure 1.

Dr. Joshua Landy: That’s going to be a perfect TV commercial, right there.

Dr. Joshua Landy: One of these days I’ll get around to writing it.

Dave Kruse: Yeah that’s right. Alright, thanks Josh and thanks everyone for listening to another episode of Flyover Labs from Madison Wisconsin. We appreciate it, we’ll see you next time, bye.