Lessons Learned Bootstrapping a Startup from $0 to $20 Million

Interview with Medsider Founder Scott Nelson

Like many of the best ideas, the Medsider community was born when someone saw an opportunity to meet a specific need for a specific audience — then brought it to life.

Well over a decade ago, Scott Nelson was a podcast enthusiast who noticed that there weren’t shows speaking to the medical device or health start-up spaces. 

He looked to his favorite entrepreneurial podcast as inspiration and started the Medsider podcast to tell the stories of health technology inventors and innovators. “It’s been a phenomenal opportunity to build out a network with people that I never otherwise would have been able to have conversations with and learn from,” Scott says. 

His story of noticing that no one else is doing this and this is interesting to me is Exhibit A of the natural curiosity characterizing Scott’s entire career. That curiosity has led him to found numerous health and medical start-ups, including Joovv, Crossfire Medical, and FastWave Medical

This unique episode of Medsider flips the script, putting Scott in the interviewee seat alongside his good friend, and temporary host, Brett Johnston. He shares where founders should focus early on, guidance for taking the leap from your corporate position, and how to know which opportunities to pursue.

Guest
Scott Nelson
Founder of Medsider

Scott Nelson has spent the last two decades in the medtech space, starting in medical device sales roles that ultimately led to startup leadership positions. During that time, he followed his curiosity through several career transitions while engaging in side projects along the way. He’s the founder of Medsider, Joovv, Crossfire Medical, and FastWave Medical. The latter two are spinouts with his partners at Big Sky Biomedical.

Key Lessons from Scott’s Experiences

  • When in a full-time role, dedicate 10-20% of your time to exploring opportunities outside your job description — the insights you gain will benefit you and your company. 
  • Acknowledge the risk inherent in any career change, understanding the potential for reward and growth on the other side. 
  • Founders need to be willing to dabble and experiment in the early days of a project, make space to pivot as the work evolves, and ensure they’re working with the right team as early as possible to optimize decision-making and results.
  • Never stop networking — stay close to your connections and allow space for future projects you can’t anticipate. Look for opportunities that align with your experiences and expertise.

Taking Risks in Each Transition

Following his first position out of college at a small commercial finance company, Scott began his medical device journey with Conmed, which later launched him into the cardiovascular space.

Nearly a decade later, Scott was a senior sales manager at Covidien through their acquisition of Bacchus Vascular, a thrombectomy start-up. He took a major leap — and pay cut — by participating in a two-year program with the company that brought sales leaders in-house to marketing positions. Scott saw the move as a valuable opportunity to learn about all sides of the business and planned to move back into sales leadership when the time was right. 

But he faced a significant shake-up when Medtronic acquired Covidien. Major leadership changes meant that Scott’s plan to leverage the role into something bigger was no longer an option. 

This led to a period of uncertainty: Would he take an internal lateral move, keep climbing the ladder, or pursue something else? The first two options didn’t compel Scott, and he soon got a first taste of the start-up space with his move to head up partnerships at Touch Surgery, a London-based digital health company that was later acquired by Medtronic.

The common denominator in each of Scott’s early career transitions was risk: shifting away from the path he was on to pursue something else in hopes of new knowledge and experiences. 

He says this is inevitable: ”The moral of the story is that every career pivot is going to come with some risk. You’ve got to be willing to take some swings.”

Going Beyond the Job Description

Looking back, Scott wouldn’t trade any of his early experiences, particularly the lessons he gained in a corporate environment. His in-house marketing role offered priceless exposure to many departments and aspects of the business that he wouldn’t have obtained on a strictly-sales trajectory. 

Anyone in a corporate role greatly benefits from spending 10-20% of their time exploring and discovering different parts of the business. This process offers major advantages for both the individual as well as the company itself. 

Regardless of your current role, go beyond your job description by volunteering for unique opportunities and raising your hand for any project that comes up that takes you somewhere new.

To guide this exploration, Scott also recommends curating a network of mentors. When new projects or opportunities come along, it’s invaluable to have individuals in your corner — even if you only talk once a year — who can provide wisdom based on their previous experiences.

