Guide to Adaptability in Medtech Startups
Adaptability is the cornerstone of innovation in medtech, where the path from concept to market is rarely linear.
Keep Asking “Why?” and “What If?”: Don’t fall in love with your solution — fall in love with the problem. Continuously ask, “So what?” and “What if?” to ensure your technology meets real-world needs, not just technical milestones.
Prepare for the Unexpected: Assume nothing will go as planned. Always have a Plan B — and maybe even a Plan C. Anticipate challenges before they hit, and surround yourself with people who’ll challenge your thinking.
Solve Problems That Actually Matter: Start with the unmet need. If your solution doesn’t make life easier for patients or providers, it’s time to go back to the drawing board. Keep your North Star locked on what truly matters.
Turn Resistance into Opportunity: Resistance is just fear of change in disguise. Understand the concerns, address them head-on, and show how your solution complements — not disrupts — the existing system.
The Real World is Your Best Lab: Get your prototypes into the hands of real users early and often. Their feedback isn’t just useful — it’s essential. Build for what they need, not what you think is cool.
Ask the Tough Questions
David Neale, co-founder and CEO of Argá Medtech, brings three decades of experience in shaping and scaling healthcare businesses globally—from cardiology to neuromodulation andrenal therapies to orthopedics. At Medtronic, David led the integration of key acquisitions as Head of AF Solutions. Now, with Argá Medtech, he’s pioneering a non-thermal cardiac ablation system to treat atrial fibrillation that utilizes Pulsed Field Ablation to create precise lesions in heart tissue.
David’s global experience has been a cornerstone of Argá’s strategy, enabling the company to quickly establish operations in multiple countries, tap into diverse expertise, and position its product for international success.
Expanding globally might not be the right approach for every company. In some cases, it’s more effective to focus on dominating one market before moving to the next. If you do opt for a multiregional strategy, David stresses the importance of understanding how healthcare systems work in different regions and learning from experts across the globe. This kind of knowledge ensures your product is versatile enough to meet the demands of various markets.
One constant across all geographies is the importance of economics. David highlights that clinical trials need to go beyond proving safety and efficacy—they must demonstrate financial benefits for hospitals, payers, and other stakeholders. “Is the hospital going to be able to make money off of it or not? Does the reimbursement system support this or not? Does it make more money for the hospital and allow it to treat more patients compared to existing technology? We have to aim for that,” David explains. For Argá, gathering this data early ensures their technology is as financially compelling as it is clinically effective.
Perhaps most critically, David emphasizes the value of asking the tough questions. Early on, his team focused on understanding what the market for atrial fibrillation truly needed and how their product could stand out. “I think that’s one of the biggest mistakes I see with some early-stage startups—you have a great technical solution, and you trust the solution to be perfect, but you minimize other input or challenges you could face,” David says. By consistently asking “So what?” and “What if?” his team has avoided tunnel vision and refined their technology to meet real-world needs.
Staying adaptive in medtech means constantly challenging assumptions, gathering diverse perspectives, and thinking strategically about clinical, financial, and market dynamics.
Always Have a Plan B
Kate Rumrill, CEO of Ablative Solutions, has spent three decades navigating the medtech and pharma industries, with key roles at companies like Eli Lilly and Covidien. Originally set on becoming a neurosurgeon, a gap-year job in toxicology research unexpectedly led her down a different path—one that ultimately brought her to the forefront of hypertension treatment. Today, she leads Ablative Solutions, where the Peregrine System, a unique device aiming to lower blood pressure, offers a novel alternative in a field dominated by energy-based technologies.
For Kate, this mission is personal. Both of her parents struggle with hypertension, giving her a unique, firsthand understanding of the challenges patients face and the limitations of current treatments. This personal connection fuels her drive to develop better solutions and informs her strategic adaptability in an ever-changing medtech landscape.
