Welcome to the Medsider interview series, a special new feature at MassDevice, which will appear regularly. All interviews are conducted by Scott Nelson, Founder of Medsider and Partnership Lead at Touch Surgery. We hope you enjoy them!
Jack Dorsey received quite a bit of attention when he was recently announced as CEO of Twitter. Why? Because that made him CEO of 2 of the most rapidly-growing tech. companies in Silicon Valley at the same time – Twitter and Square.
Well, medtech’s version of Jack Dorsey might just be Duke Rohlen. Duke led FoxHollow Technologies through an IPO and then later solid it to ev3 for close to $800M. He also founded CV Ingenuity and sold it to Covidien for approximately $300M. Now, similar to Jack Dorsey, Duke is leading 2 early-stage companies at the same time – Spirox and Advanced Cardiac Therapeutics.
In this interview with Duke, here are some of the topics and questions we cover:
- Why the CV Ingenuity team pursued a US-only strategy.
- Why CV Ingenuity managed their clinical trials internally vs. an outside CRO.
- Duke’s previous relationships with the leadership at ev3 (now Medtronic) and why they were critical to closing the CV Ingenuity deal with Covidien.
- How Duke secured a unique $300M collaboration with Merck while serving as President of Fox Hollow Technologies.
- The major lessons Duke has learned raising money for 4 different medical device companies.
SCOTT: Duke, welcome to the program.
DUKE: Thanks for having me.
SCOTT: Let’s start with a couple of your past exits, CV Ingenuity and FoxHollow, and then we’ll fast forward to the present with Spirox and Advanced Cardiac Therapeutics. With CV Ingenuity, you sold it to Covidien back in 2013 for roughly $300 million and raised about $30 million in venture capital – a huge win from anyone’s perspective.
If you think about when you got that deal done, when the due diligence was finished, the board and investors had signed off, do you remember how you celebrated that win with your team?
DUKE: It was a bittersweet moment for us, because we had a bunch of employees that were really committed to growing this company for the long run. The engine was there. So I think our people were actually surprised that we decided to pull the trigger, even though the exit value was high and the return on equity was high. We had a small family that had worked exceedingly hard, which is how we were able to move the company forward with such a small amount of capital.
That family was, I think, going through excitement at the concept of monetizing an asset quickly, but also a little bit of trepidation about what happens next and potentially the separation anxiety associated with this understanding.
Eventually, we went out and we celebrated with a bunch of bottles of Duckhorn, which is the wine that Covidien used as the code name for our deal. So it ended up being great, obviously, but there was a lot of consternation amongst the employees as well.
SCOTT: I love the story about the Duckhorn wine. I think in my time at Covidien, I do believe I remember hearing that name and did not realize what it was for.
Before we get into some of the strategies that you guys employed in that successful exit, I want to ask you a question about that bittersweet moment. Is that something that you see more often than not with early-stage medtech companies?
DUKE: Yeah, I think mixed emotions come from just the whole engine being galvanized around doing something big and lofty and creating something that has real meaning. These companies that get sold are sold because the acquirers see that there is tremendous opportunity not only with the technology, but with the team. So they want both.
But when you do that, when you’ve created this engine of confidence and capability, there’s worry about turning it over to somebody else and letting them affect the outcome of that company. There’s concerns about the way that senior management at my company is run versus the senior management of some other company. There’s an unknown there that’s concerning.
And just inherent to transition, there’s fear. So these people end up feeling like, “Gosh, I really liked what we had going with this small company. Am I going to still like that when I’m part of a bigger company when this transaction is closed?” There definitely is. I don’t think anyone who’s part of a great company feels really good, no matter what the price tag that you’re getting for the company, nobody feels totally great about turning it over to somebody else.
SCOTT: That’s an interesting point. I was just going to ask you about that. I almost wonder if it’s a sign of a really great culture and a lot of really good progress, if everyone on the team describes their feelings as sort of bittersweet.
DUKE: I think the way that families work, the way that friends work, or the way that companies work is through transparency. As a company gets bigger, a lot of times transparency gets shut down because bureaucracy starts infiltrating the organization. Necessarily, right. You need to basically have the right amount of bureaucracy in order for a big company to scale.
