How a Culture of Transparency Can Supercharge Your Start-Up

Duke Rohlen is a bit of a maverick in the medtech space. 

Starting with FoxHollow Technologies, Duke served in a number of positions before becoming President. There he drove annual sales to $200 million, guided the company through an IPO, conceived of and structured a $300 million collaboration with Merck Pharmaceuticals, and, ultimately, spearheaded the sale of the company to Ev3 (now Medtronic).

Eager for his next challenge, Duke founded and served as the CEO of CV Ingenuity (CVI), a medical device company that developed drug-coated balloon platforms for the treatment of vascular diseases. As CEO, he raised $30 million of venture capital, before ultimately selling the company to Covidien (now Medtronic) in 2013 for $300 million.

More recently, he pioneered treatment modalities for nasal obstruction as the Chairman and CEO of Spirox, and eventually negotiated Spriox’s sale to Entellus/Stryker. 

Today, Duke is the Founder, CEO, and Chairman of Ajax Health, which deploys capital and leverages operational experience to accelerate healthcare innovation across medical devices, digital health, healthcare services, and biotechnology.

It’s an impressive resume, with a number of exciting high points and victories. However, when I ask Duke how he felt in those moments of triumph — when, for example, he successfully sold CV Ingenuity to Covidien — he gives me a surprising answer: “bittersweet.”

Really?

“Yes,” Duke confirms. And he wouldn’t want it any other way. 

Feeling both elated and poignant at the point of sale, Duke reasons, is an indication that he’s done his job well. “I don’t think anyone who’s part of a great company … no matter what the price tag that you’re getting for the company, nobody feels totally great about turning it over to somebody else,” he explains. “I think mixed emotions come from just the whole engine being galvanized around doing something big and lofty and creating something that has real meaning.”

It makes sense when you consider Duke’s leadership style; he’s a communicator and team-builder who assembles dynamic groups of people committed to growing companies for the long-term. So it’s only natural that there are some mixed emotions when those companies sell, even when the exit values are high and the returns on equity are impressive.  

In this episode of Medsider, Duke discusses the three component parts all successful start-ups share, why he encourages entrepreneurs to be picky and prioritize one vector, and how he strives for transparency as he grows his businesses.

Key Lessons From Duke’s Experiences

• Successful start-ups are made up of three equally important components: technology, business model, and team. 

• Keep your eyes on the prize, and minimize profligate spending by ensuring that your company’s vector towards value-creation is as straight and focused as possible. CVI eliminated distractions and stayed focused by pursuing a U.S.-only strategy and foregoing any efforts in Europe altogether. 

• Emphasize a culture of transparency in everything you do: from internal organization, to clinical trials, to your exit. Duke’s authentic approach at CVI facilitated buy-in from his team, and helped quell calls for European expansion from board members.