In medtech, unpredictability is the norm. Kate has learned that preparation is the foundation for staying adaptive. For her, this means designing clinical trials that go beyond proving effectiveness—they must also answer critical questions for all stakeholders, from regulators to insurers and patients. “Never assume that things are going to go as planned. Always be thinking about contingencies and, as I like to say, looking around the corner,” she advises.
Her own experience underscores this point. A global pandemic disrupted Ablative’s pivotal clinical trials, forcing her team to adjust their plans on the fly. “Don’t rely on things going perfectly. Keep a plan B—and even a plan C—ready. Constantly assess risks and think about what could go wrong so you’re prepared to adapt,” Kate explains.
For Kate, a strong, adaptable team is just as important. “Surround yourself with people that are going to challenge you,” she says. Diverse perspectives help identify potential problems early and build resilience, making the organization stronger and more agile.
Adaptability, as Kate demonstrates, isn’t just about reacting to challenges—it’s about preparing for them, asking the right questions, and building a team that thrives in uncertainty.
Everything Can Change, Except for One Thing
Shriram Raghunathan, founder and CEO of Noctrix Health, started his career designing circuits for cell phones but found his true calling in neuroengineering. Fascinated by how the brain processes music, he dove into neuroscience with the ambitious idea that neurons, like circuits, could be understood and influenced. During this journey, he created game-changing devices for neurological conditions, including restless leg syndrome. Today, at Noctrix Health, Shri is pioneering wearable therapies that aim to bridge the gap between medical devices and pharmaceuticals, offering patients accessible and effective alternatives.
Shri believes that in medtech, success isn’t just about solving problems—it’s about solving the right problems. He says, "If you get enough engineers in a room and enough coffee or beer, you could solve most problems. It’s mostly, are you solving the right problem? Are you framing the problem in a manner that the solution actually makes sense?" He’s highlighting a common trap: focusing on clever solutions without ensuring they address a meaningful need.
In medtech, where resources are limited and stakes are high, it’s crucial to ensure that your work aligns with a clear unmet need. As Shriram explains, "We’ve tried various solutions, we’ve changed our clinical trial strategy some, we’ve fine-tuned a lot of things. The one thing that you absolutely cannot change is your unmet need. That remains our North Star."
Once you’ve zeroed in on the right problem, the next challenge is staying disciplined in your approach. Not every idea will be worth pursuing, and that’s okay. In fact, knowing when to let go is critical to staying adaptable. "Your time is limited, your resources are limited, you’re going to say no to more things than you’re going to say yes to. Having people around you that are wired the same way is immensely helpful because it’s not a struggle each time you’re squashing a project," Shri advises. Building a team that understands this mindset is essential. It allows you to focus on high-impact opportunities without wasting energy on distractions.
Equally important is defining what success looks like right from the start. A clear vision of success can act as your roadmap, guiding every decision and adjustment along the way. Shriram explains, “How do you know that your design and your product are actually successful? Understanding the true need in a way that’s quantifiable, like, ‘I know that I’m successful if I did X, Y, and Z,’ winds up giving you the full tactical plan for your medtech company.” In other words, defining measurable metrics for success early on ensures that your team stays aligned with clinical, regulatory, and market expectations. This approach not only builds credibility but also creates a framework for adapting as you learn.
Respond to Resistance with Understanding
Dr. Krishan Ramdoo’s insights draw from years in the clinic and the boardroom. As an ENT physician and the founder and CEO of Tympa Health, Dr. Ramdoo turned an overlooked issue—access to ear and hearing care—into a scalable solution with global reach.
“You have to develop something that solves a real-world issue. Break it down and ask, ‘How does this help the patient?’” For Dr. Ramdoo, every innovation starts with a clear understanding of its impact on patients. Early in his clinical career, he saw how a simple intervention—a hearing aid—changed the life of a confused elderly patient. Since that day, he likes to focus on solutions that address specific, meaningful problems. To ensure your work remains relevant and impactful, you need to be constantly revisiting these questions.