But the companies that I’ve run have had incredible transparency, where everybody knows what we’re doing, everybody feels bought into a vision. So when you start thinking about going to another company that’s not going to have that, I think that there’s a lot of concern. Transparency to me is our culture. Culture is the people, and that starts with me, obviously, and it goes to everybody. I think that there’s transparency, and that makes people feel good about the great things and also collectively unified around solving the problems of the challenging things. People enjoy being empowered, and that’s what culture to me represents. There’s concern about that going away with big companies.
SCOTT: It seems like you read so much about culture, especially within startups these days. So easy to read and maybe understand at a high level, but much more difficult to actually execute on.
Let’s get on to some of the strategies that you employed, because like I said before, you raised a pretty light amount of capital and eventually sold CV Ingenuity for roughly $300 million to Covidien. That wasn’t just luck of the draw or maybe good timing. Certainly maybe some of that, but are there a few strategies that really propelled you to another level? Maybe one of those that I’m thinking of is that fact that you focused on a U.S.-only strategy from the very beginning versus an EU-only strategy, a Europe-only strategy. Which I think is unique, especially for the medtech era that we’re in right now.
DUKE: It all comes down to making the vector towards value creation as straight and focused as possible. From inception, you have to say, is the market big enough that the company could actually be a stand-alone company? Or are you building this thing to have huge opportunities with just single products?
With CV Ingenuity, we recognized that there was an enormous need for a drug-coated balloon by all these big companies. We recognized that we weren’t going to be first, so what is the value driving capability of the technology? We realized it wasn’t the balloon, so we decided to develop on top of the Evercross balloon with Covidien. We realized that it wasn’t European sales or European approval, so we decided to forego any effort in Europe aside from clinical work that we did in Europe in Germany.
We decided that the biggest play with the lowest-hanging fruit was not in the coronary space. So we completely alienated any efforts that could’ve compromised our vector and went straight after the peripheral market in the U.S. without any focus on anything outside of the product itself. We were very, very tight.
What that did is allowed us to be very lean as a team, so we had a core group of people that were exceptional. Philippe Marco who was the Chief Operating Officer of that company, is best in class in terms of his ability to do what he needed to do in terms of getting approvals, coming up with the strategy, regulatory strategy, enrollment, etc. Incredible. And then we worked really, really hard with that small group of people toward those endpoints. That not only enabled us to be very focused, as I said, but that focus saved a lot of money because you’re not spending resources on distractions.
So focus and cost savings helped us raise very little money, and then when you raise a little bit of money, you have a lot of room for arbitrage. You can go and sell for $300 million, or you can still get an incredible return on equity for $150 million, which opens up the buyer universe. And by opening up the buyer universe, you end up with more offers, which, just by virtue of the fact that you have more people interested, even though some are at a lower price and some are higher price, inflates the value of the company.
SCOTT: That framework that you utilize, really focusing in on that one vector, I think is really beneficial and probably a key learning point. On that note, did you feel like by ignoring the coronary market, by ignoring other regions, Europe included, and just focusing on the peripheral market in the U.S., did you feel like that was a risk? How did you overcome balancing the fact that you wanted to just focus on that versus maybe some alternative paths that could’ve potentially worked out?
DUKE: I personally just spent a long time at FoxHollow, where we didn’t have robust clinical data, yet we had a very, very revolutionary technology with Silverhawk and atherectomy. But my whole mindset was towards clinical data. I looked at the peripheral market and I said, “Gosh, look what happened with drug-coated stents in the coronary market.” There was an enormous uptick based on clinical data that demonstrated utility within nine months.. So my feeling was the peripheral market – and this is back in 2008, 2009 – there was a lot of data that was still needed to drive utilization, yet I felt if you had that dataset, you’d be able to get and command significant market shares.
So no, I never viewed it as a risk. I viewed it as a tradeoff, for sure, but I was very confident that with clinical data, you could go after a billion dollar peripheral market and make huge inroads. I felt it was more of a race to be within a certain timeframe of the leader, which was Lutonix, and to show demonstrably better data. I felt the risk was actually not going after an isolated peripheral market.
SCOTT: I want to ask you a little bit about when the deal with Covidien came to fruition, but before we go there, I remember reading about the fact that you managed your clinical trials internally, versus a common approach of working with an outside CRO. Can you talk to us a little bit about that and why you made that decision, and whether or not it was effective?
