Dr. John Martin (Chief Medical Officer, Butterfly Network)

Dr. Martin, the Chief Medical Officer of Butterfly Network, completed a residency in general surgery and vascular surgery at Parkland Memorial Hospital in Dallas, Texas. He is board-certified in vascular surgery and a Fellow of the American College of Surgeons. He served in the United States Air Force for 7 years first as a corpsman and then, after completing medical school and training, he returned as a surgeon. He has held multiple positions throughout his career, including Chief of Vascular Surgery and Director of Heart and Vascular Services at Anne Arundel Medical Center, President of Cardiology Associates, and Vice President of Physician Operations for MedStar Medical Group. He is the founder and President of the Heart Health Foundation and the award-winning Dare to CARE Program. He has authored multiple peer-reviewed papers and book chapters, holds several patents, and has developed clinical software used across the country.  

Image: Butterfly Network
Image: Butterfly Network

Can you explain your job to a five-year-old? 

I think when you think about this simplistically and get it down to explain it to kids, I thinkit's a perfect group to talk to. What I would say is I work for a company that makes a medical device that uses sound waves to look inside your body to see what's wrong with you, whether you're sick or injured. We do that by using a little device that looks like a razor and we plug it into a phone that's like a smartphone that you would use yourself. We're able to use that information to tell what's wrong with you and then to decide what treatment is necessary. And my job is to make sure that, first of all, we build the right tools that could look and solve the right kind of problems. And I teach people how to use it, why they should use it, when they should use it, and where they should use it so that we can more effectively manage problems faster instead of having to wait to be sent for fancy pictures like an x-ray or a CT scan or an MRI. 

What excites you most about your job?

Have you ever, either with yourself or a family member, had to wait in an emergency room—or been sent for study and waited for the result? That creates anxiety with wondering what's wrong with me, when am I going to get better. And then your mind imagines all the potential different things that are out there. I think all of us can relate to that. 

What's really special about Butterfly and why I'm excited is because I look at Butterfly as conquering time. When you’re sick, providers do a history. They do a physical exam and they say, okay, what's wrong with you? When they didn't know right away—which is quite often, literally two-thirds to three-quarters of the time—it's simple imaging that answers the question.

Did I break a bone? Do I have a gallstone? Am I pregnant? Very simple things, but you have to wait to get those answers. And it's either waiting in an emergency room or being sent out to a radiology place. You get a picture, you’re waiting, you get back to the doctor. And that waiting is terrible. What you do with Butterfly is instead of history, physical, wait, it's history, physical, image. And then I instantly can answer the question. So, I eliminate that whole variable of time. And when you know faster, you can treat faster. And I think one of the really interesting things that's often lost in this conversation is everybody gets it. We hate to wait, but we've built healthcare around people waiting. Time is this ubiquitous foe that we have in healthcare. 

But the other person that's anxious—and we don't think about this—is the doctor. And I've felt it on all sides. As a physician, waiting to know makes me anxious, because I want to know what's wrong with my patient so I can do the right thing. I've been the patient too, and I found my own cancer with this tool. I had to wait, so I know what it's like to wait as a patient. I've been really sick in an emergency room, waiting for images. I know what it feels like. 

Which trend will change the future of medicine? 

Point of care ultrasound, what we do with Butterfly, is such a big change. Throughout history, we’ve practiced medicine that same way. And right now, the majority of medical schools in this country are teaching all of their students how to do ultrasound. Now, the next generation of students are going to know how to do this. If you look at the residency programs now, you have almost 40 to 50 percent of the residency programs making it a requirement. So the fact that now—instead of it being a technology job in radiology—all doctors in all specialties, in all care venues, no matter where you are on earth, can do this. Because we're now everywhere as well as up in the space station and at the bottom of the ocean.

So we're now on every continent. And that is a fundamental shift. It's a huge shift in the way we practice and why it's so important is because it's not just one specialty. When we invented the stent, we'd made it great for cardiovascular disease for cardiologists and vascular surgeons, but not for everybody. A GI doctor doesn't need that. This tool touches everyone in every care venue, no matter where you are, whether you're in a hospital, a clinic, an ambulance, in the home. So I think this is the most monumental shift in healthcare that we've seen in the last hundred years. 

Looking back, which trends have you missed or underestimated? 

Okay, true confessions. Where was I a dope? You know what, I'd probably say robotic surgery. And here's why: I've been a surgeon and I think I was a surgeon when I was born. It just took a while to get there.

It's like when Michelangelo said the statue has actually been there all along, I had to get the other stuff out of the way. I think that was me as a surgeon. There’s something about being at the bedside right next to the patient, intimately involved in that procedure itself with my own eyes and hands, touching the patient. It was hard for me to relate to somebody sitting in a little control room doing the same thing. And if you look at the early results of robotic surgery, the outcomes were not dramatically different. And it was incredibly expensive. And I may have been one of those stubborn old guys who looked at that and said, nah, that, that's never going anywhere.

It obviously did. And so I think if you had to ask me, personally, where I was the biggest dope, that was it. I saw the value of laparoscopic surgery, certainly all the endovascular stuff, but I just didn't think stepping away from the patient and not being there—that was too much for me. It's like somebody cut my umbilical cord before I was ready to do that. And I just wasn't there yet, but clearly, it's actually matured and it's a really important advance. 

