Health Tech: Turner Osler Of QOR360.com On How Their Technology Can Make An Important Impact On Our Overall Wellness

An Interview With David Leichner

Pick a problem that you are passionate about. As a lifelong medical researcher turned epidemiologist, it was clear to me that passive sitting was a serious public health problem. The typical injunctions (“Sit less”, “Sit for shorter periods”, etc.) were unlikely to solve this problem because epidemiologists know that we can’t beg, or cajole, or shame people into better behavior. Rather, we must change the built environment in a way that produces safer, healthier, outcomes; think divided highways, seatbelts and airbags, all of which have made driving much safer without requiring that people change their behavior.

In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Turner Osler.

After a 30-year career as an academic trauma surgeon, Turner went off scrip, got a masters in Biostatistics and an NIH grant and abandoned the operating room to study trauma epidemiology. Somewhere in the last decade he became obsessed with the problems that come from sitting too much, and especially sitting badly. Because no one else was doing it, Turner and some friends created a company to make active sitting chairs affordable enough that everyone could have one, and attractive enough that people might want one. Turner lives in Colchester with his wife, son and dog, all of whom have been surprisingly tolerant of his mania and are being gradually drawn into the madness. Except the dog.

Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?

I grew up in many places, but always near the ocean because my dad was a submarine officer in the US Navy; we moved every year or two, but always somewhere with a sub base. Each time we moved I found a new circle of friends, a few of whom I’m still in touch with. I fell in love with math and science in elementary school, and these remained my twin load stars as I tumbled from math to physics to neurobiology and finally to medical school and a long career as a professor of surgery and medical researcher. I’m now an emeritus professor here at the University of Vermont, but I’m still engaged with a group doing epidemiologic research centered on COVID and gun violence. And in the last several years I’ve been working to find a solution to the very significant health problems caused by our addiction to chairs that enforce passive sitting.

Can you share the most interesting story that happened to you since you began your career?

I’ve had a few careers: surgery, epidemiology, and now running a startup, and they’ve all be a source for stories, so it’s hard to pick a single story. But here’s one that touches on all my careers. It’s about meeting my first billionaire. It was an accident, and it happened like this:

The University of Vermont sometimes brings in folks to give talks about their research and a few years ago Leslie Leinwand came by to give a talk about her work with snake oil at the University of Colorado, Boulder. In under an hour, she told this fascinating story: It turns out that big snakes spend most of their lives waiting for the next meal to come by, and these waits can be long, sometimes over a year. To sustain themselves over such long fasts snakes, cannibalize themselves, shrinking all their organs size and converting the bounty to calories to keep going. Amazingly, a snake’s heart can shrink to half it’s normal size. But when a snake finally gets lucky and catches a large animal it can quickly regrow all of its digestive organs to their normal size in a matter of days. How this was accomplished was a mystery until Leslie and one of her graduate students, Cecilia Riquelme, discovered that the magic cocktail was a mix of myristic, palmitic, and palmitoleic acids in the snake’s blood. More amazing still, when injected into mice (sworn enemies of snakes) this cocktail also caused mouse hearts of to rapidly grow larger.

This finding excited both the physician and the epidemiologist in me, because physicians know that a heart attack kills off some of a patient’s heart muscle and because this muscle will never grow back, heart attack patients sometimes have impaired cardiac function and reduced exercise tolerance for the rest of their lives. And epidemiologists know that heart disease is the leading cause of death in America. So, a way to regrow heart muscle in heart attack victims would be an immense advance. I spent a few minutes talking with Leslie after her lecture, and found her to be a pleasant, unassuming middle-aged woman who was whip smart, but in no hurry to impress anyone.

As I was walking out of the lecture hall, I observed to one of my colleagues, “Boy, this snake oil stuff could be worth a lot of money as a clinical treatment for heart attacks.” My friend, who as it happened had done a post doc with Leslie a few years before casually responded, “Oh yes. Leslie is a billionaire. She heads a couple of tech companies trying to bring some version of snake oil to market.”

It seemed that Leslie had made a lot of money without trying, almost by accident: she was just exploring how the world works, following her passion for science and trying to help patients with heart disease. The ability to chase problems, rather than profits seems to me the key to a life well lived. (For more about Leslie’s work there’s a great article that was published in the Atlantic by Cayte Bosler in October of 2013.)