DUKE: Yeah, I think it turned out to be incredibly effective. Just like I was talking about at the beginning of this conversation, transparency is important. And transparency establishes trust, and trust establishes loyalty. What we did is we said, let’s go get very, very good, high enrolling physicians that trust us and are willing to go the extra mile. We nurtured and engendered incredible relationships every month before we even started the trial. And then once we started the trial, we were able to leverage those deep-seeded relationships to quickly enroll patients.
Why were we able to do that? We were able to do that because we were the ones actually dealing with not only the physicians, but the clinical staff. Some of the accountability and some of the personal loyalty goes away when that’s outsourced. So even when you get to doing a bigger clinical study, I think it’s imperative that the principals of an organization are actively involved in recruiting sites, are actively involved in not only working with the physicians, but also working with the clinical staff, because the clinical staff is just as important in terms of buy-in as the physicians who are actually doing the procedures.
So it requires more work, but my whole philosophy and my ethos about running these companies is people like to be part of success, and they’re not afraid of hard work. So if you push these people and they’re doing more than they possibly can, they feel great, just like I do. Same thing with the physicians. It’s the lack of momentum, it’s the lack of tension from a timing standpoint, that I think causes some of these things to break down. We focused on doing it ourselves, and I think it paid off in spades.
SCOTT: To be candid, I wouldn’t have expected you to answer that question in that way, but after hearing you explain it, it makes a lot of sense. Especially in regards to empowering your trial sites to get involved and feel like they’re a part of what you’re trying to accomplish as a team and as a company.
DUKE: Yeah, everybody wants to feel important, and everybody is important if they’re treated the right way. When you think about the most important thing for CVI, it was the positive clinical study. Given that the most important thing was that positive clinical study, I felt that it was the best use of my time and Philippe’s time to make sure that that study moved quickly and perfectly. And I would never have outsourced that to anybody, no matter how good they were from a CRO perspective. It was just too important to the vitality of the company.
SCOTT: Before we get into the timing around the deal that you did with Covidien, is there anything else that you want to mention in regards to how much you and your team were able to get done in four years? Any other strategies or tactics that you employed that would be valuable for the audience to know about?
DUKE: One of the things I think challenges small companies is the lack of focus. The lack of focus sometimes comes from answering to a lot of different opinions. Someone will say, “I think you should be going into Europe,” or someone will say, “I think you should be doing this, going into coronaries, etc.” When we raised money from NEA, from our individual investors before NEA, etc, we did that with a very targeted approach.
And that targeted approach allowed for buy-in, which took away a lot of questions at the board level on a going-forward basis. We knew where we were going. Everybody was galvanized around that mission, and everybody worked incredibly hard to make sure it was realized, without distraction. I think that’s a critical piece of any small company. If you look at the companies that spend a lot of money – look at companies in the spine arena for example. They’ve tried this, they’ve tried that, they’ve gone to Europe, etc. These things, they all go back to the fundamental initiative, which is are you building this to sell or are you building this to be a standalone company? What is the fastest way to get there and the most cost-effective way to get there? But that alignment upfront is critical, in my opinion, to being cost-effective.
SCOTT: You mentioned NEA, and I remember reading an article by Justin Klein, who led some of those rounds of investment with NEA. He made a comment about how you’ve done a fantastic job in building relationships at former companies and how that helped to not only get the deal done, but get it done in a way that was a win for everyone. Can you speak about that and how some of those past relationships that you forged at EV3 and at Covidien led to the eventual sale of CVI?
DUKE: Companies are bought strategically, not opportunistically. Meaning, you don’t go and develop a company in a black hole and then hope to sell it to somebody when you have approval. What happens is you have a lot of dialogue. You have a lot of strategic discussions with a lot of companies and let them know what you’re doing and when you’re doing it, and then they can monitor how you do it.
When we sold to FoxHollow, that was how we did it. I actually sat down with the CEO at EV3, who was Jim Corbett at the time, and from those additional discussions with Jim Corbett, I got to know Stacy and I got to know some of the other people that were involved. So then when we sold that company, it was never expected that I would stay at that company, and I was very clear about the fact that I was going to go and do something else.
In fact, I started CV Ingenuity during the due diligence phase of the FoxHollow deal. We had engaged in a lot of dialogues about the peripheral vascular market and potentially the disruption that could come from drug-coated balloons, and EV3 was very interested in understanding what I was doing. I also think they had some confidence in my team that we could pull off something as audacious as developing a drug-coated balloon.
