#207 | The Ugly Baby Problem Every MedTech Founder Must Avoid When Exporting (For Clinicians)

So the one thing that you're gonna learn in this episode is how to turn clinical insight into a med tech product that stands the best chance of real-world adoption. Welcome to Clinician to CEO, the podcast helping clinicians simplify your go-to-market strategy so that you can stop guessing and turn your working prototypes into international MedTech businesses. I'm your host, Hakeem Aade. Let's get started.

three things that you're gonna discover is, number one, why solving a clinical problem isn't enough to guarantee adoption. Number two, how to build clinical regulatory and commercial thinking into a product from day one. And number three the biggest mistakes founders make when trying to take a med tech innovation to market. And joining me today to discuss this is Jordan Morrison, and Jordan is the CEO of Senara, Advisory, and works with med tech innovators to bridge the gap between clinical insight and commercial reality.

In short, what that means is she helps companies build products that aren't just clinically valuable and viable, but also that can get real-world adoption. So Jordan, welcome to Clinician to CEO. Thank you so much. Thanks for having me.

My absolute pleasure. So let's jump straight into it. We know that a lot of med tech founders believe that if they solve a genuine clinical problem, adoption will naturally follow. And the reality, unfortunately, is that healthcare is littered with great ideas that never make it beyond the pilot, while other products become widely adopted despite not necessarily being the best solution that's available.

Yeah. So question to you, Jordan. You've worked with a huge range of clinicians, founders in med tech businesses, so what's the biggest misconception people have about turning a clinical need into a successful med tech product? I think it's the, like you said, if you build it, they will come concept of like, well, everybody wants my great idea.

So I think I see a lot of physicians, and, I would say 90% of my clientele are physician founders, so I'm in a really unique position to really answer this. But I would say option one is you've got someone that's building for their personal problem versus a commercial issue, and they haven't really done the market testing. They just, they see it as a problem, and they think their idea is brilliant, which everybody Idea is brilliant, but not all of them have legs to stand on. I call it the ugly baby syndrome, like I have to tell your baby is ugly.

I'm sorry. So I feel, I think that's the first one, and then the second one is, same thing in the same vein, but they might have a brilliant product, but they don't have, I hate to say it, business 101. It takes, it truly takes a village to make products come to market, and I think a lot of times, especially what I see in academic facilities is, again, you'll have this brilliant innovation, it's truly solving a problem, and their end goal rather than their beginning start point is a regulatory clearance, and they really haven't thought of like, "Well, what happens once I get regulatory clearance?"

Great, you have to sell your product, and I think that's where it, like, comes crashing down on them, is they are very academic. They're very focused on building and validating. They understand those processes, but they do not understand what commercialization means. So I think those are those two, two things.

Ugly baby syndrome and lack of commercialization understanding Yeah, no, and let's just extend those out then. So in terms of the ugly baby syndrome first, so effectively what you're saying is that people identify problems, and because it's a problem for them, and it might be a problem for some of the people that they initially validate the idea with, but it's not necessarily a priority for the wider community. So how do you distinguish between, that what is a problem and then what is a priority which is actually gonna move people to actually change their behavior?

And that's where I think, really focusing on commercialization from day one is what makes the difference. Because if you have an ugly baby, is what we're gonna call it, then you're not going to get people that want to adopt it. They're gonna say, "That's very neat. It's very shiny.

It's very cool. It's a great concept," but they're not actually going to want to adopt it. And so I think being a founder that focuses on, from the very beginning, market validation, that it's not just a pro- like a, something that's solving your personal problem, but do your other peers, are they interested in it? Not beyond just a, "Is it cool?

Oh, this is really neat," but, like, will they actually put it into their hospital? Will they invest? I'm giving my secret sauce away, but I have all of my founders run through I call it family and friends, but essentially a family and friends round of funding, and it's to other physicians and surgeons in their field. So let's say you're developing in the...

Like, I have a device I'm taking to market in the colorectal space. The very first people I want to invest are other colorectal surgeons. That is proving my market validity. That's proving I'm solving a problem.

That's telling me outside that there are other people interested in it that wanna see it built. So I make all of my founders go through what I call a family and friends round, and it's not actual family or friends, but just other peer-to-peer support. So you're hearing from other people, the people that are gonna be your end user adopters, that they wanna be part of this and they wanna build it. And so now you've created market interest, you've actually created a buy-in, so they're interested in seeing that product come to market, and you're raising funds, all under market validity.

That's what I highly encourage everyone, 'cause it's, it is very easy to build in a silo, and you think your idea is the best because you have this terrible problem. and then turns out it's shiny, it's pretty, but doesn't mean that people are gonna actually adopt it. It's not solving a true problem. It's solving your headache.

It's not solving an actual problem. Okay. So just on that point, 'cause I think that's a really interesting point, and it's not, and it's not something that many people, talk about. Cause effectively what you're saying is you're validating the idea by seeing whether or not people are gonna fund it.

Yeah, absolutely and most people won't think about that for several reasons, and I'll come onto a couple of those. So firstly, how do you go around doing that? Because obviously people listening will be thinking, "Okay, that sounds like a good idea," but- I have no idea how to ask somebody to fund my idea. That's the first question.

