A Salute to Paul Yock and His Legacy
A recent fireside videochat hosted by Andrew Cleeland offered an intimate glimpse into the life and achievements of Dr. Paul Yock, an iconic figure in the medical technology innovation arena. “Tales From the Voyage,” is an insightful discussion and look into the stellar career of this accomplished physician, innovator and educator.
Paul is the Martha Meier Weiland Professor of Medicine, founding co-chair of Stanford’s department of bioengineering and founder of the Stanford Byers Center for Biodesign. He also plays a critical role in the long-standing partnership between Stanford Biodesign and Fogarty Innovation.
Paul is known for his inventions that have improved care for millions of people around the world, including the Rapid Exchange stenting and balloon angioplasty system and the Smart Needle, which helps clinicians accurately guide needles directly into a patient’s blood vessel. He also conducted the foundational work on intravascular ultrasound imaging and formed a company to commercialize it.
Extraordinarily self-effacing and humble, Paul has won numerous awards for the impact he has had on advancing healthcare, including the prestigious National Academy of Engineering’s Fritz J. and Delores H. Russ Prize and Bernard M. Gordon Prize for Innovation in Engineering and Technology Education.
“In addition to the vast impact his inventions have had, I believe Paul’s multifaceted legacy will be kept by his influence on the innovators of today and generations well into the future,” said Andrew in his introduction. We are honored to share highlights from the lively conversation below. The full video recording is available on the Fogarty Innovation website.
Meet the young Paul Yock
Paul recounted growing up in a suburb of Minneapolis, in what he calls “a solid, middle-class Midwest family.” Unlike some future inventors, he claims he wasn’t a “tinkerer,” as in “somebody who knew how to take apart a radio and put it back together.”
He enrolled at Amherst College as a pre-med student but became intrigued with philosophy. That led him to quickly complete his chemistry major so he could do an independent study in philosophy his entire last year. He wanted to devote more time to the subject, so attended Oxford University’s Trinity College to study philosophy.
A pivotal conversation with his mentor at the close of an internship at the Institute of Society, Ethics and the Life Sciences sealed his choice of a medical career. When the mentor asked what Paul wanted to do with his life, he explained he really liked philosophy and medical ethics but had also completed pre-med coursework and had some early acceptances to medical school. “My mentor looked at me and said, ‘Go to medical school,’ which I did. While I still have an interest in philosophy, I’m thankful this was my path.”
The beauty of mentorship
After graduating from Harvard Medical School, he completed his residency at University of California, San Francisco (UCSF) and then moved on to Stanford, where he has spent the bulk of his career.
“What attracted me initially was the fact that Stanford was really coming up in the field of cardiology, influenced by Dr. Tom Fogarty and Dr. John Simpson, and echocardiography was just taking off, so it looked like the place to be for training.”
He credits Tom and John as life-changing mentors, who are extraordinary in different ways. “Tom has a drive for excellence that encompasses everything he does… and he makes you want to hit those standards,” Paul said. “You wanted to be your best for him.” And, he continued, John was a brilliant physician but with the special characteristic of determination. “I admired his persistence; it was something I wanted to emulate.”
A look back at his life-changing inventions
Paul shared how he was inspired to invent while he was doing an angioplasty fellowship with John. He showed Paul an atherectomy catheter while he was studying for his cardiology boards and remembered that plaque usually builds up on one side of an artery. He realized there needed to be a better way to guide the atherectomy cutter to the target plaque and considered the possibility of making a transducer tiny enough to look inside the artery; the fundamental intravascular ultrasound approach was developed.
Rapid Exchange emerged from his experience with angioplasty at a time when the most commonly-used process required two operators, which Paul saw as flawed because of the potential for miscommunication. He realized there had to be a better way and ultimately came up with the Rapid Exchange, which had a shorter wire and required just a single operator.
He recounted how his concept went on to be commercialized as the dominant product configuration in the market today. First ensuring that he filed a patent, he then presented a prototype to the late Carl Simpson, head of R&D of Advanced Cardiovascular Systems (ACS), a leading angioplasty company Paul shared a vivid memory of using the heart model Carl had on his coffee table to demonstrate single-operator angioplasty. Carl ran out of his office and called in the head of sales, Gary Curtis, who immediately saw its benefits – and the rest is history.
Founding Stanford Biodesign
One of things that had attracted Paul to Sanford was its combination of engineering and medicine, accompanied by its robust entrepreneurial spirit. And that, plus the desire to pay forward the mentoring he had experienced, was the impetus for ultimately founding Stanford Biodesign. “There’s a set of techniques and a discipline that could be taught (in the invention process), and Stanford was the right place to do it.” Josh Makower joined Paul to lead the creation of the Biodesign fellowship program, implementing a training method that has been widely emulated across the country and around the world.
In retrospect, Paul is proudest of the program trainees, many of whom have gone on to lead health technology start-up companies, found innovation training programs, become faculty members of major universities, or return to clinical practice with a new understanding of how to evaluate and solve problems in care.
His work at Stanford Biodesign is not yet complete, as he turns his focus to examining gender, racial and health inequity issues. He also believes Biodesign needs to focus on putting additional resources into getting technology “business ready” to attract funding, along with creating a team that can take it forward. He sees tapping the expertise of Fogarty Innovation for this as an important piece of their continued partnership.
Paul shared additional thoughts on how COVID will affect the ecosystem going forward, including an amplification of the shift to a consumer focus in healthcare and technology, with patients being treated at home, not just monitored.
Words of advice
Of course, no conversation with such a luminary would be complete without asking for advice. Returning to the mentorship theme, Paul believes it’s important to proactively look for a mentor as they won’t always come to you. “Pick someone based on experience, of course, but also somebody with good character.”
After all, the character he saw in his mentors, Tom and John, so many years ago led to this impressive career that has touched the lives of millions of patients and families—and will continue to do so.