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Reconstructive surgery is a precise and delicate business, even for procedures as standardized as carpal tunnel surgery. Dr. Michael Bell, an assistant professor at the University of Ottawa has performed more than 7,000 carpal tunnel operations over his 30-year career, and he recognizes a good surgical tool when he sees one. That's why, almost a decade ago, he made what many in the medical community would consider an unorthodox move: He created a custom scalpel—out of a woodcarving knife he'd bought from Lee Valley Tools. Designed to trim chairs and cabinets, the knife was one of the standard tools in his basement workshop, and had a handle that was rounder and easier to grip than his flat-handled scalpel.

In the summer of 1999, Dr. Bell wrote a letter thanking Lee Valley CEO Leonard Lee for inadvertently helping to create the world's best scalpel. Lee was intrigued that one of his tools was being used in surgery, and responded by visiting Dr. Bell's clinic with several of his designers. He was immediately appalled at the heft and relatively awkward feel of modern surgical instruments. Lee's short-term fix was to create a new handle for Dr. Bell using stainless-steel components.

Within weeks, however, the prospect of entering the life-saving business began to captivate Lee. He stepped back from his position atop the $100-million-a-year hardware chain and embraced the adrenalin-spiked rush of small-business entrepreneurship.

He had launched Lee Valley by selling cast-iron stove kits on evenings and weekends, so how hard could it be to start a tiny R&D-based medical equipment maker?

Eight years later, Lee has his answer. Encouraging woodworkers to add another $12.95 chisel to their collection is considerably easier than persuading surgeons to forsake the hallowed tools of their trade. If there is one thing Lee now knows for certain, it's that not every doctor is as inventive as Michael Bell in being willing to repurpose woodworking equipment for the O.R. Today, Lee's start-up, Canica Design, appears to be on the cusp of success or failure. Either it will be instrumental in popularizing some radically innovative new medical devices, or it will succumb to the inertia and conservatism of a health-care industry with little appetite for change.

To discuss the challenges of breaking into the medical industry, and the difficulties of starting a new company—even when you're existing business is a household name—Leonard Lee will join us online today at 1 p.m. EDT

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Noel Hulsman, Small Business Editor, globeandmail.com writes:Leonard, thank you very much for joining us today. Before we start, I should mention that you are the cover story on our Spring issue of Report on [Small] Business magazine published today ( Under the knife ). Before I get to the readers' questions, I think it's only fair to give you a chance to comment on the story, if you would like.

Leonard Lee writes: In general, the story is factual and really quite kind. Where it goes astray is where most stories of this kind are unreal. I do NOT do most of the invention or anything else. I try to hire sound people, then create an open atmosphere among staff where they can be happy and have the tools for their work. They do all the rest and tend to go unmentioned in most articles of this type, this one included. The emphasis is always too much on the CEO. But, as one of our boys once said, "You are going to get all the blame so you might as well accept all the credit." That's Ok as long as people know the truth; I am carried daily by a very sound staff.

Rob C from Toronto writes: I heard about Dr. Bell's innovative use of Mr Lee's tool a few years ago and it caught my interest. My company uses Lee Valley tools on a daily basis and so does my family and friends. Not just for dedicated workplace- products for everyone. My question is: I am curious about the types of medical tools and innovation that are being develop by Mr. Lee's new company. In regards to the slow acceptance rates of the medical establishment mentioned in the article: 1.) Is it because the tried and trusted tools that the medical establishment prefers- does the job as opposed to newer innovative ones that cost more? 2.) Or is it a stigma that a woodworking tradesman type company should not be in the medical business? I took a look at some of the products at Canica Design and personally, I am all for newer innovations that would make surgery quicker, safer and less painful- with quicker recovery times. Especially if I am the one under the knife!

Leonard Lee writes: As you must know, you often like a tool because you have used it for years and you understand its idiosyncracies. (It is like many friendships in that regard.) Tool use is not all logical and if you are frequently in critical situations, you want to use a tool you know well. It is easy to put off getting used to a new tool.

To a certain extent, using one of our new wound closure systems is similar. Why risk screwing up an installation if you are comfortable with what you have always done. These are guesses on my part but I think they are close to the mark.

Oleg Kuzin from Toronto writes: I have read that invention is taking something that is known 80% and adding the last 20%. If I am correct , you were also instrumental in the development of cheese rasps from the carpenter semi-round interchangeable blade rasps. I also notice n your gardening catalogue that a personal pump mister was adapted to mist house plants. Can you describe your state of mind when these inspirations come to you?

Leonard Lee writes: The state of mind is probably some form of inventive dementia. More seriously, many of you have seen where products can be imoproved or new ones developed. Much of invention is just following through on that instinct. The market soon tells you whether or not you have good instincts.