So if you could just answer that, and then I've got a follow-up. Well, so to be clear, I am not a securities attorney. I h- I work with a great securities team. I keep two securities attorneys on staff and engaged at all times.

S- so to be clear, I am not telling people how to do their funding. That is not my wheelhouse. But What I will say is find a good offering. So that goes back to building out a good business plan, right?

And these are things that you're gonna have to do sooner versus later. And again, I find physicians specifically, academic physicians really struggle with this. I actually work with, Harvard, I'm sorry, this is Stanford has a high impact technology fund, and I work as a mentor for them, and these are all these incredibly academic, brilliant, great innovators that are in their accelerator, but they don't have a business plan. They don't know how to ask for funding.

They don't know how to justify their ask. They don't... Their valuations don't make sense. So I would say the very first thing when you wanna go into funding and you wanna do the ask is, number one, have a business plan.

You can talk clinical to your peers, and when you go to actually asking them for money, you can have that piece. But you need to know the business of it, because a clinical deck is only gonna make sense to someone in that clinical market, and that's not actually gonna be what gets them to invest. What gets them to invest is to say, I think this is gonna go somewhere. I need it in my office.

I would use it in my office. And not only do I need and want it so badly, I'm willing to give you money to make it happen." So really, what are you gonna do with my money, right? So again- Teaching from the very beginning, what is your business plan?

What is your model? What roadblocks do you see? Like ask all the nos ahead of time, and that way you kind of have an answer when you're going to funding. And I honestly, when I pitch for funding, again, I give away the secret sauce.

I approach it from a, I'm trying to build this as a clinician. What do you see? What do you like about this? What do you not like about this?

What would you do differently? So that they're involved from the very beginning, and they feel like they're part of the process. And then it's a really easy ask to say, we really like the value that you have provided, and we really wanna see this come through. Is this something you would actually utilize in your clinic?

And if so, would you invest?" Because that gets rid of the ugly baby syndrome really quickly, right? Everyone will tell you, Oh, that's beautiful. It's so shiny.

It's so cool. It's really great." I mean, you and I worked on a project together that falls in these parameters where they got a lot of what they considered positive feedback because yes, it's shiny, it's new, it's exciting. But when it comes down to, would you actually use this in your clinic?

How would you use this in your clinic? How is it gonna affect your workflow? Is it gonna make a difference in your workflow? And will you open your pockets for it?

The answer was a resounding no. And to me, that is the greatest test of market strength right there. I've got another one right now, I just had to go through ugly baby, where she's got an idea- but the concept that, like the standard of care she's going against is soap and water. No matter how brilliant your concept is, if you have a 200-year-old process of soap and water, it is gonna be really difficult to change the mindset and change the idea of this new product in the market.

'Cause now you're saying you have to spend money to fix something that can be solved with soap and water, to be clear. And, and it's the same concept I've had this conversation so many times with so many different people that, they come to you and they think, "Oh, well, there's nothing else like it on the market." And you're thinking, "Well, there always is," even if that's inertia, and actually inertia- Right is the hardest thing to move. Yeah.

Having a competitor- Yes in my opinion, is always better because you've got- Yeah it means that somebody has seen it as a priority, and they're actually investing in another type of product or service. Yeah. And actually what you've just talked about there in terms of the funding almost ticks two boxes. 'Cause what you said, I at the outset was the challenge is that people look at the regulatory pathway and that's the only pa- thing to worry about.

Yeah. And they're not focusing on- That's all they have drilled in their heads. And kudos to regulatory for drilling that in their heads. And the reason why it's drilled in their heads is, as we know, like, if you make a mistake in your trial setup or you are collecting the wrong data or you don't have the quality metrics that you need, that will shut your idea down.

Yeah. So kudos to the regulatory system for scaring them straight and being like, "You have to make this a priority." But I really see so many founders build as that is the f- the finish line, and that's the starting point. That's just your green flag to say, "Okay, great, now make money."

That's not a congratulations, be all, end all, you've arrived. That's not the pinnacle. You're at base camp. Yeah.

You've just made it to base camp. exactly. And that's the biggest problem because lots of people will spend, and literally, you, we all know it, will spend years on the regulatory g- getting the evidence. Yeah.

And at all this point, they've got money, and they're burning the cash. And just before they- And exactly the start line where they need to commercialize it, they run out of cash, and they can't commercialize the idea because they've got an idea, they've got, regulatory, they've got clinical data, but they actually haven't got a commercial plan. Whereas what you're saying- Yeah which I really like, is the funding and forcing yourself into funding forces you, number one, to validate your idea, and then number two, to actually, ensure that you've ac- that people have actually kicked the tires, and you've then created a business plan because you need a business plan- Yeah to get the funding.

Yeah. And I know you, we've been on a call recently and I know you've talked about this. So lots of people think, "Yeah, but I'm gonna bootstrap it. It's much better if I can bootstrap it.

It looks great to investors." Oh. And they, they- No. D- d- just tell me your view on that, 'cause I know you've got quite a strong view on it.