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I am indebted to many mentors over a long career. But Dr. Susan Baker of the Johns Hopkins School of Public Health really gave me the key early in my research career, back in the 1990s. Sue was a towering figure in the battle to reduce deaths due to car crashes. She taught me that one couldn’t harangue, or cajole or even beg people to behave better; one had to redesign the world to make dangerous behavior impossible. Decades later I understood that the only chair that could reduce the harm of passive sitting would be a chair that made it impossible to sit passively, and it was this insight that led us to develop our first active chair.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“If you try to play tennis by staring at the scoreboard alone you will play terrible tennis; but if you just pay attention to the tennis ball and let the scoreboard take care of itself, well, your tennis will improve quite a lot”. In short, don’t keep score; keep your eye on the ball. I think this applies to most endeavors, among them entrepreneurship: focusing on short term profits can distract from the vision that will be the source of any real success. If the idea is a good one that solves an important problem, you’re likely to make money whether you’re checking your bank account daily or not.

You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

First, it’s important to be tenacious, but not rigid. That is, one needs to have a vision that persists, but be willing to change the implementation of that vision when new facts or problems come along. Often times the problems that arise on the way to market can lead to important improvements in the initial vision, and for this reason problems can be thought of as forces that guide the evolution of a design or product rather than, well, “problems”.

Second, “Fail fast, fail often” is an often-quoted aphorism, to which I’ve added “… but fail cheap”. When we first started designing active chairs we used as many off the shelf office chair components as we could in our chairs both to speed development and save on manufacturing costs. But as we considered ways to make less expensive chairs, we began exploring dramatically different components, components that unfortunately failed when subjected to the stringent ANSI/BIFMA testing regimen (100,000 cycles of dropping a 125-pound weight on the chair’s seat.) Because it was time consuming and expensive to build prototypes only to have them fail, we switched to doing our initial testing using computer simulations of the stresses involved, so called “finite element method”. This allowed us to explore many different designs, quickly and inexpensively, before committing to a real-world design that we could do real life ANSI/BIFMA testing on.

And finally, running a business is always a team effort. As a result, leadership style is a crucial element that makes success possible. There are of course entire libraries devoted to leadership, their shelves groaning with tomes on how to lead well, and it’s likely that different leadership styles will work for different leaders. But for me the essence of good leadership was best summed up by Lao Tzu in the 6th century BCE, and his approach is one that I try to apply to every problem: “A leader is bad when the people fear him, and not so good when the people adore him, but best when people barely know he exists, when his work is done, his aim fulfilled, the people will say: we did it ourselves.”

Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?

Our modern lives require that we sit, and that we sit a lot; on average 8 to 10 hours each day. Unfortunately, we’re not designed to sit. Our bodies have been optimized over 3 million years to be hunter gatherers, walking many miles each day. And then, in just the blink of an eye in terms of evolution, we went from the active life of a hunter gather to the seated lives of cubical dwellers. The results have been, in a word, catastrophic.

We now know that ignoring our inborn biologic need for activity has profound consequences for our health: epidemiologists believe our lives are shortened by as much as two years by our addiction to passive sitting. Sitting has other consequences as well: slumping inertly in an “ergonomic” office chair results in weakened core muscles and poor posture, often culminating in back pain. While back pain may seem a trivial problem compared to two lost years of life, as a physician I came to understand that those suffering with back pain are profoundly miserable: as the Marathi proverb has it: “When one’s back isn’t right, nothing is right.” Additionally, back pain costs over $100 billion dollars in the US each year; that’s right up there with cancer and heart disease.

How do you think your technology can address this?

By making sitting active, we encourage, indeed require, people to engage their core muscles continuously while sitting. This immediately results in better posture, and over time stronger core musculature. More importantly, it also increases metabolic rate by 20% to 30%, not enough to make one breath hard or sweat, but enough to change metabolic parameters significantly: lipoprotein lipase levels increase, good cholesterol goes up, bad cholesterol levels go down. An entire cascade of metabolic improvements results for simply staying muscularly engaged. And we know that even slight, continuous, muscular activity is sufficient to produce better health outcomes: just fidgeting has be found by epidemiologists to result in longer, healthier lives.

