Yeah, exactly. We've got now people who have been deckhands and then between second officers, first officers, chief officers, and now captains. We've seen them progress through that career. We supported them along the way. This is the Ben Taylor Podcast, the home of marine industry insights. Enjoy. Hi, everybody, and welcome back to another episode of the Ben Taylor Podcast. This is another collaboration with the Superyacht Services Guide, a very highly trusted directory for large yacht services all around the world. I need to thank Puella Bianca, which is the beautiful venue we're on board today for hosting us. It's listed for sale with Ark & Yachts, so thank you to them for hosting us and providing the beautiful venue that we're on. Nice to see you, Spike. Welcome to the podcast. Yeah, nice to hear you as well. Give us some context. Just from a really high level, what are you guys about? What does MSOS do? Well, for me personally, I got into remote medicine. I used to be an offshore engineer, so I spent a lot of my time working at sea, and then went into medicine, and then did a round-the-world yacht race back in the 90s, and that got me into remote medicine, but getting real experience of what it's like sailing upwind all the way through the Southern Ocean and trying to sort out medical and trauma problems on the boat in the middle of nowhere. I did that for about nine years, working for that company, the Global Challenge Business, and then formed my own company, which was mostly racing yachts and things like that to start with. I'm the medical director now for most of the round-the-world yacht races, but we've expanded hugely into the super industry and also now more and increasingly into the commercial side of things as well, so wind farm support companies, bulk tanker fleets, and things like that. We provide medicine, remote medicine, remote healthcare, as long as it's a remote location on land, mostly at sea, some aircraft as well. I think remote is going to be one of the key words, but in terms of, I'm going to say normal, more traditional medical support, what are the big differences between what you guys can provide and how you operate compared to a more normal run-off-the-mill medical support organization? Well, I'm still a full-time intensive care consultant for the NHS, so that's a big support system. That operates, obviously, just on land in the UK, and it is very, very organized. My company runs on a similar kind of basis that we try to do the best we can for patients or anybody requiring our medical support. We take the ethos of trying to do that, and we try to apply that to every client. It's a question about being organized and providing what we call an integrated service. The ethos of what we do is really in the name of the company, so medical support offshore. In terms of medical support, what does that entail? Well, three main strings to the company or routes to the company. The first one is medical kits. We supply everything from small coastal sailing medical kits up to small hospitals that we put on big boats these days, and we do everything in between. There's a lot of thought goes into what kind of medicines, what kind of equipment you're going to put out there on a vessel, but then we run training courses as well, so we train people how to use everything that we put on board, and then we run a 24-7 telemedical support service as well. If something goes wrong offshore, they've got a medical kit. We know what training they've got, and then they ring up, and then we can tell them what to do. The basic business model is very, very straightforward, but the key is providing an integrated service so that all three aspects, medical kits, training, and telemedical support are all linked together. We do everything in-house. What would be the difference if it's a relationship with you guys through the telemedical support? Is that literally kind of like a phone number that any crew member on board can pick up the phone and have support there and then, right to actually you guys being on board and running a hospital for more serious situations and scenarios? Well, so the communication system for the control room, so the control room is manned 24-7, 365. Is that based in the UK? That's based in the UK, and so all calls and emails, those are the two routes of referral, go through to that system, and then the controller then puts the call through to whichever doctor's on call, and so the whole ethos about that service is to try and make it as quick as possible from the call coming in to the- To getting the right information and having the right person on the other end. Yeah, it's going to give you the targeted advice, and the targeted advice is they know what you've got on board, and so they can give you advice which is achievable, because there's no point telling crews to do something that they can't achieve. Yeah, of course. So it's pragmatic, achievable advice. That's the key. So last year, for instance, we dealt with over 1,600 medical incidents offshore, and the average time between a call coming in and talking to the doctor was less than two minutes. Nice, well done. Very well done. Yeah, because the controller has to take some initial information, like where there is the boat and the name of the caller, name of the casualty. All right, that's within that two-minute period? Yeah, within that two-minute period, yeah, and then get hold of the doctor as well, so it's good. And so, I believe you're a storyteller. You're a bit of a story man. I'm sure you've seen plenty of things. What's a really good demonstration of something going wrong in really quite a difficult environment to provide medical support, and you guys have been able to do something about it? I mean, the majority of calls that come in are reasonably kind of routine, but somebody on board the vessel has been moved to call us for advice. So, it's quite like general practice type of advice that we give. But probably about 5% of the time, it's an absolute emergency. So, for instance, we had a vessel out in the Caribbean recently, and they had... So, the charter guest on board had two children on board. So, the seven-year-old had a known anaphylaxis reaction to nuts. So, they had some ice cream on board, which had pistachio nuts in it, which is questionable whether you should do that, of course, but they did. And so, the seven-year-old was keeping clear of that, but the two-year-old on board ate some of the stuff and immediately started having quite a serious reaction. So, the parents had seen this type of reaction with their older child. So, they knew what it was like. So, we got a very quick call from the captain on board. And so, we were able to tell them what to do, and the child was okay. But that required very, very quick intervention. That's the whole thing about anaphylaxis. If you get in there very quickly with the right kind of medications, then you stop a drama turning into a crisis. So, we're quite good at doing that. Okay. And what kind of things are starting to change? So, are there technologies that are improving the service that you can do? Are there different ways of operating that are