You know my view. So to be clear, that is one of the biggest, misnomers, I guess is the word to use, or, mistakes f founders make is they think that it's a success story that they are bootstrapped. That is the worst thing to tell an investor. If you are bootstrapping it, you are essentially saying, "No one else wants to pay for this product but myself."

So number one, kudos to you if you have an unlimited supply of money and you just don't know what to do with it and you wanna burn it. Great. Love it for you. Most people aren't even in that area to start with.

But I think they, they prioritize where they're putting their money first, right? You get a guy, they say, "I have a great idea. I have no money, and I'm gonna bootstrap it." So they're literally, like, taking it out of their own paycheck.

That is the worst scenario. Again, it... you're telling, Why would I invest if you can't find anyone else to invest?" I don't wanna be...

Nobody ever wants to be the first person to jump off a cliff, right? But if you got- Yeah three lemmings ahead of you, then it's really easy to go from there. So that's why, again, I go back to that friends and family because it's like, pocket is market validation. And that's giving you capital to do the things you're gonna have to do and you're gonna have to spend money on anyway, like hire me.

I'm a little, biased. But also, like hiring any of your people that you need. You have to hire your attorneys to paper you so you can take funding. You have to go through, at minimum, a patent study, some sort of pathway to know what your patenting is gonna look like so you can protect your IP.

You have to go through, just the basic things. And you... it seems counterintuitive or it seems like obvious maybe is the word, but like, yeah, it could be up to 10 grand to just paper it appropriately to get funding. So why would you be, why would you be putting money out of your pocket for development when you're gonna be spending all that money on just papering it appropriately, right?

The sooner you can get to funding, the sooner you can get to the ask- The show me the money part, the sooner you're gonna set yourself up for success. And I think funding is a daunting task, and it's a two-fold process. So one, people are like, they think that's their biggest issue is funding. If I just have money, everything will be perfect and everything will flow.

No. Again, if you don't have a pathway, the easiest way to spend money is through the wrong clinical trials, the wrong, consultants, the wrong team, right? Even just having the wrong team and people that are charging. I try to...

All my team members, we work on a fractional basis so that we're trying to keep the cost as low as possible, because that also is gonna show to the investors when I do give you money, you know what to do with it. You're not gonna go take it and give yourself a $350,000 salary. That's the other thing I see. Yeah.

So really, like, funding is honestly the, like, kindergarten to business 101, right? It's not the be-all, end-all answer. It's not gonna graduate you from high school. It's gonna say, "I'm gonna create a business and I'm learning how to have a business.

I'm learning how to speak the language of a business." And that is, what is my business plan? What is my commercialization structure? Will I make money on this?

I love that especially physicians, we're all bleeding hearts and we wanna change the world, but you can cure cancer, and if it doesn't make money, you're not getting anywhere. So you have to have that concept in mind from the very beginning. How do I make money? That's what commercialization means.

And your funding, a- again, people see it as this, very daunting task. It's not. If you have a good product, it's not gonna be that difficult to get the funds that you need. I think you need organization and structure, someone like me that can help you.

But al- or even not me, but, you are gonna need experts in the field, 'cause nobody knows how to do it all appropriately. But if you have a good product, funding will come. It really will. It...

That's the easy part of the whole process. I think that's the most- guaranteed. Just one last question on funding, and we might come back to it a bit later, but I don't want to get too into it- Oh, I get so excited about it. That's my favorite part, to be clear.

To- but one, one, one of the reasons people do try to bootstrap, apart from the fact they think they're, they'll look great even though, and you just explained why, it's the complete opposite, is but lots of people don't want funding 'cause they think, "Oh, if I get funding I'm gonna have to give them that percentage, then this percentage, then that percent. Before I know it, I'm giving away the farm," for want of a better term. So how do they manage that, and what's your suggestion in terms of, okay, you're going to friend and family first and then you've got private equity maybe later down- Yeah or VC later down the line.

Yeah. How do you make sure that you keep control of the business without having to give up, keep giving away equity every time? Well, and I'm gonna, I'm gonna counter with why do you need control? Like, as a physician- Okay this is the thing, and I, they, I try to s- to, to steer them towards exit from day one.

Because at the end of the day, you're a physician, you're a founder, you have your day job is what we'll call it, and then you have a brilliant idea. If you wanna quit your day job and just run this business, more power to you. By all means. You're gonna learn very quickly you probably don't have the skill set to do it.

You, I, just to be very clear. Number two, You can, again, securities attorney, cannot say highly enough, it's important to always have someone that's reviewing and making sure you're not signing, 'cause there are very predatory agreements that are out there- Yeah and very predatory groups that do... they see a mark when they see one. They see that you're inexperienced, they see you don't have that business acumen.

They'll promise the world. I will say on that side, there's a couple caveats to watch. Number one, watch anyone that is promising funding for a percentage. So I raise X number of dollars and get X percentage back.

Unless they're a broker, that is illegal. You can do success-based milestone bonuses, but they are not tied to a percentage of the funds that you raised. So that's caveat one. Free advice, look at your contracts that you're signing.

