What if a single idea, born out of frustration and a moment of clarity, could change the lives of millions and save the healthcare system billions? This episode is a front-row seat to that exact possibility.

Josh Cary sits down with John Erbey, founder and CEO of Roivios, to explore his revolutionary medical device, JuxtaFlow. Designed to sustain kidney function and potentially prevent dialysis, JuxtaFlow isn’t just a product, it’s a category, defining breakthrough. But this conversation isn’t just for healthcare insiders. It’s for entrepreneurs, innovators, and visionaries who want to understand what it really takes to bring an industry, disrupting idea to life.

You’ll hear the origin story of the device, the mindset required to leave corporate security for startup chaos, and the leadership philosophy that guides John’s team as they tackle one of the biggest, and most overlooked, health challenges in America.

What You’ll Learn in This Episode

The Power of Asking the Unasked Question

How John realized the kidney care model was broken and the moment he saw what everyone else missed.

From Pharma to Founder

Why John left a successful career at top companies like Bristol Myers and St. Jude to bet everything on an unproven idea and what he discovered about risk tolerance along the way.

Turning Skepticism into Curiosity

The secret to winning over experts, regulators, and skeptics, one conversation at a time.

Why the Best Products Solve Invisible Pain

How Roivios’ JuxtaFlow targets not just physical health issues, but economic strain on hospitals and systemic inefficiencies in care.

Entrepreneurship in a Regulated Industry

What it actually takes to innovate in healthcare, play by the FDA’s rules, and still move fast.

The Vision for a “Kidney Pacemaker”

Why this first device is just the beginning and how John plans to build a 24/7 implantable system for kidney function support.

Leadership That Moves People

How John’s leadership evolved through real-world pressure, and why he believes in rallying a team around six and a half patients per minute.

Memorable Quotes

“This is the biggest problem no one’s talking about, 35 million Americans have chronic kidney disease, and more people die before dialysis than after.” – John Erbey

“I convinced myself this idea worked in 2016. Now, the job is to convince everyone else.” – John Erbey

“It’s not about what you’re capable of, it’s about what you’re willing to do.” – Mike Tomlin, quoted by John

“Juxtaflow started as a crazy idea. Now, it’s a potential movement that could redefine how we treat kidney disease.” – John Erbey