Taking the Leap from Corporate Life

Many entrepreneurial-minded people are prone to having side hustles alongside their full-time roles — and Scott was no exception. However, he’s not quick to advise someone making hundreds of thousands of dollars per year to simply take the leap to a side hustle they find interesting, either. 

“There are few and far opportunities where you’re going to basically be able to turn a side hustle into something that completely displaces that gig,” he says. 

Abruptly taking the leap from a high-paying position to going all in on something you find interesting results in a considerable amount of pressure. What you once loved will become painfully high-stress.

Scott further explains that the career leaps he’s taken haven’t been dependent on immediate success. It’s important to have the financial flexibility and runway to pursue passion projects before depending on them to pay the bills.

After spending just over a year at Touch Surgery, Scott felt that the product-market fit wasn’t right, and the risk of staying seemed greater than the risk of leaving. He moved to a marketing agency that was growing its medtech practice, where he learned an immense amount in a year’s time.

During that same time, Scott had been working on a significant side hustle: Joovv, a red light therapy company that was inspired by his wife’s success with the treatment at spas and his interest in exploring at-home options. 

Once again, he followed his natural curiosity, this time to commercialize a product in the red light therapy space. But the early exploration and prototyping work took place while he was still working full-time. 

A full year into what he calls “dabbling” with Joovv, the product started to take off. He had a specific monthly revenue target in mind that would compel him to leave his full-time role — and once Joovv became a million-dollar business, he took the leap to run the company full-time.

The leap was worth it. Scott profitably bootstrapped Joovv from $0 to $20 million in revenue over the course of three years.

Key Values for Founders

Ultimately, risk is involved with any move from a stable position to starting something new. Some projects won’t come to fruition. Others, like Joovv, will be the win you’ve been looking for. 

Scott points to several startup essentials for the success of various endeavors he’s been a part of.

1. Willingness to explore 

Scott and a few engineers worked on another medtech startup during the early days of Joovv. They spent several years exploring prototypes, collecting voice of customer research, and pitched the company to various investors before ultimately pausing it.

Some projects will be a swing and a miss; others won’t. “You’ve got to be willing to dabble a bit,” Scott says. Exploring and experimenting — including trying things that don’t work — are going to be the best ways for founders to discover which projects will ultimately be a success.

2. Being ready to pivot

With Crossfire Medical, another of Scott’s co-founded startups, the original team circled back around in mid-2020, bringing new life and ideas to the company, and ultimately closed on a seed round of financing about a year later.

Scott says that flexibility is key for founders, who need to be willing to allow projects to evolve and change over time. If stepping away is the right move — either temporarily or for good — entrepreneurs need to be open to either shutting something down or pushing through the challenges.

3. Aligning as early as possible

One of Scott’s key lessons has been to be sure to work with the right people on a project as early as possible. As soon as a side project starts to show promise, assess the team you have and make adjustments sooner rather than later.

Down the road, even if you have the right contracts or legal elements in place, if you disagree with the people around you about capital-raising or major business decisions, the end result likely won’t turn out well.

Finding Opportunities Rooted in Your Experiences

Now at Big Sky Biomedical, Scott works on early seed-stage medtech startups to help them avoid what he calls the “medical device valley of death.” 

Scott and his partners at Big Sky assess three key factors when engaging new projects: the clinical need, the regulatory pathway, and the reimbursement outlook. Big Sky works within a narrow window of projects that check each of these boxes. 

When considering opportunities to invest or start a project from the ground up, explore from that same place of natural curiosity grounded in your prior experiences.

For Scott, this means staying close to the consumer health space. He found the fast pace and tangible impact incredibly exciting. Using this domain expertise, Scott now looks for ways to apply direct-to-consumer best practices into traditional medtech projects.

Even if you’ve transitioned out of one area, there are likely principles that you can pull into your new space. Stay tuned into your former industry niches — you never know what future opportunities you might encounter. 

Perhaps most important,don’t lose touch with industry contacts, especially those with whom you connect and share your fundamental beliefs. Scott has found the well-known cliche to be true: your network is your net worth. It’s one of the most valuable tools for opening up new opportunities. 

