Essential Frameworks for a Medtech CEO

Tess Cosad, CEO of Béa Fertility is a former marketer who decided to make fertility treatment more accessible. Béa Fertility offers a user-friendly and affordable alternative to traditional clinic-based in vitro fertilization (IVF) for those on their journey to conceive.

Being a CEO, making decisions constantly is the name of the game. Tess shares an anecdote from a stroll she took through downtown Manhattan with a mentor who had successfully built and sold multiple companies. They were looking for a bakery she didn’t know the exact location of. At each juncture, her mentor asked Tess “left or right,” and they took a turn based on what she answered. Although initially frustrated, Tess eventually realized the lesson: You don’t always know where the finish line is, but progress, even with a few wrong turns, is better than getting stuck. The path to success in medtech is rarely a straight line anyway.

Being a CEO means you'll have to make decisions constantly, often based on incomplete information. Obsessing over perfection will paralyze you. The goal is to maintain momentum by consistently making decisions and course-correcting as you go. Tess’s advice is to trust your intuition, seek advice from experts when necessary, and get comfortable with making a few wrong turns. Moving forward is better than getting stuck, whether it’s one right or three lefts.

As she puts it, “The point of making decisions is to move forward, to course-correct, and to learn. And if you can do those three things over the long arc, you will get to where you want to go. It doesn't matter if you take three lefts where you might have taken one right. If you're learning all the time on those three lefts, your next right will likely be a good one.”

At the helm of InterShunt Technologies, Harlee Sorkin is steering the development of a catheter to alleviate the symptoms of heart failure by making a shunt within the heart. It improves blood flow and lessens cardiovascular workload, a promising method that is redefining standards with this disease.

Harlee readily admits that the learning curve in entrepreneurship is steep, especially if you’re coming from an academic background. While he humorously refers to himself as the Chief Fundraising Officer, he knows that his role goes beyond simply securing capital; it also includes building strategic partnerships, acquiring essential talent, and negotiating favorable terms.

Above all, as the CEO, you need to serve as the primary point of contact between the top – investors, shareholders, and your board – and the rest of the company. “The CEO is the skinny waste of an hourglass, the single point of contact,” Harlee says. The job is to articulate to the top what the mission is and what resources it will require, and then allocate those resources with your team in order to accomplish the company’s goals. This demands clear upward communication of the company’s needs and target milestones, as well as effective downward resource allocation to achieve those goals.

While it’s easy to get lost in day-to-day operations from time to time, a CEO needs to be accountable in the long term by ensuring the entire team is able to execute on commitments made to investors. For that, you must set and clearly articulate realistic milestones, communicate the product development roadmap, and the resources required. The cycle of defining, executing, and demonstrating success is crucial for garnering support for the company.

In Harlee’s words, “It's this process of defining what you're going to do, telling people what you're going to do, and then go do it. Then go back and show them what you did so that you can then begin that process all over again.”

Sean Morris’s career in medtech began modestly, with the sale of medical devices for AngioDynamics. He then quickly progressed into various leadership roles, ultimately becoming a serial entrepreneur. Today, as CEO of Amplifi Vascular, Sean is spearheading the development of the Vein Dilation System, a tool to enlarge veins using a proprietary blood pump technology.

A startup CEO is the person who holds ultimate responsibility for the success and direction of the company. This means immense pressure and immense responsibility. Sean likens it to being a cornerback on the football field; there's really nobody behind you. He shares, “You can't depend on anybody else to do your job for you. You have to be incredibly resourceful and know that it's not going to get done unless you do it."

This means that you must be willing to roll up your sleeves and tackle the “dirty work.” Don’t shy away from any aspect of your business. Become intimately familiar with regulatory, R&D, clinical, marketing, and other key areas to make informed decisions. You need to be a self-starter, find solutions, and take the initiative to move forward.

Having said that, Sean also stresses the importance of teamwork. As your venture grows, so do your responsibilities. He stresses the importance of delegating effectively and choosing partners who bring not just capital but strategic value to the table. In short, good people and smart money are essential as you scale.

After an early career as a professional musician, Dr. Steven Mickelsen decided to tackle medicine, specializing in electrophysiology. He later developed into a serial medical device entrepreneur with a focus on pulse field ablation (PFA) technology. His success with Farapulse revolutionized cardiac care and was acquired by Boston Scientific. Now, Dr. Mickelsen is the CEO of Field Medical, developing next-generation PFA solutions to address an unmet need in treating ventricular arrhythmias.

As a CEO, your primary roles are to secure funding and steer the company on the right path – something that’s easier said than done. For that, Dr. Mickelsen stresses the importance of experience. A seasoned CEO that has "done it before," can provide investors with realistic projections about costs and timelines, establishing trust and confidence in their leadership.

However, this doesn’t mean you should fret if you’re a green entrepreneur. If that’s the case, surround yourself with advisors or seasoned team members, people whom you can trust with financial and strategic decisions.

The other equally important thing is to be adaptable and prepared for the long haul. You need to be able to make critical adjustments as circumstances evolve, all while keeping the ultimate goal in sight.

And finally, don’t obsess over equity. Maintaining ownership is important, yes, but you need to understand that investors take significant risks. "You're asking people and firms to take incredible risks with their resources. No matter how good your idea is, you have to give them something for that," says Dr. Mickelsen.

The long and short of the matter is that while experience is invaluable, you can be successful in medtech with the right mindset. Understand that this is a long-term game that requires adaptability, be realistic about fundraising expectations, and take an upfront approach with investors about potential challenges.

When you’re passionate about improving patient outcomes, it resonates with investors and motivates your team, especially during challenging times. In Dr. Mickelsen’s’s words, “You should not have the expectation of holding on to 50% of your company, for example. Maybe that happens in Silicon Valley. In medtech, the real goal is to have a successful technology that's needed by physicians and deserved by patients. If we can bring that forward and our investors can come out on top, then it's a win-win."

Carla Spina is the CEO of Noa Therapeutics, a Canadian biotech company poised to change the treatment of immune diseases. She holds a Ph.D. in Bioinorganic Chemistry and has a wealth of experience in top companies like BASF and Exciton Technologies. But perhaps more than that, inspired by her sister’s struggle with lupus, she's determined to find better solutions for those living with immune disorders. Today, she’s developing small-molecule therapies that target multiple aspects of inflammation at once.

Carla believes that recognizing your strengths and weaknesses is crucial for success. That’s why she took advantage of a modest grant from the Business Skills Development Program to hone her executive skills and connect with valuable mentors. “That small bursary not only enabled me to identify mentors in this space and connect with the greater ecosystem but also gave me the skills I needed to start Noa,” she shares.

Carla also stresses that building a successful company requires collaborative effort. Your ability to connect with the right people – mentors, the right investors for different stages, functional experts like IP strategists, and vendor partners within the broader ecosystem – holds immense weight when it comes to your company’s success. "It takes a village," Carla emphasizes, "and understanding what you need at each stage of development is vital."

True to her belief in collaboration, Carla is also all for giving back to the community. Follow her lead: share your experience and knowledge, foster collaboration within the larger ecosystem, create opportunities for partnerships, and help others learn. Remember: It doesn’t have to be a zero-sum game.