Why I’m shaking my head about JNJ - because of Robotics and… a few other things

Today's post is a lit bit of therapy for me - so stay with me.

I’ve had a perfect storm of things come that have shaken me up about the company I once admired, and spent 16 years of my life dedicated to it and its CREDO. It has been an amazing company - and at the time it had Med Device, Consumer and Pharma - and I lived within the medical device bubble and rode that through open to laparoscopy with Ethicon Endo-Surgery. Endo was a company I once had massive admiration for -  excessively. But in the last few weeks my understanding of the entire company has been rocked by a few things and I’d like to lay them out.  The last one… will be about their robotics program and gets a bit ranty - so strap in.

Baby powder - No More Tears

The other day I finished the powerful book No More Tears by Gardiner Harris. And even though I know a lot about the back story of things like the Vaginal Mesh - and feel that the facts around that are not exactly right. There is enough questioning in my mind about the ethics of a company I once loved and respected, to make me sit up. I was one of the people that saluted the CREDO and in my heart of hearts believed we were doing the right things for patients and customers. Honestly - 100%.

But by the end of this book… well it’s the same sentiment as to why I would never work in Tobacco companies. Similar patterns they exploited in the past. Quite scary.

I had a sense of almost embarrassment that I was part of that period where it seems (according to the book) that so much was covered up about asbestos in baby powder. The same baby powder I used on my kids years ago. A sacred part of the brand that was always held up as a shining light.

“We can’t have a product like that for cardiac - I mean we sell baby powder and our Brand is built on trust. What if things happen to patients.” - that is a genuine conversation I witnessed. It was a north star of “Brand above all.”

There is something in my moral compass that since reading the book, that has made me feel sick. I read that book and found enough possibility in the pages that it became hard for me to hold the same sentiment for JNJ as I did in the past. And the discussion that the “Texas two Step” was used - well that was simply too much. (You need to read that to see what they allegedly did.)

I did feel a little contaminated myself after I read the book. Interestingly, I finished it just as other news broke…

Divesting the Orthopaedic Business

Ortho (hips and knees) for JNJ was a big business (and mentioned in the book) - seemingly a slow and sluggish business. Growth was not in line with what “investors wanted?”

I looked at the communications around spinning off this business and started to wonder - if this is about patients or about ensuring accelerated growth - more profits and Wall street optics.

Maybe I’m tainted by coming off the back of the No More Tears Book - but I now see the corporation through slightly less than rose tinted glasses. I no longer believe it is all about “patient first.”

This umpteenth divestiture is not about “Orthopaedics” per se. I have been expecting this for some time. But it makes me wonder about the actual overall direction of JNJ. And their commitment to medical devices. And yes they are doing great in cardiovascular with Shockwave,  and that is giving them great growth. I’m sure there are other areas they can do well. (Vision.)

But at the same time I sense that Biosense Webster have struggled (correct me if I’m wrong) and they just are not super competitive on PFA (pulse field ablation.) Is this next to go the way of Cordis and Depuy? Could this be a slow unraveling of the MedTech business?

I’ve also seen the constant drain of great people from the corporation (to me feels like cyclical cost cutting of heavily salaried managers more than good sense) - the people with the knowledge that have left the medtech business year after year. It is the people that ultimately make medtech - not just the products.

My personal sense is that JNJ has become a Pharma company that has a problem child MedTech Unit, and it is trying to understand what to do with it. I can’t help but feel Kenvue 2 on the horizon.

Let me be clear - I’m a MedTech guy 100% - and I live and breath medtech. As I see more and more of the MedTech heart of JNJ being spun off over the years - I feel a greater and greater push of the company to Pharma. (Maybe just my viewpoint from where I sit…)

I don’t do Pharma, I don’t root for pharmaceutical companies - I don’t understand them enough.

So with the recent news of the Depuy divestiture / spin off / sale - (I get the maths and optics) - but it feels like yet again throwing part of medtech over board to chase growth. Wall Street before Patients?

On the flip side… Could it be good for Depuy-Synthes ? Maybe. But my heart was in JNJ and that just became less medtech with that announcement. I perosnally don’t support pharma.

And so two things started to come together - the scathing book and the divestiture. And much of that has an impact more on my internal compass rather than the logic of the business numbers. Of course the slow growth business divestiture makes sense to money people - of course Pharma is a bright future. It’s just not a place where I invest my heart. I so hope that Depuy-Synthes  will find its place in the world - and get back onto an innovation and growth phase.

Ultimately - The attitude to robotics

So for the last few years I’ve been watching the messaging on Velys, Monarch, Ottava - and the discussions around a coherent digital play - data and connected systems. Which honestly made sense to me in a big way. With Polyphonic at the heart of it. The logic was sound - it is all down to execution. JNJ ability to digitise across multiple areas of the business and pool that data for the hospitals, surgeons and patients... and - well wow. What a great vision.