So our Series A, our seed investment included money from Covidien – it was actually EV3 at the time, before they merged into Covidien – that was all driven by relationships that we had formed as I was exiting FoxHollow.
So relationships are key, and I think one of the critical pieces. Just like the CEO or the person who’s driving strategy at these companies has to be involved in the high value initiatives, they also have to make it a priority to know the acquirers on a personal basis. To get to know them, to understand what they’re thinking about, and to engage them proactively.
I probably met with Covidien or EV3 like 20 times. I’m not kidding. Maybe 20 times before we actually did the transaction. Covidien knew what my endpoint was; they knew that I was going to sell the company at IDE approval. So they had a lot of time to do due diligence on the company, understand what the opportunity was. So when I said, “Listen, I want to sell the company and we’re going to do it, and you can be competitively advantaged if you go and move quickly,” they responded immediately.
They also knew that optionality is what I completely subscribe to. You have to have options, and they know that. I was very transparent and said, “Hey, listen, if you don’t want to buy it, we’re going to sell it to somebody else, and there are a bunch of buyers that would want it. So either step up and step in at a big level, or step out.” There was a lot of confidence in my ability to communicate that.
SCOTT: The mantra of “people buy from people,” that applies, even in this type of situation, right? They trusted you, they knew your experience. You’d built solid relationships over the years. Clearly it impacted your success in making that deal happen.
DUKE: That’s right. Ryan Drant and Justin Klein funded CV Ingenuity, and Ryan and I had gone to Stanford together and didn’t know each other very well at Stanford. But Ryan had been involved and seen how we operated our companies at FoxHollow. Ryan and Justin were true partners in CV Ingenuity. Incredibly value-added guys who are great investors, in my opinion. Great because they buy in, and great because they add value. They buy into the strategic direction because they think it makes sense, and then they add value on a going-forward basis. But that relationship doesn’t happen overnight either. You’ve got to nurture that along so that they’re ready to pull the trigger on investing when it makes sense for them to do so.
SCOTT: That’s a great perspective. I think the takeaway is just like in all relationships, don’t burn any bridges and really try to foster and take advantage of everyone you cross paths with as time goes along.
As I mentioned in the intro, you spent quite a bit of time at FoxHollow, led that company through an IPO, and then eventually sold it to EV3. You participated in a lot of interesting things, like the partnership with Merck that I think was very unique. You took that company through an IPO. When you think about some of those deals that you participated in and led at FoxHollow, do a couple of those come to mind? Any takeaways that were valuable for you after you exited FoxHollow?
DUKE: One of the things that I take a lot of pride in is the deal we did with Merck. That was a deal that was unprecedented at the time, which is that we were taking out this plaque, and we thought we could figure out a way to use the plaque to help understand disease process after it was influenced by medicine.
So the concept was that you could get a baseline of disease in one leg (when you do an atherectomy on one leg) by taking that plaque out and doing the analysis. You could then put a patient on medicine, and then when you go back and treat the diseased leg on the other side, you could see if the medicine actually influenced the disease process.
It was a really novel idea, and it was also a big idea. What I learned about that is it just takes a lot of knocking on doors. We just started talking to companies and trying to sell them on this vision, because I thought that the vision made sense. And then we ended up doing that deal with Merck, and it became a multi-hundred million dollar deal, with Merck buying 10% of our company.
One of the takeaways for me about that deal was I had complete conviction that there was value that could be realized from this transaction. As I was flying all the way around the world selling this concept, I knew somebody should buy it. Somebody should engage in it. Again, it goes back to knowing with confidence that there’s a value-added proposition associated with the efforts you’re doing, and then being very, very tight about who could benefit from it, and then going after it. We ended up finding a group in Merck that had a very visionary approach to drug development and engaged in a big way.
The takeaway for me is that you’ve got to work pretty hard and you’ve got to be pretty clear about the value proposition in order for you to get anything to happen. And it took a year; it took a lot of knocking on doors and a lot of failed ideas and potential meetings for that to happen, but we ended up getting that deal done.
The second one was in regards to the actual sale of the company. We were at this pivotal point as a company where we needed to consider becoming an aggregator company by buying other companies – we had looked at the LifeStent, we’d looked at Invatech out of Italy, and the feeling was we either needed to leverage our distribution channel or we needed to sell to some other company. We were at the size where it was hard to sell a company, because we had a lot of money invested at that point.