Download a copy of the interview transcript right here.
Share:
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Like many of the best ideas, the Medsider community was born when someone saw an opportunity to meet a specific need for a specific audience — then brought it to life.

Well over a decade ago, Scott Nelson was a podcast enthusiast who noticed that there weren’t shows speaking to the medical device or health start-up spaces. 

He looked to his favorite entrepreneurial podcast as inspiration and started the Medsider podcast to tell the stories of health technology inventors and innovators. “It’s been a phenomenal opportunity to build out a network with people that I never otherwise would have been able to have conversations with and learn from,” Scott says. 

His story of noticing that no one else is doing this and this is interesting to me is Exhibit A of the natural curiosity characterizing Scott’s entire career. That curiosity has led him to found numerous health and medical start-ups, including Joovv, Crossfire Medical, and FastWave Medical

This unique episode of Medsider flips the script, putting Scott in the interviewee seat alongside his good friend, and temporary host, Brett Johnston. He shares where founders should focus early on, guidance for taking the leap from your corporate position, and how to know which opportunities to pursue.

Guest
Scott Nelson
Founder of Medsider

Scott Nelson has spent the last two decades in the medtech space, starting in medical device sales roles that ultimately led to startup leadership positions. During that time, he followed his curiosity through several career transitions while engaging in side projects along the way. He’s the founder of Medsider, Joovv, Crossfire Medical, and FastWave Medical. The latter two are spinouts with his partners at Big Sky Biomedical.

Key Lessons from Scott’s Experiences

  • When in a full-time role, dedicate 10-20% of your time to exploring opportunities outside your job description — the insights you gain will benefit you and your company. 
  • Acknowledge the risk inherent in any career change, understanding the potential for reward and growth on the other side. 
  • Founders need to be willing to dabble and experiment in the early days of a project, make space to pivot as the work evolves, and ensure they’re working with the right team as early as possible to optimize decision-making and results.
  • Never stop networking — stay close to your connections and allow space for future projects you can’t anticipate. Look for opportunities that align with your experiences and expertise.

Taking Risks in Each Transition

Following his first position out of college at a small commercial finance company, Scott began his medical device journey with Conmed, which later launched him into the cardiovascular space.

Nearly a decade later, Scott was a senior sales manager at Covidien through their acquisition of Bacchus Vascular, a thrombectomy start-up. He took a major leap — and pay cut — by participating in a two-year program with the company that brought sales leaders in-house to marketing positions. Scott saw the move as a valuable opportunity to learn about all sides of the business and planned to move back into sales leadership when the time was right. 

But he faced a significant shake-up when Medtronic acquired Covidien. Major leadership changes meant that Scott’s plan to leverage the role into something bigger was no longer an option. 

This led to a period of uncertainty: Would he take an internal lateral move, keep climbing the ladder, or pursue something else? The first two options didn’t compel Scott, and he soon got a first taste of the start-up space with his move to head up partnerships at Touch Surgery, a London-based digital health company that was later acquired by Medtronic.

The common denominator in each of Scott’s early career transitions was risk: shifting away from the path he was on to pursue something else in hopes of new knowledge and experiences. 

He says this is inevitable: ”The moral of the story is that every career pivot is going to come with some risk. You’ve got to be willing to take some swings.”

Going Beyond the Job Description

Looking back, Scott wouldn’t trade any of his early experiences, particularly the lessons he gained in a corporate environment. His in-house marketing role offered priceless exposure to many departments and aspects of the business that he wouldn’t have obtained on a strictly-sales trajectory. 

Anyone in a corporate role greatly benefits from spending 10-20% of their time exploring and discovering different parts of the business. This process offers major advantages for both the individual as well as the company itself. 

Regardless of your current role, go beyond your job description by volunteering for unique opportunities and raising your hand for any project that comes up that takes you somewhere new.

To guide this exploration, Scott also recommends curating a network of mentors. When new projects or opportunities come along, it’s invaluable to have individuals in your corner — even if you only talk once a year — who can provide wisdom based on their previous experiences.