But with the Depuy spin off, I start to ask - “okay so how does that unified approach all work now?” And the cracks in the story start to feel bigger. And it feels more like "a story." Because (unless I’m reading it wrong) Velys is tied to implants so most likely will toddle off with Depuy. So how committed are JNJ to the big picture they painted of this cross specialty digital architecture? It’s all about the hospitals, doctors and patients… right?

I look strategically and it makes me shake my head and shrug.

So… the even bigger red flags I got last week were around some of the “chatter” I got coming from Tim Schmid in an interview; I think at Device talks or in one of the op ed pieces.

I saw this statement from an interview with Tim, and honestly I had to read it twice.

“Robotics progress with Ottava and Monarch

Schmid said J&J's plan is to "win across robotics," outlining a multi-platform approach that includes both Ottava and the Monarch robotic systems. He said the company recently made an investment in a robotics company in China [note-  Ronovo] to advance a "cart-based" system tailored for regional surgical needs, a move he described as further evidence of J&J's global commitment to robotics.”

I like Tim, super super great guy and knew him from my days in JNJ. So this is nothing against Tim. But whoever is feeding him these “sound bites” is delusional.

And whoever wrote this just handed CMR, SSi and Medtronic the “Cart based systems are excellent” and needs their noggin looking at from a marketing point of view.

Schmid said J&J's plan is to "win across robotics,” - wow. So JNJ coming to the party almost a decade late with Ottava (and needing a plan B in China) still think they are going to “win”?!?!?

That to me reads - “We plan to beat Intuitive!!!” I just don’t know how else to read that? - and I am afraid that is just a non starter statement.

I’ve explained in excruciating details how the maths around this just does not add up - even IF (and it’s a big IF) they did have a da Vinci 5 beater. Which I am utterly and totally 100% confident Ottava will not be.

But even if it was… you cannot “Win” - you can perhaps compete successfully - you could drive hard to be the second player in the market. But that one word - “Win” is the straw that broke the Camel’s back for me. I literally read that and put JNJ in the delusional box with a wave of my hand, fingers clinched, in front of my face in a very Italian way. The book (No more Tears), the apparent pull back from MedTech, and the delusional attitude to Ottava was enough for me.

And in my internal discussion “Are you really that upset with them?” I read a little deeper and became more convinced my internal thinking is right.

It’s not just Ottava - it was also saying they will “Win” with Monarch. Maybe more feasible - but all the market intel I have is that Ion is winning hands down. Intuitive is crushing it.

Four different reports claim between 60%-70% share of Ion, vs 30% to 40% Monarch - with Ion widening the gap.

“I plan to go to Mars”… but if I said that to anyone they would think I’m nuts. Just ‘cos you say statements doesn’t make it true, or feasible, or credible.

And it is this irrational type of statement that makes me wonder if they (Ethicon) really understand what they are up against. You don’t win just because you have a JNJ badge on a robot. You win by having such a superior robot at a a compelling price point that out performs the market leader - and you can deploy 10,000 plus robots in the next 5 years. (Is anyone hearing this?) That is what WIN means.

You then pile on top Ronovo (Carina robot where JNJ is doing a co-sell deal in China) and what that does to Ottava. I absolutely get that they are so far away with Ottava in China that Ronovo makes utter sense - it’s on the market and not a boom architecture.

It would be almost unthinkable for the Ethicon - Ottava team to concede that “booms are better” - as the entire thesis of Ottava will be built on “Beds are better.” Signing up with a Medbot or an Edge would just destroy all credibility of their future fight of Ottava against da Vinci. How could they fight against booms if they had one. They would just be endorsing da Vinci and the boom.

But they just handed that “Cart mounted arms are perfectly good” to every other company. (Oh and they are by the way.) How do you then say “The ultimate answer against Intuitive’s boom is zero footprint table mounted. Unless of course you’re in China and then carts are fine and zero footprint isn’t that big of a deal there."

For me this is all a big problem - not a strength. I love John ma and his team and what they are doing with Rovono - but are they being pegged as “a Chinese robot just for the Chinese market” with this deal? How’s it gonna work with Ronovo out in Europe and other parts of the world competing head to head with Ottava? It all just feels not well thought through. Unless... hmm. Hold my beer.

For me - and this is just me - this is optically a China play - but I suspect also a plan B. And why would they need a Plan B? I’ve heard nothing but “we are all in on Ottava and the Ethicon Instruments being exclusive to Ottava !”  - except now we are not - and for China we have Ronovo… (will that have Ethicon staplers?)