Number two, you don't need to hire a full-time staff position. I had s- I had a doctor that just showed me a contract where this guy said he could get, $5 million in funding, but oh, he makes a $350,000 salary regardless of what he raises. Predatory contract. Be smart.

Yeah. Business 101. Get your attorneys, get your group, get your advisors to read your, your contracts. So I I start with- It is fair to be protective of your equity to make sure you don't get taken advantage of.

At the same time, if you want to be a successful business, there is no one that's doing it 100% alone, period. There isn't. You have a group of people you're working with, whether they're on an advisory level, whether they're on a fractional level, you're going to have to give up control at some point in time. The goal is...

and if it's a true company and they're aligned with your vision, that's who you wanna get your funding from. The other misnomer I hear or, issue is with funding every dollar is good dollars. That's not true. Like, once again, if you are being appropriate and you have your business plan and you start with a friend and family round, you're not desperate.

Now you can control the narrative. Now you can decide how you negotiate. Funding is not a, Please, sir, give me dollars." It's, I have a product.

I am asking for money so that you get the return in the back, in the future," right? That's funding. So if you know your business plan and you know what you're building, now you can negotiate. So really it's back to business 101.

Know what your product is worth. You can have the contr- control... I don't like the word control. I work with a lot of surgeons, so control is a hot spot for me.

So I do try to tell my founders like, "You're gonna have to take in some sort of strategic partner, give up some sort of control to be successful." Now, that doesn't mean you want, you always wanna be looking for people that align with your vision. That doesn't mean you're not in the captain's chair. That just means you have a co-pilot.

I guess that's the way we're gonna say it with control, is it's look for funding partners that wanna be a co-pilot, not a captain, right? And that you trust. And build those partnerships around people that have the same end goal in mind, that you really line up. It's a marriage, and I learned this the hard way from my device that I'm taking to market.

I wish I, I wish somebody had this conversation with me. When you are looking for partners it is a marriage to the ninth degree. So before you sign those paper- that paperwork, make sure you have a good prenup in place. Make sure you guys have the same values.

Make sure that you guys are working as a partnership and that it's equal or that, everyone's bringing their strengths to the partnership. And in a true marriage, every partner makes the other one better, right? You rise, you bring them up, right? So think of it as a marriage.

Honestly, I mean- I'll let the married man answer this question, but I would think it is as important or more important than a marriage. I, it really is. And I don't think a lot of people go into the concept of funding or partnerships, with that in mind. And like I said, I learned this the hard way.

I went on somebody that was passionate and saw the goals that I had in mind, and then they just were incredibly unprofessional, and they set the development and the funding, months and months behind. I had to essentially, like, dissolve the whole partnership, start over. And the reason why I was able to catch it is my securities attorney was, like, taking her time on the paperwork, and she just kept asking questions like, Are you sure that this is a really good partnership? Do you guys all feel really valued?"

And she, to her credit, she was very professional and she stayed very neutral, but she w- she asked the questions. I was just really excited that somebody saw my vision and wanted to build this with me, and I was like, "Yeah, it's exciting. It's new. Let's do this."

And then she just kept being like, Are you sure this is a, the partnership that's gonna be the most beneficial?" So take that time to, like, again, not all funding is good funding, and don't be desperate that you'll take any dollars. Don't sell your soul either, right? Like, if you have a good product, you won't be in that position and I think it's a really good p- point that you just made there, 'cause I was go- and I was gonna talk about partnerships and you've actually jumped in, into that particular area because as you said, no, no person is an island, so you can- you're not gonna deli- Yeah Deliver on your own.

And what's the statement? If you wanna go fast, go by yourself. If you wanna go far, do it together in a partnership. Yeah.

And I think you go- That's a beautiful statement far quicker if you get the right partnership. And I think one thing that you talked about, which actually lots of people and lots of founders don't have, is a vision. Yeah so if you've got a very clear vision, and then you're very clear on the values that you have and you wanna bring to your business, it's a lot easier to get the right sorts of strategic partnerships because the question that you ask that partner, similar to your security advisor, they're asking questions which are about your vision and your values- Yeah and that starts to come out and you start thinking, "Actually, we're not on the same page here, are we?"

And if you're not on the same page- Yeah I don't care how much money they've got, I don't know care how great they are, the partnership is doomed to failure at some point. You're gonna have- Yeah you're gonna have arguments, you're gonna have problems. You're gonna go, wanna go this way, they're gonna wanna go another way. So it, it's really important at the beginning that you identify what is your vision, where it is you're trying to get to.

So- Yeah simply, if you wa- if you're lo- looking to hold the company for the next 25 years and that, and your partner wants to sell in three years, you've got a problem. Yeah if you wanna go into the US and your partner's thinking, "Well, it'd be better if we go into the Middle East," you've got a problem, et cetera, et cetera, et cetera. Yeah. You need to make sure you're going down the same path.

Which again brings us back to understanding and having a business plan, almost from day one- Yep because that- Yep helps you to articulate everything that you wanna articulate, whether it's friends and family, whether it's VC, et cetera. So I think that's- A really important point I'm actually also a huge fan of the triad partnership. And I say, and my securities attorney is the one that brought this up. I like the concept of a...