Which MedTech initiative or startup deserves more attention? 

One of the other companies that I've just watched along the way is a company called SurgiBox. They've created a way to operate, creating a sterile operating field in the middle of nowhere. So essentially, they've created a box around the body and you can put your hands into these gloves and you literally have a sterile field, even if you're in the middle of the jungle, in the middle of the desert. It doesn't matter where you are, you have the ability to create a sterile field and operate on somebody in an environment that you could never imagine that you could. 

So maybe I'm attracted to that one because I'm a surgeon. I gave a TED Talk with the founders. I thought it was interesting and I still think it's developing. It's a fascinating application in the developing world where that is a real issue. Or on the battlefield, if you will, where it can make a big difference. 

Where would you put a million dollars? 

I came to Butterfly in a very interesting way. Almost 25 years ago now, I started a foundation that does free cardiovascular screening and education for the public. And it started again, based on one of those experiences where I came into the emergency room to see a patient who had what was called a ruptured aneurysm. The blood vessel in the belly ruptured. The patient died. It was depressing because I know if I'd found it electively, I could have fixed it with a 98 percent chance the patient would have lived. Then before I left, I was called to see a patient that had a stroke from carotid blockage, something that I also could have easily fixed if I found it ahead of time. And if that wasn't bad enough, I got called in on somebody getting CPR who had a heart attack who clearly wasn't on the right medicines and it wasn't diagnosed. 

And then driving home, I was pretty depressed because my life was built around fixing problems typically after they caused an issue in people and that's how they were found, and I didn't like that. I literally wanted to put myself out of business, so I started the very next day this foundation where we offered free screening to a high-risk patient population so that they could find problems early and fix them. It started out with one single program and then grew and now, 25 years later, there are almost 70,000 people in my county who have been through the program.

We've had a huge impact on healthcare. It's now a routine part of what primary care doctors use. And literally before COVID, we knocked heart disease off the top as the leading cause of death in our community. And it was all about early detection awareness. We spread the program across the country and internationally.

In that process I actually partnered with a major medical device company who saw what I was doing and wanted to help. It was Medtronic. And Medtronic was digging with me saying, how do we make it even cheaper? Because we had to have an ultrasound machine that at the time was pretty expensive and not easy to be portable. And they found this little patent that was submitted for this company that was trying to put ultrasound on a chip. And they said, do you want to go to a meeting with them? Because we've set one up. And I said, sure. So I actually sat in the back of the room. There were no introductions done. So nobody other than the Medtronic people knew who I was—the Butterfly people sure didn't. And so they made their presentation. I saw everything that they were doing. And this is pre-release. Pre-finished product and all the Medtronic people turned and looked at me and said, what do you think? Meanwhile, the Butterfly people ask who's that? Why are they asking him? And I pulled out my wallet and said I'll buy one right now. I literally saw the impact that I thought this device could have not just for what I was doing but for the world. And literally weeks later, they called me and said would you like to come be part of the company? And so that's how I got started.

Now, I wouldn't give it to myself because I would never do that. That's just not the way I am. I would probably do this: There are two different companies or people that are working on super tools, if you will, artificial intelligence tools. One of them is a doctor by the name of Jeff Stringer at UNC who is working on an OB super tool. He is developing a tool where you actually take the device, just go up and down three times and back and forth three times with the Butterfly. And it spits out the gestational age. It's incredible what it can do, but he's also developing tools that will give you placental position: Is there one baby or two? Is it head up or head down? How much amniotic fluid volume is there? So I’d probably give it to him to accelerate that and to have that done because the impact that could potentially have on maternal-fetal mortality around the world is incredible. And not only there, but I think one of the quiet, maybe unstated stories in this country is we do amazing things in the developing world.

One of the places I’d want it to go are the FQHCs in our country, the Federally Qualified Health Centers. So in the state of Maryland, for instance, where I live, there are 107 of them. Zero of them, zero, have imaging in that clinic. None. And I want to change that with Butterfly, and OB could be a good place to go.

What's the best advice you've ever received? 

I'll say three things. You know me, I can never give one answer. I always have to give choices. 

Number one would be: Be a fanatical reader. And I do, I read incessantly and people around the company know this. I torture them with the next new book they need to read. I've hosted a big book club. I do think reading and that perpetual learning is a great place to be. If you never consider yourself an expert that's done you always have a chance to be better and grow. 

Number two: Lean into the painful things. The things that are most hard that we don't like to do, the decisions that you don't really want to make, the problems that you don't really want to solve, lean into those. Because if you can lean into those problems and make decisions in a world full of ambiguity where the answer's not crystal clear, you become incredibly valuable to everyone around you. Because if the answer becomes simple and all the facts are there, anybody can do that. It's the people who can make those decisions when there's ambiguity to the right course of action—those are the people who really can help an organization. It's an incredibly important tool as a surgeon. You're not going to have all the information. You’ve got to open the abdomen. What's the surprise that's there? You’ve got to be comfortable being able to do that. 

And the third one: Lead like you would like to be led yourself. If you lead in that way, you will tend to be a much better leader if you always think of it in that lens. Would I like it if someone was doing this to me, is this how I would want to be taught to be led, to be guided? I think those are probably the three best pieces of advice I've ever gotten.

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