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John Slamin graduated from the Wentworth Institute in 1974. That was before biomedical engineering really existed and certainly before the U.S. launched the Safe Medical Devices Act of 1990. A new graduate, Slamin interviewed with Johnson & Johnson in Randolph, Massachusetts, to work with an R&D group. He hasn’t left the medical device realm since.
Slamin spent 33 years at Johnson & Johnson’s orthopaedic division and ran the knee R&D program between 1987 and 1996. In 2007, he joined the ranks of Conformis, a startup at the time, and began serving as its CTO in March 2021.
While at Johnson & Johnson, Slamin worked with biomechanical engineer Peter Walker, Ph.D., which is where he got his start in knee design and biomechanics. After a string of “not successful products,” Slamin said he and others recognized that they had one more chance for success. What they devised in 1986 was the “rousingly” successful P.F.C. (Press-Fit Condylar) knee implant system. It became the number two knee worldwide, and the brand name lasted for more than 20 years, Slamin said.
Johnson & Johnson acquired DePuy in 1998. Slamin stayed at DePuy for nine more years, but realized the now-larger company was more risk averse, and he sought a more innovative role. He was introduced to Conformis Founder and CEO Philipp Lang in mid-2007, and he never looked back.
What attracted you to Conformis? Is it that ability to innovate?
Slamin: It was a fundamental idea that Conformis had what was well-understood in the market: that patient satisfaction was not very good for knee replacement surgery; only about 70% — it’s still true — of patients are satisfied with their off-the-shelf knee replacements. Hip replacements are more like 90%. There are biomechanical reasons for their satisfaction rates. When I was at DePuy, we were talking about a satisfaction program. But as soon as (Lang) presented to me his ideas of how to change satisfaction, the light came on.
I can take that idea with my knowledge of the design and knee replacements and do something significant to it. And we did. It was the opportunity to really innovate “out of the barn.”
What kind of advancements do you expect that we’ll see in the knee and hip space over the next decade?
Slamin: Well, I’m hoping that the application of patient-specific implants will catch on. So far, it’s an uphill battle. You present the opportunity to have more satisfied patients, and the first reaction of a surgeon would be “Well, I don’t have that problem.” Let me tell you a little analogy that a famous surgeon told me once: orthopedic surgeons use data much in the same way that a drunkard uses a lamp post — much more for support than illumination. Doctors are only interested in believing data that supports their view. If it’s a newer, different view, it’s very difficult to change.
You will see that most of our customers, not all, but most of our customers are young surgeons right out of their fellowship who are interested in being on the cutting edge. So, I mean, my hope is that more patient-specific implants will be able to become adopted and widespread, and that we are successful in bringing the cost of that down. Even though there are studies demonstrating that the use of our implant long-term saves the system money, because there are less complications, it’s another case where surgeons don’t want to be confused with the facts.
What would you say is your favorite part of the product development process and why?
Slamin: The early stages of “What is it going to look like?” and then “What are the engineering methods we’re going to use to validate this idea?” Really early, looking at the ideas and developing it. “What combination of computer analysis and physical testing is going to be required in order for us to prove that and then prove that to FDA?” That’s the true innovation part of it that’s early on.
Would you say that there are two or three key lessons you’ve learned over the years?
Slamin: I’m sure there are.
Or even, maybe, two lessons you’ve learned in your time as a CTO?
Slamin: Most of the important lessons involve how to manage people. My management style is much more to allow individuals to make some mistakes. I’m not going to let them make a catastrophic financial mistake, but the best way to learn is to make a mistake. I try to teach them as much about the history as they’re willing to listen to, which I think is important in any engineering. What doesn’t work, you don’t have to make that mistake again. Maybe my proudest achievement is actually the people whom I’ve trained, not the product.
Going off of that, what do you think is the most important thing that company leaders can do to look out for the wellbeing of their teams?
Slamin: Allow them to innovate, encourage them to take reasonable risks and provide financial and professional rewards when it’s appropriate. People need normal and appropriate salary growth, but in some cases, special incentives are warranted.
Let them be part of the decision process, too. Don’t dictate to people. I would much rather steer a conversation that brings them to the conclusion that you want them to come to, rather than tell them what to do. Sometimes, that takes weeks or more.
Do you have any additional comments you’d like to add, or feel like it’s important for folks to hear?
Slamin: I’ve worked with some amazing people in my career, both engineers and surgeons. I’ve built a lot of great relationships across the industry and with people that make stuff for us, long-term relationships.
