by Tiger Buford  and  Marty Wynkoop


You are the Founder / CEO of a promising new orthopedic startup.

As you begin your journey, you know that the odds are against you. Ninety percent of all startups fail and you want to be in the rarefied 10%. You have some early funding, some patents, a corporate entity and maybe even a website, but you haven’t built your team yet. The first people that you bring in will either set you up for success… or… cost you valuable time and burn precious capital. 

You absolutely have to get your team right. The common thread with your first hires is cultural fit and shared passion for your vision and mission. Each new add must have good judgment and flexibility and communicate with transparency.  Look for individuals who are DOERs and are real, practical and clear. It is difficult to evaluate a DOER by looking at past experience. Look for people who aren’t afraid to voice their opinion. You need them to not only be smart and driven but also vocal and unafraid to disagree with you. What I like to say is, “It’s OK to tell me I am wrong, but bring me a solution or proposed improvement, otherwise it’s only complaining and I don’t want to hear complaining.”

Ok, here we go.  A look at your first six people. 

#1 – Partner or Co-Founder

This person is a trusted friend who will keep you honest. He or she must have a complementary skill-set to yours. You can talk to your Partner about anything and receive unfiltered feedback. Your Partner will be more interested in doing it right, than being nice to you. Your Partner could be a board member, or CFO or lead any one of the “C-Level” roles. Recruit this person from your trusted career contacts. Blunt TRUST is paramount.


#2 & #3 –  Engineering / Technology

Likely your first real hires. You will need cash to add these people. Equity alone will not be enough to attract them. You need an engineer who can do the technical work, then transition into a leadership role (often referred to as a “Hands-on Engineering Leader”).  It is not easy to find an engineering veteran who has the right stuff for a startup. This individual may have to go back to CAD modeling and detailed design work that they performed earlier in their career. If you are a Technical leader yourself, this person will be the person who executes the design. Ultimately this experienced engineer may grow into your technical operations role as well, and initially responsible for managing the QA/QC and Regulatory Consultants.  They will also manage your outside manufacturing processes.

The third hire will be a less experienced engineer, willing to take a risk with a startup.  This person will share the engineering load with the veteran engineer above and be developed into the person who does the lion’s share of the basic CAD work and documentation.


#4 – Quality / Regulatory / Clinical

Initially, this role will be filled by your engineering lead. As your business becomes more complex, you will need to hire someone to head up all your Regulatory and Quality operations. This person will manage all of your outside manufacturing, inspections, packaging, testing, sterilization, and clinical studies. These functions will be performed by consultants, until the day that you grow large enough to support the roles internally. Always think Quality first. The Quality System must be built well before your first Regulatory filings.


#5 – Marketing / Sales

Surprisingly, this add should come earlier than you think. You will need to hone your value message early. What problem is your startup solving?

So you think you know Marketing?  You may even have a “Sales” background and think that you know the marketing skill set – too bad, it is not your job anymore, so stay out of the way any get someone who can do both. Your job is LEADING the orchestra, not being the lead in one of the sections.  Find someone during your career who has impressed you with their Marketing and Sales performance and recruit them to join your team. You can help them formulate the Marketing and Sales plan, but they must own it and LEAD it.  Once you find the best person, they can execute your strategies. They need a keen eye for solutions that work in the OR. They should fine-tune the message and prepare the first products for commercialization. Remember, if you can’t sell it, you will FAIL quickly. 


#6 – Finance / HR / Corporate Ops / Legal

This role can be outsourced initially, but there will come a time for a day-to-day financial strategic mind inside the company.  Initially, he or she will be putting together board materials, keeping the corporate entity compliant and managing key contracts with suppliers, consultants, and surgeons. Later, this person will be instrumental in developing the long-term financial strategy for your company.