And again, they can be fractional, so when you talk about equity and control, you can still be the majority captain. But I like the concept of a triad partnership where you have a CEO who's the visionary, the person that's laying the roadwork down. Then you have a COO. That's the operational person.

That's the person that, that translates the CEO's vision. Okay, this is the road we're going. Here's the bricks to make the road. And then you have the third person, which really is the tiebreaker person.

I can, I call them either a strategy officer, marketing officer, it could be the medical officer, but the person that sees both sides. They see the product. And actually, my founders I try to put in that third position. I like them to hire out or fractional out a CEO and a COO, and then the third person, the tiebreaker person, be the founder and say, "Okay, I see you wanna make your road here, and these are the bricks we wanna do to make that road.

I wanna take it to the right a little bit. I want it to..." And now you're steering the boat like, like a true captain. I love that triad partnership.

I think every founder, a- again, you can retain majority ownership and have them on as fractional pieces, but that three-person team, they really keep each other accountable. There, you also have, you also always have a no man. Like, surround yourself with no people. That's your number one way to success.

I know all of the things we say are very, they've been said many times over and over again, but they're said that for a reason, because it's true, right? Do not surround yourself with people that won't tell you your baby's ugly. Do not surround yourself with a whole bunch of dreamers and no people that can execute the dream, cause then you're gonna sit around and have $500 lunches and accomplish nothing. So really find the people, again, that partnership of, like, where your strengths are, that is their weakness.

Where their weaknesses are, those are your strengths. That really good balance, and that three-person partnership will... You don't need more than three people on your founding team, in your pitch deck, in your team, in anything, until you are way down the line. You can run a really lean system on three people, especially if you're all aligned to that end goal.

And I, like, you don't need a lot of, you don't need a lot of other, a lot of other extraneous extra roles or equity given away or funding given away. Work on that three-person team, and then fractional out anything you need additional from it. But w- but you guys are only picking who you need together as a three-person team Yeah, no, and it's really interesting actually, 'cause I've said this for quite some time, and you're probably the only other person who's ever said it to me.

I've always said to people, 'cause you get lots of people, founders, they might be husband and wife, they may be, man and brother, brother and sister, et cetera. But they're both yeses just sitting there back and forth to each other. I've always said you need three people, because you need somebody. Because when you've got two people, either y- w- e- each one of you is gonna compromise because you want to keep- Yeah the other person happy.

Whereas when you've got- Yeah a third person, then you've got a person who's gonna say, "Well, actually, no, I agree with that person, or I agree with that person." But you have- Yeah you have more of an opportunity to have ideas. And then the other thing that I always say to people, and if someone, someone said it to me, is about being agnostic about the ideas. It doesn't matter where the idea comes from, and this comes back to what we were talking about, the vision.

If you have the, a similar vision, then you shouldn't get precious about the ideas. If your idea- Yeah the truck st- stom- stomped on, but then it's because we got, get a better idea, it doesn't matter. I don't care about- Yeah my ideas, actually. I just want the ideas that work.

I don't care if they're mine, I don't care if they're yours, I don't care if they're someone else's. I don't care. Is this the best idea to move the business forward? And that's what you should be focusing on.

And I think, w- you know, advice to anyone listening or watching this is don't get bogged down in an idea because it's your idea. Yeah. And think, "Oh, no, no, no, I've always had this idea and I know..." If 15 people have told you, "I don't think that's gonna work"- There is no room for ego in the founder pathway.

Like, you are gonna have your best and worst days as a founder, but you have to leave your ego at the door. I was... I just actually before you had a conversation with a company, and they do, a, an organizational psychology breakdown. Because what happens is I can build out your business plan, I can build out your structure for success, but if you guys have ego and you're not willing to listen and you're not willing to ask for help, it doesn't matter how successful a roadmap I make you, if you're not, if you won't be coachable.

The it's the same thing, ego and co- coachable. If you want... It doesn't matter what your product is, what your business plan is, what your funding structure is, if you as a founder has an ego and is uncoachable, you will fail. I don't care if you are coming up with the newest, greatest thing that could solve world hunger.

I don't, whatever. I don't care what it is, your amazing idea, if you have an ego and you are uncoachable, you won't get funding, you won't be able to build, you won't be able to move forward in the process and you certainly won't be able to do it all by yourself. And that, like- Yeah, no if I have clients that, that, that aren't coachable or sh- or aren't going to listen to my, And again, it's n- again, not my ego. It's, "Here's my recommendations.

Do with it what you want." But if you're just gonna sit there and just, Nope, it's my way. This is how we're gonna do it," great. I'm probably not the firm to work with you, because I'm here to make you successful.

I'm not here to stroke your ego, tell you your baby's pretty when it's not. I wanna get to the no as soon as possible to keep you from saving, from wasting money, to keep you from that failure. I want to make you successful. But if you think you already have it, be all, end all, know all, and again, a little triggered, I work with a lot of surgeons.

Love them, but they already have that mindset of I know all the things. And you do. You know everything about what you do very well. But you have to be humble enough to say, "But this is out of my wheelhouse, and I'm gonna learn it and I wanna be part of it, but it's out of my wheelhouse."