different today to maybe what were common practice five, 10 years ago? Well, going back further. So, in the mid-'90s, when I did the round-the-world yacht race, going through the Southern Ocean upwind, we had SSB radio through Portishead. So, the connection was fairly difficult. When I was an offshore engineer on the drill ships and what have you, we had plenty of accidents and the communication was all SSB. And so, quite patchy, quite difficult to get coherent advice that you could actually follow. But now, with the advent of global communications over the past 25 years, it's changed things massively from our point of view. And we have a telemedical communications platform ourselves, which we developed called Themis. And that basically measures... It's like a case monitoring system. So, it measures all of the kind of vital signs and crew can write all the things in there, all the medical notes in there. And so, it's a really good record of what's been happening. And we see this on our... So, somebody can start a case down in Antarctica and 15 seconds later, we see it on our laptops or our smartphones or whatever. And what it means is that we get objective data about how a casualty is and what I mean by that. That's exactly what a doctor wants. Yeah. So, I know I'm an intensivist, so I like numbers, but it does give us numbers. And that's what we call objective data. And that improves our diagnostic kind of capability. Right. And I suppose in an emergency situation, it's typical for someone to be panicked or in a really stressed environment. So, to really focus on the right data points and communicate that can be actually quite difficult. Yeah. So, it's having a framework within which to think. And that's all our training is based around that. So, that people keep calm and they know the kind of data that we want. The opposite to objective data is subjective data. And that's the old days when somebody would say, well, something looks unwell or whatever. And that can be true or may not be true. So, numbers tend to be more believable. And so, maybe a bit more kind of reliable. But combination between objective data and subject data is good. But having a framework with how you report medical incidents, that's very important. It's important inside the NHS. So, when I'm getting a report from a registrar about an intensive care patient, it's exactly the same kind of process as getting a report from a medical officer or chief officer or a captain from offshore somewhere. And having it presented in a logical kind of way is very, very helpful indeed. The vast majority of our clients, when something bad has happened, they're used to dealing with emergency situations. And the vast majority are very calm, very collected and perform extremely well. There's some that need some more kind of support. A bit of managing, a bit of guidance. Yeah. But that's what we do. So, we bring... It's like if I go down to ED for a small baby or something like that, my job is to bring something which is nice, calm, quiet, controlled, organized, and reassuring. So, that's our job with the telemedical support service as well. Yeah. And so, how much information do you have? So, if you have a client that's a yacht, do you instantly or right at the start of an emergency situation, do you know the qualifications of the crew on board, their own medical history and things like that? Is that already known or do you find that out during the situation? You tend to find that out during the incident. So, our telemedical communication platform, that has a medical kind of library on board. So, all the crew can have their medical kind of details put in there. And if there's a medical incident, then they just import that into the case. And then we see it on the back end. Medical data is... So, medical data is obviously quite sensitive. And so, we don't really want to share data if we don't. Right. So, there's a line there between privacy and what's needed and medical data is going to be very sensitive. Absolutely. So, we're very, very careful about. And confidentiality is massively important about this. So, and all our data is kept, all our medical data is kept between quite a lot of firewalls and security systems to make sure it doesn't get taken. Yeah, of course. Yeah. So, or compromised in some way. Yeah. So, yeah. Okay. And what's coming up? So, like, and who are you starting to work with? Is it the boats directly? Is it your management companies? Is it shipyards? Where's the main relationships for MSOS? Well, that's very interesting. I mean, most of the referrals we get are word of mouth. Okay. So, it's clients who were captains or chief officers or whatever, you know, move on to a new boat. And we've been doing this long enough now. These guys really helped me once. I'm forever in debt to them, so. Yeah, exactly. And we've got now people who have been deckhands and then between second officers, first officers, chief officers, and now captains. And we've seen them progress through that career. We supported them along the way. And I do think, like, I speak to a lot of companies in the supply chain. You're like, all right, okay, supply something nice on board or an object or a bit of equipment or something like, nothing's going to have as much of an impact as helping someone in a medical emergency. Yeah. Because if you are there at the right time and you really help them out, the loyalty there and the value of it is just going to be sky high. Yeah. I remember another case, another anaphylaxis case, actually, between Panama and the Galapagos. Right. And the chief officer on board was a very, very capable woman. They rang up one night and this chap was known to be, have anaphylaxis to fish and had eaten what he thought was chicken off the barbecue. It turned out it was fish. So, and literally, I mean, there's not much help around anywhere near. And she was the chief officer on board that vessel and she dealt with the situation, organized everything really, really well on board. And she's now a captain on a boat that we do the support for as well. So that's a very typical kind of, you know, example of- It follows the people. Yeah. It follows the people. I mean, you develop that relationship, long-term relationship with people in the industry and hopefully that persists. And that's what we, you know, that's what we try and do. We have a very simple business model, but it's the case of delivering that every single time as well as we possibly can. Okay. Fantastic. Thank you so much for your insight, Spike. Lovely speaking with you. Thank you very much. Everybody, that's another episode of the Ben Taylor podcast. This was a collaboration with the Superyacht Services Guide, a very highly trusted directory of large yacht services. MSOS is, of course, part of that. Once again, I need to thank Perla Bianca, the beautiful venue we're on board today. It's listed for sale by Ark & Yacht, so big thank you to them. All being well, we'll see you again on the next episode. That's all for now. Bye. Thank you for listening to another episode of the Ben Taylor podcast, the home of marine industry insights. We'll see you again very soon. Bye for now.