From an anthropologic perspective, active sitting is the most accessible of the so called “active resting postures”. Our hunter gatherer forbears had no furniture, of course, but they did have need of an active rest postures: they weren’t always actively hunting and gathering after all. Study of the bones of our ancestors show wear points on their tibias which indicate the resting posture they universally adopted was squatting. Further confirmation comes from the observation that squatting is still the preferred posture of contemporary hunter gatherers such as the Hadza in Tanzania. Most Westerners loose the ability to squat by the time they enter school as a result of sitting in conventional chairs, and few adults can regain the ability to squat comfortably. A chair that encourages active sitting is a work around that gives everyone access to a healthy active resting posture.

And speaking of kids, we believe that getting kids to sit actively by providing inexpensive active chairs could be a game changer. If we can help kids develop better sitting habits and strategies early in life, we might help them avoid the burden of back pain which affects 80% of American adults eventually. Our idea was to create a design for an active chair for kids that we could give away. We found a way to make a pretty reliable chair out of about $5 worth of plywood and a lacrosse ball. We have a website (ButtOnChairs.org) where anyone can down load the design, along with a CNC router file that will allow anyone with access to a CNC router to stamp out hundreds of these chairs, sort of like making Christmas cookies. I did a TEDx Talk on this idea; you can google it if you have a kid in your life.

Can you tell us the backstory about what inspired you to originally feel passionate about this cause?

As a physician who’s suffered from a tyranny of conventional chairs for most of his life, my search for a healthier way to sit was quite personal. Here’s how it happened:

In 2016, I left the operating room to do research full time. This required sitting at a desk far more than I was accustomed to and soon enough I began having back pain that was pretty unpleasant. I took a deep dive into the medical literature on back pain, and I was surprised to find almost nothing was know about its causes and still less about its treatment.

It soon became clear that I needed to create a better sitting solution to push back against the terrible chairs that “Big Chair” and ergonomists have sold us for decades. Working with a team of other doctors, designers and body work experts we created not just a new chair, but an entirely new way to sit that worked with one’s body. We believe that your body’s perfect internal ergonomics, its skeleton, is a far more reliable route to perfect posture than conventional “ergonomic” chairs that try to shore up one’s body with external supports: head rests, foot rests, backrests, arm rests, and the coup de grace: lumbar support. These “supports” serve only to distort one’s naturally perfect posture, leading to a host of problems: poor posture, decreased core strength, and back pain. Worse yet, by suppressing natural movements such chairs reduce metabolic rate, leading to obesity, diabetes, heart disease, and increased all-cause mortality. By making sitting active we were able to solve these fundamental problems at a single stroke.

How do you think this might change the world?

The twin epidemics of “sitting disease” (obesity, diabetes, heart disease, culminating in shortened lives) and back pain are immense problems, costing millions of life years and billions of dollars. By creating active chairs that are affordable, attractive, and effective, we can introduce and popularize active sitting that will keep us all healthier and bring down the exorbitant cost of health care.

Our goal is a big one: we plan to make active sitting so ubiquitous that eventually when someone sits on a conventional office chair their response will be, “What’s wrong with this chair? It won’t let me move.”

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?

It’s hard to see a downside to making sitting healthier. But there is this potential downside: by making sitting at our desks healthier, we may make it even less likely that people will leave off their work and go for a walk in the woods. While being in motion at your desk is an improvement, being free of your desk altogether and out in the world is what our anatomy and physiology and spirits really crave.

Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”?

1. Pick a problem that can be solved, but don’t avoid stretch goals. It’s of no use working on an insoluble problem, but this is a more nuanced question than it seems, because a problem that may be insoluble now may become solvable once other pieces are in place. So, had Einstein been born a few thousand years earlier, before the invention of calculus and related mathematical techniques, it’s unlikely that he would have discovered relativity. It’s sobering to think that the talents of many Einsteins may have been wasted simply because they were born too soon.

The technologies to make furniture, even active furniture, is well worked out. Injection molding, CNC routing, robotic welding, bending plywood, all these technologies are widely available. So, we felt confident we could produce active chairs at a scale and price point that could succeed. Yes, there were problems (we have a basement full of failed prototypes), but we have now won design awards for our chairs and have sold thousands of them to delighted customers.