Like I, you laugh. My, my favorite saying is I always try to be the dumbest person in the room, 'cause if I'm the dumbest person- Yeah in the room, I'm gonna, I'm gonna make so mu- I'm gonna learn so much. I'm gonna make sure that we're moving forward. I always wanna be the dumbest person in the room, and I have no problem saying it.

Like, great, they know so much better. Let me direct you to the person that knows how to do this part best, 'cause they're, you're not gonna have a single person founder that does everything all by themselves and you're not gonna have s- like, you're not gonna succeed. If you wanna build in a, in your basement all by yourself, guess what? When you die, they'll see your manuscripts of all the things you wanted to do and you never did 'em.

Yeah. Yeah, 100, 100%, and I think, we've been talking about the, that, that founder journey early and actually getting the right mentality. And that's, when I talk to people about building a business, I talk about the vision first and I talk, the next thing- Yeah I talk about is the mentality and the attitude because that is, is 90%, it's 90% of it. It is.

You can have a great business plan. It is. If you haven't got vision, you haven't got the right mentality, you're not gonna be successful. So just on that, what are the biggest barriers to adoption that you think that founders underestimate in your experience?

Like I said, kudos to regulatory, 'cause they have beaten it into everyone's head- Yeah that like you don't go past go, you don't collect $200 without regulatory. So but I will touch on that piece- There are a lot of people, because it's such a need, that again, are very high priced, that are these very large bloated firms. So do your due diligence. Just like they're doing due diligence on you, do your due diligence on the experts.

Be willing to find out what is, what's, are they, are, is it a large firm? Are you paying for a whole bunch of extra people you don't need? What do you need? Like, try to also like build in sprints.

So I think as far as barriers, let's go back to barriers. Sorry, I g- I have, I g- have regulatory things that get me flustered too. But, so barriers. I think number one is Timing.

I don't think people think how long... They don't realize how long it's gonna take. No matter what, you have to be patient and you have to be diligent. Like, we talk about the valley of death in funding or we talk about, like, that building.

So I think the first one is timing. Like, you need to go into it with your mindset of, like, and everyone says six to nine months. It's three to 10 years, even on a best day. So go into it like you're playing the long game.

You're not playing the short game. Be pleasantly surprised if everything goes faster than you anticipate. So I think that's the first barrier. I think the second barrier is perfection.

So I find a lot of founders get stuck in a perfect iteration, or, "We just have to do this one thing just right," or we just... And no. Your ver- first version is never gonna be the one that exits, is probably never gonna be the one that even sees the light of day. But you're not gonna get to that final product if you don't just...

You have to, at some point, you have to just put it out there, test it, fix it, move on. You, I have, I've got this founder that hurts my heart every day. They've been building a product for nine years. Nine years.

Oh. They have amazing clinical data. Ame- a amazing product. And if they would've brought this out to market nine years ago, they could've made a change in the market, and now every day that they're not moving forward, they're getting close to obsolete.

And I- Yeah and I tell them, I'm like, "I don't,, this goes back to they were so focused on the build, the research, the development, they forgot at some point you have to sell this. At some point you have to go further. So again, I think, perfectionism is a big barrier. And I get it.

You want everything perfect. It's your name, it's your baby. That's again where those, that three-person triad is really gonna help. You have to have a visionary and you have to have a builder, and then you have to have someone that reins them both in.

, it's just... Cause you can have, I, the, yeah, the perfectionism. And again, working with the group I work with, I think I see it more specifically, and it's heartbreaking to see just brilliant innovation just getting stuck in this quagmire of, Well, it's just not quite right. It's just not quite right.

If we just do a little bit more, if we change the screws..." Stop with the screws. I don't care what you're building, stop with it. Like, give me a funct- like, give me some actual clinical trials and get me something to sell.

Give me something to sell. It may not be your best thing, but it shows you're moving forward. And again, this shows to your founders, to your investors. It tells you that you're gonna keep moving forward, that you...

The, and I think the third barrier, and this ties into that perfectionist thing, you have to be able to pivot You might be going down one direction and you think you've got, we are full steam ahead, 180 degrees down this direction, and then you get market feedback or you get, some sort of indicator that you need to change your pathway. You have to be willing to pivot. That is where you- Yeah where you see fail. A- again, I have a brilliant company, brilliant, shiny idea.

They got the feedback that they needed to change their plan. Their go-to-market plan just needed to change very drastically. Essentially they thought they would be... I'm like, "You're never gonna make it in the US.

Let's just start there. You are not gonna make it in the US. You need to focus on, this is the market you need to focus on, maybe in the, EU. Focus on, or India or Ch-..."

Like, focus on a global place because you're not gonna make it through USA's, like, BAT committee. You, you failed the BAT committee. That's really what happened, is their product failed every BAT committee stress test I could put them under. And so I told them, I'm like, "Listen, you do still have a brilliant concept.

Your baby's not ugly, it's just a little janky. It just needs a little bit of fixing, okay? So you need to re- restructure where you're spending your funds on." And they can't pivot.