Presumptuous One from Toronto writes: Mr. Lee, I am somewhat apprehensive about making a comment as I am afraid that I will lapse into adulation and sound like a road show groupie. In terms of your products it is clear that your focus is on 'neat' things - I use the term in the same sense that people used to talk about 'elegant' software - stuff that superbly and efficiently does the job it was designed to do. The miracle of Lee Valley isn't the 'neat stuff' rather it is that your company is such an ethical and decent organization to deal with. I don't know how you do it but you seem to have a 100% batting record in terms of finding polite, knowledgeable, reasonable staff. Surgeons of the world arise - at a minimum you are going to get a better grip on your job!

Leonard Lee writes: Hiring is a vastly under-rated activity in business. The secret in any service business is to first of all hire people who like helping others and do not see it as some kind of demeaning, servile activity. The activity is what you make it by your approach to it.

Second, hire people who have good belief systems that hard-wires them to act ethically.Our staff have all the authority they need to solve customer problems. Almost never will you hear one of our staff members say "You'll have to talk to the manager on that".

Third, don't create incentives that encourage people to act in a manner counter to good customer service. For example, we have nobody on commission and no sales targets. In my view, both conflict with good customer service.

Finally, support your staff. If any of us has made a mistake, we will apologize, refund, replace, or whatever is necessary but nobody should construe this as the time to play "The Customer is Always Right" card and start personal criticism of the individual they are dealing with. That person has the right to walk away (or hang up, if it is a phone call) because there is no amount of money worth crawling for. They know management will support them.

Noel Hulsman writes: Could you speak to the differences between running a large business like Lee Valley Tools and a tiny operation like Canica? In terms of the scale of the issues, are there any comparables?

Leonard Lee writes: The main difference of large vs small is that you know all the staff in the latter and you find yourself trying to remember names and faces in the former. Accordingly, there is an ever decreasing efficiency in communication and in comfort as the company grows. A newsletter does not cover what you learn from casual conversations in a small company. There is less comfort in all relationships because they are not based on as much understanding. I will take small every time even if it does mean you have to refill the toilet paper holder in the bathroom every once in a while.

S. Garlick from Nova Scotia writes: Congratulations for recognizing and pursuing a new venue for your fine tools. Considering how many of my fellow woodworkers sustain injuries from hand-held tools, aren't you in a potential conflict of interest? Do you have a timeline for attaining profitability? Against whom do you compete in this specialized field? Thanks for the tools and the dedication to quality. Good luck.

Leonard Lee writes: If wounding yourself and needing repair is a conflict of interest I was in such a conflict just last week and the conflict is healing nicely. Closed, I might add, with a much simpler product than those we make. Whatever timeline I had forecast and that has changed several times) has proved wrong but we make market inroads daily, the most recent being acceptance of our systems by a front line US Marine hospital in Iraq and are stocked for them by the Marine hospital in Germany where cases are sent from Iraq once they are stable.

As for our competitors: we compete with several several companies but mostly we compete with the status quo. It is hard to change established practice

Noel Hulsman writes: On the issue of competing with the status quo, it seems that the status quo is much more formidable opponent in Canada than in the U.S. Is that true? And if so, what can Canadian small businesses do about it?

Leonard Lee writes: It is only a question of degree. Americans have always been early adopters of any new product but we had adoption in Canada plus excellent co-operation from a number of Canadian doctors before we approached the U.S. market seriously. The problem is more institutional than professional. We frequently need the help of doctors working internally to get a hospital to carry our products. In fact, that should read "always" not frequently. I cannot think of one example where a hospital decided to carry a product based on the decision of anybody other than a doctor who wanted to use it. Like most institutions, there are far more people in hospitals who can say no that there are authorized to say yes. There is not a huge difference between the two markets in that sense or in the interest of doctors. Small firms just do not have the bucks to sponsor extensive trials and hospitals almost invariably ask suppliers to pay internal hospital costs for such trials as well as supply free product or else they will not appraise new product even if it is accepted by a number of doctors.

The secret is to have enough funding to weather all the delays in acceptance. It is not a game for the faint of heart.

Noel Hulsman writes: In the story ( Under the knife ), you express some frustration over the 'rationality' of the purchasing process in hospitals. Who do you feel should be making the decisions on procurement? The health authorities instead of the doctors?

Leonard Lee writes: What I can say is that if U.S.Marine doctors did not have a discretionary budget for operating room purchases, we probably would not have seen our systems initially in use in Iraq because the first time the doctor involved used the system was in a stateside Marine hospital where he bought the product from his discretionary budget. When he got to Iraq he saw much wider use for it and we sent him a dozen sytems (free of charge) for use there. As the wounded soldiers migrated to Germany and later to the U.S., doctors along the way became familiar with it. Now it is stocked in a number of US Army hospitals.

That discretionary budget made all the difference. By comparison, we are not aware of any other hospital system in North Americas where such budget freedom is given to doctors. The counter argument is that such a system can lead to abuse.

In general, giving someone even limited control over what he or she works with has merit but it is very difficult to do that in healthcare because it is hard to recall patients for rework if something defective has been installed. That is why peer reviews and product selection committees exist. Such questions are never black and white.

Noel Hulsman writes: Leonard, thank you very much for your time today. We appreciate you sharing your thoughts.