You can usually tell pretty quickly whether a founder understands how hospitals actually get paid. Ask what happens to a hospital's margin the first time it uses your device. If the answer starts with the price of the device, they're probably missing the bigger picture. If it starts with the Medicare DRG, they've at least done the work. Most haven't. That distinction matters because the economics of a new technology are not determined by what the hospital pays you. They're de

The Expectation Engine That Determines Whether You Scale or Spend 18 Months Putting Out Fires Your investors are not impatient. They're doing math. That's the whole finale. Founders love to frame a demanding board as emotional, short-sighted, or "not getting it." Usually they're none of those things. They're looking at a return that lives or dies on time, and your commercialization timeline is the variable making their spreadsheet sweat. This is Step 12, the final step of the

You Sold the Hospital! Now the Real Work Begins. One of my favorite memories from my time as a clinical specialist went something like this. My phone would ring. "Hey Rob, good news. We sold a robot." "Awesome. Where?" "Hospital X." "Nice. When do they want to launch?" "Tomorrow." "...Tomorrow?" "Yep." My facial expression after I get the news of an urgent launch so the capital rep can recognize revenue before the end of the quarter. That was usually the extent of the handoff

Your Product Doesn't Speak for Itself. Neither Does Your Website. One of the biggest myths in MedTech is that great technology sells itself. It doesn't. If it did, hospitals would be full of incredible products that nobody's ever heard of instead of products backed by companies that built strong commercial engines. The reality is much less satisfying. The moment a hospital stakeholder can't immediately explain what your product does, why it matters, and why they should care,

You Built the Device. Now What? Let me paint you a picture. A brilliant founder spends three, four, sometimes seven years developing a medical device. They run studies. They survive the FDA process. They get the 510(k). They pop the champagne. Then they walk into a hospital and get absolutely nowhere. Not because the device doesn’t work. It works great. Not because there’s no clinical need. The need is obvious. But because FDA clearance and hospital adoption are two entirely