And it is not the first time they have announced a “Cart based venture together.” When I was at CMR they announced something similar for Versius. But then went all in on Ottava - saying “It is the solution” and walked from the CMR deal. To me, it’s flip flopping on a colossal scale. And screams in my head “So what is really wrong with Ottava? Does it work? Is it going to be a regulatory nightmare? Will it be way too expensive for most markets?” Why the plan B?

Being fair (and breaking character for a minute), it’s probably the right thing to do…

(okay back) but to me it reads like “We are not really sure what we are really doing.” “We are scrambling,”

And we must remember - Ottava is still in clinical trails. And it’s unclear if it’s progressing. And now with this, some indications make me wonder about more slippage. It’s just not great optics.

In an early Seeking Alpha article  a JNJ spokesperson mentioned Q1 2026 for submission to FDA.

This then morphed to “early” 2026 - which in my book means April or earlier.

And now we have H1 2006 / first half of 2026.

Slippedy slip slip???

(and you announce Ronovo?!?!?)

Yes Q1, Early and H1 - technically are all the same - but I read this is the corporate speak of - “It’s going slower than we’d hoped.”And at the end of it - they get maybe one specialty…. That doesn’t “Win” against Intuitive.

I read this whole thing (and I am often wrong so feel free not to listen) - as:

Ottava is a long way off from China - get a plan B

The Plan B may also help if they slip further with clearances as Intuitive is putting more and more daylight between them and JNJ as they fill the shelves with installs  - and deploy more DV5s across the world.

Other companies (up to 30) are filling the shelves and if they don’t get their shit together soon there will be no shelves left for Ottava.

The plan B may also be there - as Ottava is no longer  the sure fire guarantee?? There is a long path between first human use - successful outcomes (that are as good if not better than da Vinci) “YES THAT'S THE BENCHMARK”And then a longer path between controlled clinical success in one specialty - FDA clearing a device (which I do think will happen but way way later than most think) - and what might be actual, realworld commercial success.

Forget “Win!”

In short - it could be all too little too late - a product that competes but is not better - and I predict a similar price to DV5 not “cheaper” as that’s not JNJ. Ottava will struggle commercially as “what does it bring?”

(Okay going out on a limb here - it will be more expensive then DV5… just scale economics. Hold me to this when it launches...)

Ahhh but !!! "It’s not really about robots" - according to what I read. It’s a about the data.

And again I roll my eyes… Intuitive has 17 Million cases logged in. They are deep into the data architecture and light years ahead of anyone else. And on “data” JNJ will “win” ??? It’s either they really don’t know what they are saying…

They just slip words like “win” out by accident…

Their PR team thinks pumping these statements will bend reality…

Or worse - they actually genuinely believe they are “going to win in robotics!”

None of these are good.

So roll that back to the Depuy - Synthes move and well - if Ottava doesn’t hit as they expect (and they are setting themselves up to fail by thinking they win) - do they actually still have a surgery business worth hanging on to? And would Ethicon be the next  slow growth divestiture? And if so - JNJ becomes even more of a Pharma company than med device?All in all - it just ain’t the JNJ I once loved.

The perfect storm

For me, the No More Tears book, the Depuy divestiture, the seemingly misguided attitude and strategy on robotics, the fragmentation, the plan B has all come as a perfect storm.

For me - ethically - business wise - motivationally (Pharma vs Medtech) - it just all makes me hang my head.

I’ll repeat until I’m blue in the face. I am rooting for Ottava stronger than people know - I am rooting for every single company that is trying in surgical robotics. I love and want competition. It makes the industry healthier. But I beg each and every management team to speak with humility. Especially leaders high up in organisations - why?

Because anyone out in the field - watching day to day what is happening in hospitals across the world - is so connected to the pulse of the market. They are connected to the reality - that glib “we will win” statement, or other such statements of “We will finally democratise” “We will crash costs” - to those thousands of employees genuinely connected to the field - each and every day - it reads as delusion. It is almost offensive to their hard efforts.

“We on high say we shall win - so make it so!”

Despite the reality of the world that employees live, every single day.

In my opinion, it also shows that the mass of PR writers sitting in corporate are clearly disconnected from the reality - and they need to learn that pushing out trite comments like these are potentially damaging to a company - they don’t show strength - they show ignorance. Maybe they need to spend a year in the field selling before they are allowed to pen a single line? Pen reality, not hype. Be humble. Acknowledge the hard fight. Acknowledge any success will be a success. Success does not equal win. Any customer choosing a system is a victory - but say it’s hard - the teams in the companies work so damned hard - the fight is so damed hard. BUT if surgeons get choice - and patients get choice - then that is the real win. Not "we win" but "They win."

These are just opinions of the author for both educational and entertainment purposes.