They're, they can only go in the, this one direction and I'm like, "This, you're, again, you're not gonna set yourself up for success. You are stuck that this is the only way you're gonna be successful, and you're gonna end up spending millions of dollars and never have anything to show for." And that is so heartbreaking on, on, on many levels. And they have a good concept.

I think if they pivoted, they could save it and actually, it may not be the $100 million exit they wanted, but 10 to 15 isn't bad. It's a good... It's enough to make you go to your next project, right? Like, don't...

that, that doesn't have to be your retirement plan. It could be your funds to the next project and the next project, but being willing to pivot. So yeah, I think the three barriers, and I try to warn every founder on this, is timing and perfectionism and being able to pivot. Like- Yeah all three of those are things that you just, you will get stuck and never be able to recover from that.

Yeah, and I think that they're really important, put important one that you've identified there and probably the top three that I would also pick. So based on that, 'cause it, as you were talking about the pivoting, you were talking about the vacumitting, your example. So how or do you have any frameworks that you use to evaluate the scale- scalability of products and solutions? Yeah.

So personally with my company, because we're so focused on commercialization from, like, day one, we put you through due diligence at every step of the process. So once again step one, I want you to get funding from other peers. That's a good market analysis. Step two, now we're getting clinical data.

I wanna actually see letters of intent. I wanna see a business plan. What, how are we gonna make money off of this, right? So you al- always having a validation chart.

I'm a scientist at the end of the day, so everything is, if I poke it here, what happens? If I do this, what happens? So I think, I do, try to work with my clients in sprints, 'cause then you always are continuing that momentum forward, and you don't get stuck in those kind of valleys of death we talked about. So sprint one is-...

let's get funding, and that is market analysis, plai- plain and simple. I wanna see, do other people like it that are within your field? Sprint two is now we need to get a regulatory pathway. So I w- I start even before we're, before you're engaging in a the breakthrough designation.

They like to get the new in class. You, you don't need to reinvent the wheel. If there's a way to keep from reinventing the wheel, that is not a weakness in your market strategy. Like you said, it's actually better to have competitors than to not, because you can see that there's a market need for it, right?

And you can always do it better. Challenge accepted on competitors. But if you're going into that new space no one's ever been before, you are already gonna have an uphill battle. So that's, like, my next little test point.

Is there any way we can do this on, a preexisting? Is there any, what is our framework of where we've seen success in this before? And if you truly have an idea that no one has ever come up with before, that's never seen the light of day, the next piece I want is I need an IP strategy that has that lockdown before you're going anywhere. IP is one of the most, mistaken or forgotten things.

People either put too much or no emphasis on it. There's no middle ground. So I c- I, again, I'll see people that'll spend $30,000 or more for a patent, and then they get their patent back and they're like, "No, this exists somewhere else," and now you have to deal with licensing and freedom to operate. Start with a basic patent study.

It doesn't cost a lot of money. Do a basic patent study, and now you can show your investors at every step of the way due diligence too. Like, you're building the, you're building a case. I think a lot of times when people hear business plan, they think that means like, "Okay, my spr- my sprocket costs this much to make, and my sprocket is gonna sell for this much, and that's my business plan."

Your business plan is, what am I gonna do with your money, and how am I gonna use it appropriately? Okay. Here. Investors, look, I already did the work to show that we have a clear patent pathway.

I already did the work to say, "Look, this is going to be commercialable, or commercialized, and ASCs are gonna take it. Here's a back study I did." I think we underestimate the amount of how much a good deliverable can change your story. Like, every piece that I work with my clients is a deliverable that will stand up to investors, and it's telling the story of their whole production, okay?

Here's the clinical trial. This is the outcomes we saw. This is what we learned from it, and this is how we're gonna pivot. And now you're not saying, "Well, it was a terrible clinical trial and ev- and it was awful, and now we're gonna, we just wasted all your money."

You're saying, "No, we actually, we learned our baby was ugly, and now we're making it pretty. We learned to change and pivot." An investor will g- will give you X number of dollars, and then if you tell that investor story, the honest truth of, "Okay, we went to market, we studied, we, we did this testing. It didn't come out like we planned."

They'll go, "Okay, here's another extra X number of dollars. Let's keep building it." Because you've already shown them, "Hey, I got it. I heard what's happening."

Versus a lot of times you'll g- you'll get, you'll get a clinical study and it's not what you wanted or it's not the data that you needed, and it's, everyone goes, "Oops. Now..." And it gets stuck. And go, "No, tell the story appropriately.

Be like, 'Here, we absolutely found out this. We found out this failed the VAT committee test. We thought it would fly, go with flying colors, but turns out that the amount of change we'd have to make a measurable difference...'" And then pivot.

If you can always show- Yeah you're pivoting and changing, now you've got a successful investor story. You can keep building and developing, and you keep moving to that end goal, right? Yeah, and I- I think of you saying that pe- people in, people invest in the people actually. So if they can see that you've got a clear idea but you're also- Yeah prepared to pivot and you, and you listen to the market and the data, and you make the decision- Yeah based on that, and you're not gonna waste that person's money, they'll invest in you- Yeah and they'll give you more money.

