Four Leaders You Need To Know

Robert transformed Vermont from a money-losing small company into a much bigger, profitable company ($1.7 million in 2004) -- without losing the small-company culture and attention to quality. A key part of the strategy involves in-sourcing. When Vermont works with overseas suppliers, as it does for some of its production, there are no intermediaries or brokers. Most phone orders are handled by reps who work for the company full time. Vermont has also been exploring whether it should package plant and flower orders itself, rather than rely on growers to drop-ship them. And it serves as its own ad agency, pocketing the standard 15% commission.

Robert also believes by skipping the middlemen, she and her team members can learn more quickly what's effective and what's not. "We can be flexible and nimble," she says. This CEO likes to do her own shopping, but she's doing more than just bargain-hunting.

Trusting the Customer

Lonnie Smith

Intuitive Surgical Inc.
Sunnyvale, California

On a small patch of the sprawling factory floor at Intuitive Surgical Inc., a four-armed robot is dancing. Each of its arms extends and then performs what looks like a bicep curl. The dance, explains Lonnie Smith, Intuitive's CEO, is a series of tests Intuitive conducts to make sure the robot is ready for delivery.

Intuitive has sold more than 250 of these da Vinci surgical robots, at about $1.2 million each, to hospitals that use them primarily for prostate surgery and heart bypasses. The robot gives surgeons more control than they'd have using laparoscopic instruments, but like laparoscopy, it doesn't require a large incision -- so recovery time is faster than in traditional "open" surgery.

Today, the company has 320 employees and is one of the 50 fastest-growing companies in Silicon Valley. But when Smith took over as CEO in 1997, Intuitive was a startup with no customers and 12 employees. The da Vinci hadn't been used in a living human yet, and it was unclear what doctors would want to do with it -- if they wanted to use it at all.

"I'm a big believer that once you have a device to sell, you put it into the market and listen to the users to find out where it brings value," Smith says. "I call it 'going early and ugly.' You have to give people something to react to." The Intuitive system won approval first in Europe, where doctors used it to perform cardiac surgery. But where they saw the greatest advantages with the da Vinci system was in removing cancerous prostate glands. A surgeon in Frankfurt happened to try it for a prostatectomy, and the result was less blood loss and fewer complications like incontinence and impotence.

Intuitive has found that the best way to get the da Vinci system into a hospital is to let surgeons test drive it and become the company's advocates -- "surgical champions," Smith calls them. To give more doctors a hands-on experience, Intuitive has outfitted a tractor-trailer with a demo room that roams the United States. (There are also two mobile robots that get trucked around to be used in hospitals in the United States and Europe.) When the trailer is parked outside of a hospital, surgeons come through -- as many as 20 at a time -- to get their hands on the system.

Smith is also pushing his team to add new features to the da Vinci based on customer requests. For example, some doctors wanted the ability to look at ultrasound scans, or other diagnostic images, within the field of view as they operate, so several Intuitive engineers are working on a technology that will "tile" those pictures into the da Vinci's screen. "Our goal is that most surgery will be done with a device like this," Smith says. "We hope that it will become the standard of care when you go in for an operation."