Taking the Leap from Corporate Life

Many entrepreneurial-minded people are prone to having side hustles alongside their full-time roles — and Scott was no exception. However, he’s not quick to advise someone making hundreds of thousands of dollars per year to simply take the leap to a side hustle they find interesting, either. 

“There are few and far opportunities where you’re going to basically be able to turn a side hustle into something that completely displaces that gig,” he says. 

Abruptly taking the leap from a high-paying position to going all in on something you find interesting results in a considerable amount of pressure. What you once loved will become painfully high-stress.

Scott further explains that the career leaps he’s taken haven’t been dependent on immediate success. It’s important to have the financial flexibility and runway to pursue passion projects before depending on them to pay the bills.

After spending just over a year at Touch Surgery, Scott felt that the product-market fit wasn’t right, and the risk of staying seemed greater than the risk of leaving. He moved to a marketing agency that was growing its medtech practice, where he learned an immense amount in a year’s time.

During that same time, Scott had been working on a significant side hustle: Joovv, a red light therapy company that was inspired by his wife’s success with the treatment at spas and his interest in exploring at-home options. 

Once again, he followed his natural curiosity, this time to commercialize a product in the red light therapy space. But the early exploration and prototyping work took place while he was still working full-time. 

A full year into what he calls “dabbling” with Joovv, the product started to take off. He had a specific monthly revenue target in mind that would compel him to leave his full-time role — and once Joovv became a million-dollar business, he took the leap to run the company full-time.

The leap was worth it. Scott profitably bootstrapped Joovv from $0 to $20 million in revenue over the course of three years.

Key Values for Founders

Ultimately, risk is involved with any move from a stable position to starting something new. Some projects won’t come to fruition. Others, like Joovv, will be the win you’ve been looking for. 

Scott points to several startup essentials for the success of various endeavors he’s been a part of.

1. Willingness to explore 

Scott and a few engineers worked on another medtech startup during the early days of Joovv. They spent several years exploring prototypes, collecting voice of customer research, and pitched the company to various investors before ultimately pausing it.

Some projects will be a swing and a miss; others won’t. “You’ve got to be willing to dabble a bit,” Scott says. Exploring and experimenting — including trying things that don’t work — are going to be the best ways for founders to discover which projects will ultimately be a success.

2. Being ready to pivot

With Crossfire Medical, another of Scott’s co-founded startups, the original team circled back around in mid-2020, bringing new life and ideas to the company, and ultimately closed on a seed round of financing about a year later.

Scott says that flexibility is key for founders, who need to be willing to allow projects to evolve and change over time. If stepping away is the right move — either temporarily or for good — entrepreneurs need to be open to either shutting something down or pushing through the challenges.

3. Aligning as early as possible

One of Scott’s key lessons has been to be sure to work with the right people on a project as early as possible. As soon as a side project starts to show promise, assess the team you have and make adjustments sooner rather than later.

Down the road, even if you have the right contracts or legal elements in place, if you disagree with the people around you about capital-raising or major business decisions, the end result likely won’t turn out well.

Finding Opportunities Rooted in Your Experiences

Now at Big Sky Biomedical, Scott works on early seed-stage medtech startups to help them avoid what he calls the “medical device valley of death.” 

Scott and his partners at Big Sky assess three key factors when engaging new projects: the clinical need, the regulatory pathway, and the reimbursement outlook. Big Sky works within a narrow window of projects that check each of these boxes. 

When considering opportunities to invest or start a project from the ground up, explore from that same place of natural curiosity grounded in your prior experiences.

For Scott, this means staying close to the consumer health space. He found the fast pace and tangible impact incredibly exciting. Using this domain expertise, Scott now looks for ways to apply direct-to-consumer best practices into traditional medtech projects.

Even if you’ve transitioned out of one area, there are likely principles that you can pull into your new space. Stay tuned into your former industry niches — you never know what future opportunities you might encounter. 

Perhaps most important,don’t lose touch with industry contacts, especially those with whom you connect and share your fundamental beliefs. Scott has found the well-known cliche to be true: your network is your net worth. It’s one of the most valuable tools for opening up new opportunities. 

Download a copy of the interview transcript right here.
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