But if you're one of those people that just says, "No, I've been working on this for nine years, and this is what I believe." Doesn't, it doesn't matter what the market tells me- Yeah this is what I believe. It's really hard for me- You're gonna struggle to get it to get you funding at that point. It's really hard for me- Yes to save you and protect you at that point.

Again, you... the question was, like, how do I validate? With my firm, from the very beginning we had the physician involved from day one. Yeah.

I have a whole physician advisory. And not only is it the end user involved, every one of my people on my advisory board, they're all founders. Many of them have had exits. Many of them are currently in the same process you're in, so they understand that pathway.

So there's validation from the very beginning. Before I even take on a client, I sit down with whatever advisor's in that silo. We'll use my colorectal project 'cause that's how Seno was built. But I go to, "Hey, I have a client that's looking to me, they have an idea."

And I go to the colorectal surgeon and I go, "Hey, would you be interested in this?" Yeah, this has some legs to it." "Okay, great. Let me talk to them and let's see if we can help them."

So you've got that KOL advisory, you've got that end user that's involved in the very... You've got the clinician, so clinical intelligence from the very beginning. And then you mark, you stress test it every step of the way. Look for the no.

I think people are too scared for the no. Like- Yeah we all know the statistics, and we all think we're gonna be the unicorn. The reality is- in 100 products, how many even make 'em to, make it to market and are profitable? Like 10?

On a good day? Exactly, yeah and then of those 10, how many of those are gonna exit? How many of those are gonna actually sell, right? Or how many of those just continue...

we call them l- like, like lifestyle changes. So like, it may not be your $100 million check, but you might be able to make a nice little recurring revenue of a couple million a year. I'm okay with that. Exactly.

Like, so just reevaluating. Like, at the end goal, like the end goal should always be how do we, A, provide better patient care, 'cause I'm all med tech. That is my happy space. But whether it's med tech or not, business as a whole, how do we make a difference in the consumer population that's gonna be utilizing this?

Number one. That's always your end goal. Is this zipper going to change pants? Is it revolutionary?

Great. Then- then have that passion and that drive to keep moving it forward at every step of the way, and then test it be- every step of the way. Okay, great. Five users like this.

Great. How do I get 10 users to like this? What's the price point that they will do? What, like test it.

Always look for the no. Don't be scared of the no. Like, 'cause the no you can recover from. If you just blindly run into a wall, there's no fixing that, right?

Like, if you- if you're just, like I c- again, if you're gonna be the captain of your ship and you see an iceberg, the Titanic could have been avoided if you just turned the ship a little bit. Exactly. All you had to do is turn the ship. So I, like always validate against what's the market handling right now?

What's the feedback? What's the honest answer? Like, again, leave your ego at the door. Hear all the nos 'cause then you can make a better product 100%.

And I'm looking at the time, and I don't I, I say this on every episode, I can't believe how quickly the time goes. So- I know. have we moved towards the end? And I've got the decision-making scenario that I give to all my guests, which is based on the topic we're talking about, and something that I hope that people will have either seen or they're about to see.

So it's just hopefully, an opportunity to give a hypothetical and then with your answer. So the decision- Yeah scenario for you, Jordan, is that you are advising a startup with a promising medical device. Early trials are encouraging, but regulatory hurdles are slowing progress. So do you, A, push ahead with a full submission; do you, B, generate more clinical evidence; do you, C, adapt the products based on clinical feedback; or do you, D, partner with a larger company to push it through?

What's your choice and why So tune in to the next episode to hear Jordans, answer. on that particular scenario. But before I let you go, Jordans what I've decided to do is I wanna start finishing e- up each e- episode with one question. So the question I want you to answer is complete this sentence.

Most med tech companies fail because... Take it away. Most med tech companies fail because they don't move forward. They get stuck in one way or another.

That's what I see. They get stuck at one point or another. Again, that's a great one. I see a hurdle, and instead of jumping over the hurdle, instead of going around the hurdle, they just run straight into it, and they don't know how to pick themselves up.

So be comfortable with failure, and then you will succeed. Thank you very much. And we've come to the end of it. And what I've taken away from this conversation, there's millions of things, but if I have to try and condense it down- Yeah it's really that successful med tech companies don't just build products, they build a path to adoption.

Yeah and that's, that... Everything you've said is really that from start to finish. Yeah. In fact, you've got to build that path all the way, and you do it from day one, rather than focusing on just a specific aspect to start with.

Yeah. Thank you very much for joining us on Clinician to CEO, and, really appreciate you. 'Cause to everyone listening, if you're developing a healthcare innovation, remember this, a clinical problem may spark the idea, but adoption is what determines whether or not you actually make some money from it, and it becomes a successful business. And you actually change patient lives.

You can- Yes can't change a patient life if nobody wants to buy it.. So thank you very much for that, Jordan. And if you're building a MedTech business and you're not sure whether your next move should be around evidence, market access, commercialization, distributor strategy. Or adoption.

Do not guess. Book a healthcare export accelerator diagnostic Call with me. Use my link in the show notes. And in that session I'll help you identify the specific constraints blocking your momentum and the commercial move most likely to unlock your progress.

Thanks for tuning in. Until next time, thanks for listening. Keep challenging your assumptions and keep growing.