“In the early days, you may think you have the best idea in the world, but if you're unable to accept feedback, then you're never going to evolve your product. People give feedback for a reason, not just for the sake of giving feedback.” Listening, even to tough critiques, helped shape Tympa’s hardware-software solution into a practical tool for community care. Feedback, Dr. Ramdoo insists, is a gift—an opportunity to refine and improve.
While listening to feedback is a talent, discerning naysayers from constructive feedback is another one. Dr. Ramdoo shares recalling the early days of Tympa, “Some naysayers were worried—‘Is this going to take away business?’ But now, it’s better for the system. Specialists can focus on cases they’re trained for, while simpler cases are addressed earlier.”
Resistance often stems from fear of disruption. If you understand these concerns, you can frame your solutions as complementary rather than threatening. For Tympa, this meant showing how their platform allows ENT specialists to focus on complex cases while freeing up resources for simpler interventions.
This, once again, demonstrates the need to thoroughly understand the problem you’re solving. "With anything innovative, you've got to change the mindset of how things are currently being done,” notes Dr. Ramdoo. Tympa’s approach to ear care—bringing advanced diagnostics to pharmacies and primary care settings—required challenging traditional notions of where and how care is delivered.
Like Dr. Ramdoo, you might find yourself in a spot where you need to question long-standing practices and explore new approaches. When that day comes, to stand confidently behind your offering, you need to focus on solving real-world problems, stay open to feedback that refines your vision, and adapt to resistance with empathy and understanding.
Have Real-World Needs as Your Compass
With a biomedical engineering degree from the University of Rochester and a master's from Johns Hopkins University, David Narrow cut his teeth as a healthcare consultant at Health Advances, tackling challenges like financial forecasting and market research for global medtech companies. At Sonavex, the company he co-founded, David has spent nearly a decade pioneering automated ultrasound solutions like EchoMark and EchoSure, aiming to transform dialysis care.
Medical devices often begin with a strong idea, but aligning that idea with real-world needs is where success is determined. For David, engaging with end users—whether dialysis techs, nurses, or other stakeholders—early in the development process was crucial to identifying practical gaps. This type of fengagement provides invaluable feedback and reveals how the product fits into daily workflows and how it can be improved.
“A lot of that iteration came from usability testing,” David shares, “You make these assumptions when you first start inventing things, but until your target end users actually try to implement the solution, it’s all theoretical. The rubber meets the road when you actually have these people put their hands on it.” By testing your prototypes with end users, you also avoid wasting resources on designs that don’t work in practice.
This adaptability extends to shedding features that, while exciting to engineers, may not matter to users. David recalls how his team overengineered their first version, assuming providers would love the added complexity. Instead, feedback revealed a need for simplicity. “We totally overengineered the first version, and we put it in front of our users, and all the stuff that we thought was so cool, they didn’t care about. Now we’ve totally dialed it back, and they love it.” Stripping away the unnecessary allowed them to create something far more effective and user-friendly.
It’s easy to become emotionally attached to a design, but David highlights the need for objectivity. He stresses the value of external input and scoring systems to guide choices.“As much as you can, try to make decisions objectively, and involve others. Use surveys or other types of market research tools to make sure that you’re in a good enough place to move forward,” he stresses. This increases the likelihood that the decisions will be sound.” By stepping back and inviting diverse perspectives, teams can make better decisions, grounded in collective wisdom rather than personal bias.
Adapting to real-world needs also means understanding how solutions fit into the broader ecosystem. Every stakeholder in medtech—whether a physician, a payer, or an administrator—has unique incentives and challenges. David illustrates the importance of tailoring solutions to address these needs directly. “Look at every stakeholder as an independent group with their own P&L. For the physician, what’s their P&L for the procedure before and after they adopt your product? For the payer, what does it look like before and after?” By viewing each stakeholder as an individual piece of the puzzle, entrepreneurs can build solutions that resonate across the entire system.