But we also wanted to find a way to help people embrace the idea of active sitting and make it a part of their lives. We hit on the idea of creating an app that would show people just how many extra calories they were burning as a result of sitting actively, a sort of “fitbit for when you sit”. Crucially, to keep costs to a minimum, we wanted to do this without resorting to any dedicated hardware. Because almost everyone has a smartphone, we decided to measure this increase in movement using the accelerometers built into every standard smartphone. This really was a stretch goal, because it wasn’t clear if we could actually find a way to convert the output from accelerometers to work done while sitting, but we got our app (“FitterSitter”) running on any smartphone; among other things it shows a graph of extra calories burned while sitting actively. And, because it’s an app, it will be easy to share over the web.

2. Pick a problem that you are passionate about. As a lifelong medical researcher turned epidemiologist, it was clear to me that passive sitting was a serious public health problem. The typical injunctions (“Sit less”, “Sit for shorter periods”, etc.) were unlikely to solve this problem because epidemiologists know that we can’t beg, or cajole, or shame people into better behavior. Rather, we must change the built environment in a way that produces safer, healthier, outcomes; think divided highways, seatbelts and airbags, all of which have made driving much safer without requiring that people change their behavior.

I’ve spent a lifetime working for better health outcomes, and I was convinced that making active sitting an attractive and affordable option for people would have a far greater impact than anything I’d done in my career. This was my last, and best, opportunity to change the world.

3. Pick a problem that has important consequences. To remain in the game when setbacks inevitably occur it helps to have unshakable commitment to the project. For me this kind of commitment comes from the vision of improving the health of everyone who must sit while earning a living, which these days seems to be most of us.

4. Find a solution that is affordable and will scale. When we first began making active chairs, we were building them one at a time in our basement. People loved our chairs, but we couldn’t keep up with the demand and our chairs were expensive. Additionally, we were working way too hard as production line workers when we should have been creating better designs and introducing the idea of active sitting to the world of people trapped in bad chairs all day long. We were saved by partnering with a local company, Manufacturing Solutions Incorporated (MSI), that took on the task of assembling, boxing, and shipping our chairs for us. We were now able not only to concentrate on growing awareness of active sitting in the world, but we were also able to go from shipping hundreds of chairs to shipping thousands of chairs overnight. Best of all, MSI is a big operation: they ship every Concept2 rowing machine in the world. So we’re confident we have a partner that can scale with us for years to come.

5. Find a way to make your effort self-funding. If at all possible, avoid waste time begging for money when that time could be much better spent designing a better solution or finding more customers to validate (and fund) your solution.

If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?

I’d tell any young person this: The reason to make a positive impact on our environment or society is not to make our environment or society better, but to make you better. Once you find that you have this power, the power to change the world, you’ll come to regard yourself in a completely new way. Not only are you more powerful than you dreamed, you have the power to make the world a better place. This is the backstory of every superhero, of course, but thought of this way it’s not fiction or fantasy; it’s simply a fact.

Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)

Sara Armbruster is the CEO of Steelcase, the largest manufacturer of office furniture in the world. I’d like to have a chance to pitch the importance of active sitting to her. She just might buy into the idea of “doing well by doing good.”

How can our readers further follow your work online?

I can be reached through my University of Vermont email: tosler@uvm.edu. I also occasionally write for the Vermont paper of record, VT Digger (vtdigger.org), and even more occasionally on Medium (https://turneroslermd.medium.com/); I also write a monthly blog (https://qor360.com/blog/). Finally, our little startup can be followed @QOR360 on Instagram, Facebook, Twitter, Linkedin, all that stuff. And for a quick, bare bones look, you can look me up on Wikikpedia.

Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.

About The Interviewer: David Leichner is a veteran of the Israeli high-tech industry with significant experience in the areas of cyber and security, enterprise software and communications. At Cybellum, a leading provider of Product Security Lifecycle Management, David is responsible for creating and executing the marketing strategy and managing the global marketing team that forms the foundation for Cybellum’s product and market penetration. Prior to Cybellum, David was CMO at SQream and VP Sales and Marketing at endpoint protection vendor, Cynet. David is a member of the Board of Trustees of the Jerusalem Technology College. He holds a BA in Information Systems Management and an MBA in International Business from the City University of New York.