I think the lesson for me was if you’re going to be a single product company, and if you’re going to be public, you’d better have a pipeline. And that revenue line had better be stable. I think that we found a great buyer in EV3. I think actually EV3’s ultimate acquisition by Covidien was in large part attributed to the logic of having atherectomy with their balloon and stent lines. So I think the ultimate vision of having a multi-product company that leverages an infrastructure was realized. I would say that I think FoxHollow could’ve done it if we had thought about being an aggregator company, but we weren’t organized to be that kind of company from inception. You have to be able to do that well if you’re going to become a standalone company.
SCOTT: Back to your example with Merck – if I understand that right, I presume you got a lot of “no’s” as you were pitching that proposition. But as you mentioned, the underlying conviction that there was true clinical value at the core of that concept led you to keep knocking on those doors despite the no’s. Is that fair to say?
DUKE: That’s absolutely right. I was working with some great scientists over at Stanford. We knew that there was a lot of rich data in the plaque, and we knew that plaque could be influenced by drugs. If we could basically measure that, it would have tremendous value for companies that are spending hundreds of millions of dollars trying to get an outcomes-based study complete. If you can know what’s going to positively influence a disease process early, which is what we were trying to demonstrate, it’s worth an enormous amount of money.
And that’s where I felt very confident when we structured that $300 million deal with Merck in saying, “Hey, listen, this is worth $300 million,” even though we were basically selling them the stuff that we were taking out of the bodies to throw away. It was that confidence that gave me the ability to negotiate a strong deal.
SCOTT: Let’s fast forward and talk a little bit about your experiences at Spirox as well as ACT, Advanced Cardiac Therapeutics. You recently raised a Series C for Spirox, so congrats on that. I think I read it was around a $45 million round. I want to contrast that with the deal you structured with Abbott for ACT back in 2014 that was more of a corporate venture collaboration. Can you compare and contrast the two in regards to your experiences raising money for early stage companies.
DUKE: I think they’re very different. Spirox is a technology for the ear, nose, and throat space. You’re right, we did raise money from our insiders, so we had Venrock, we had Aperture involved, we had WTI involved, and then we brought in Aisling and KKR. So we have a very strong syndicate. Unlike most medical device companies, we have about $60 million in the bank. We spent about $10 million to get where we are and we still have a lot of money in the bank. And we’re approved to start selling the product.
It’s a very different paradigm, it’s a different world right now, where capital risk is a significant risk for companies. So I thought, let’s just take out that capital risk by bringing in the money that we need to get to a hundred-plus million dollar revenue company and bring in a group like KKR and the other syndicates that are involved in the deal that give us flexibility to make moves – make moves to either buy a company or to build a company the right way, without having to worry about short-term responses. So to me, optionality and reducing capital risk is a critical part of being a medtech CEO.
The Abbott deal was somewhat similar. Advanced Cardiac Therapeutics was a company that I’d known and followed for a long time. They had run out of money and were looking at shutting down the company. I called up Justin Klein, who’s a friend of mine, and said, “Let’s go and recapitalize that company, because I think there’s a lot of interesting room to grow that company.” And we did it. We took advantage of a lot of good work that had been done and raised $7 million.
And it just so happened that Abbott was putting together this compilation of companies that was going to be the basis for their EP franchise. They looked at Topera and they looked at ACT. So it made sense for us to not take venture money from them, but to give them the opportunity to buy the company. They put less than $30 million into the company without any equity rights; they basically just got the option to acquire the company, and the acquisition trigger point became CE Mark.
What that did was effectively gave us a straight vector to what the value creation inflection point was, and for us it was to build this to CE Mark approval and show that it works in humans, and then you get paid. So we took out all market risk, we took out all capital risk with them, and made it a straight shot execution play, and I was able to build an incredibly good engine to do that.
Spirox has an incredibly good engine, too. It’s just a different play. We have big investors that have a lot of money, so we are going for a big company there. But the differences in the model allow for me to actually manage both companies effecitvely. Spirox has got a great team, ACT’s got a great team. But ACT is focused on CE Mark, whereas Spirox is focused on growing a company that can hopefully be a publicly traded company that has multiple products in the next three to four years.
SCOTT: I can see why you’d say that it allows you to effectively manage both because of the clear shot to the goal with ACT versus what you’re trying to do with Spirox.
Before we end our conversation with a couple rapid fire questions, what is your general advice for those early-stage founders that need to raise money? Do you have any advice in regards to raising it with traditional venture capital firms vs corporate venture arms?
DUKE: I look at companies as three parts that are equally important. You have to have a technology that addresses an unmet need, that has reimbursement, that can get clinical data and can come to market in a timeframe and with a cost allocation that makes sense. If it takes you 20 years to develop something, the market’s going to move beyond you. So there needs to be a period of time that that makes sense.
That technology is complemented by two things. A team for sure. And what is the team? The team is not just the technology people that know the product. The team is the people that are required to develop a business plan. That could be the venture guys, that could be a private equity group, that could be advisors. If you’re going into a highly political industry, it could be people that represent political persuasion.
But the third piece has to be that business model. So you have to have a business model that says not that “We’re going to be able to sell this amount of product to get this amount of revenue”; you have to be able to say, “This is how we’re going to get equity returns for the investors.”
So when you look at it at this whole, you have three contributing factors. You have a business model which has to be sound and clear. Are you building a product to sell or are you building a company to last? Two, you have to have a great technology that facilitates that. And three, you have to have a team that’s all comprehensively oriented to that business model. I think a lot of mistakes are made when people just focus on the technology. “We’re going to build this technology because…”, and there’s not a lot of business strategy around that.
The next thing is that you have to be capital efficient. You just look at all of the roadkill that’s on the side of the roads from the last 10 years of medical device investing; it’s given this space an incredibly bad name. It’s because they’ve spent a lot of money and they don’t have a lot to show for it, and it’s not because of anything other than changed business plans. I think you have to be incredibly capital efficient. Capital efficiency requires tradeoffs, and tradeoffs are based on creativity. So you have to be creative and capital efficient with early money in order to be able to track later money.
And then the last thing I would say is you have to have an ace in the hole. The ace in the hole, for me, is somebody who knows without question everything about that technology, everything about that space, and can give you a competitive advantage over somebody else who doesn’t. Every one of my companies has at least one employee, if not two or three, that are what I call “ace in the holes.” I work with the best and the brightest in order to make sure that we’re nailing what we want to do.
I think if you nail those three things, you have a chance. And then things have to break your way in order for it to work out.
SCOTT: Three really, really good takeaways in regards to raising money for early-stage companies. Before we run out of time, let’s transition to the last 3 rapid-fire quetions. First, what’s your favorite nonfiction business book?
DUKE: I have two. I love Stephen Covey’s book, 7 Habits of Highly Effective People. I know every one of those habits. I’ve read those books maybe 20 times; I think they’re phenomenal. I have them on tape, etc. I think that’s the best nonfiction business book I know.
I also read a book about five years ago. It’s about this guy Peter Barton, who founded Liberty Media. He ended up dying of cancer. But his book was Not Fade Away. It’s an incredible book about his life and lessons in balancing family, work, and career aspirations. Those are my two favorite books.
SCOTT: Is there another CEO or business leader that you’re following right now?
DUKE: My favorite CEO is Jeff Bezos from Amazon. He basically lives by the philosophy of “attack, attack, attack, let’s keep going, let’s keep going, let’s keep going.” He thinks big, he invests the right amount of money, he’s grown a company that’s profitable and that’s taking over the world. He’s not in the medtech sector, but he’s a guy that I think is extraordinarily bright and has combined beautiful strategy and vision with unbelievable execution.
SCOTT: And then lastly, when you think about the course of your medtech career, if you could rewind the clock a little bit and give some advice to your 30-year-old self, what would that be?
DUKE: One time when I was at FoxHollow, a board member – I don’t know if he liked me or didn’t like me, but he told me I was “impetuous but honest, competitive but convivial.” I didn’t really understand what most of those words meant at the time. But I wrote it down, because I thought it was really interesting. Initially, after looking up those words, I thought he was dead wrong.
But, I think he was actually dead right. I think you have to be impetuous, you have to be honest. I think you have to be competitive, but you also have to be friendly, and you have to do it in a way that makes people want to continue to work with you. Because it is based on relationships; at the end of the day, you’ve got your integrity and you have your relationships. Those will attract people that will allow you to be successful. You’ve got to be competitive. You’ve got to push hard, and you’ve got to attack, attack, attack. So to my 30-year-old self, I would advise myself to continue to be aggressive.
SCOTT: That’s good stuff. Duke, thanks again for your willingness to do this interview.
DUKE: My pleasure. Thank you, Scott.
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