#2 Magic or Medtech - 🧩 5 underrated strategies for finding product/market fit

Plus: how to adjust your vision as a founder, the best job openings in medtech, Apple wants to read your mind, and more

May 24, 2024

Product/market fit is the whole game. Nothing else matters if you don’t have it. The FDA does not care if you sell your product. No one is going to buy your device just because it’s well-engineered.

Arash Samimi (founder of Eliomedica) and Oleksiy Zaika (co-founder and CTO of Vessl Prosthetics) held a panel discussion in the upstart medtech hub of London, Ontario. I’ll be writing about what they had to say for weeks, because I think their conversation was the best encapsulation of what you need to know before starting a medtech company I’ve ever heard.

This week, we’ll start with the big one: product/market fit.

I’m not going to say something pithy like “the secret is that there is no secret.” There is a secret. There are many. There are things you just kind of have to do right.

Here’s five of them, courtesy of Arash and Oleksiy:

1. Realize - and internalize - that product/market fit is a moving target.

Customer needs and expectations change. Regulations and reimbursements change. Technology improves. Understand right from the beginning that you can never stop pursuing product/market fit.

Lodge this concept in your brain - you haven’t “found” product market fit. You’ve just caught up to it for now.

2. Stay aware of changes in your market.

Network like crazy, otherwise you might get left behind. Don’t rely on public information to learn about changes to your regulatory or reimbursement regime. Meet the people who understand and influence the landscape you’re building in.

You also need to understand the context around your market. Oleksiy - who has designed an automatically-adjusting leg prosthetic socket - observed that his end users are overwhelmingly diabetic.

Changes in diabetes treatment can have a significant influence on his market. Knowing about advancements in treatment and prevention, as well as changes to regulations around prosthetic sockets, has helped him project more accurately and even revealed a new competitive advantage.

3. Provide value to all of your stakeholders, not just your end users.

In medtech, your customers are almost never actually your end users. Your customers are their care providers and, in many ways, insurance companies. You can have a device that patients would do anything to get their hands on - but if their care providers lose money on it, you don’t have a business.

Optimize for care providers. Optimize for reimbursement. Figure out as many use cases or conditions for use of your device as possible. Cast a broad net. Your market might be bigger than you think it is, and your original plan for commercialization might not be the best one available.

Consider how your product fits in your market. Look upstream and downstream, find where the money actually comes from, and provide value to everyone you see.

4. Be ready to pivot.

There are stories of companies who pivoted and successfully found product/market fit. There are stories of companies who persisted and were ultimately vindicated.

Knowing when, and how, to pivot is a judgement call. Here’s how you can evaluate your options:

Not all pivots are hard pivots. Sometimes you just need to adjust a bit.
Think about the problem at a high level. Is your solution heavy handed? Is it incomplete?
Do you need to revisit your market? Have you really understood all your stakeholders?
Have you received feedback that you didn’t really listen to?

5. Know what your other options are, and why you aren’t pursuing them.

This ties in to the previous piece of advice, but deserves its own section.

You’ve probably gone through multiple iterations of your product. You’ve probably scoped out multiple business models and distribution channels.

Can you point to each one and explain why you didn’t choose it?

Keep track of the decisions you make, and make them intentionally. At worst, it reinforces the lessons you’re learning. At best, it gives you a set of vetted options for pivots.

Bonus advice from the author

It can sometimes feel like you don’t have time to network. Maybe you just don’t like it.

I encourage you to do it anyways. Go to events like Arash and Oleksiy’s panel. Walk up to a few people, make eye contact, and hold out your hand. That’s enough to start a conversation and you never know where those conversations will lead.

If you want to succeed in this industry, you can’t know too many people.

Madness or Medtech - Founder’s Tip #2

Finding product/market fit often requires adapting your vision.

Julia Slanina - founder and CEO of Treehouse - shared her story of how she adapted her vision with me in the latest episode of the Magic or Medtech podcast.

It was genuinely hard to pick just one piece of advice from Julia, but ultimately I think this is the most important - and hardest to internalize: Your vision doesn’t matter if it doesn’t overlap perfectly with the problem you’re trying to solve.

A lot of entrepreneurs start with a vision. A few start with a problem to solve. The successful ones start with both and shape the vision to fit the problem.

If you find yourself reacting defensively to feedback from customers, consider taking a step back and asking yourself if you’re building the right thing.

The week in medtech

Neuralink bounces back, women fight back, and Apple wants to read your mind.

🧠 Neuralink’s big week (again)

Neuralink is bouncing back from the news that their first patient had begun to experience a decline in functionality.

First, they reported they managed to not only fix, but improve Noland Arbaugh’s link. And now the FDA has given them the go-ahead to implant their technology in a second patient.

Elon Musk is… polarizing. At best. But I think we can all agree that Neuralink, more than most medical technology, epitomizes the namesake of this newsletter:

Any sufficiently advanced technology is indistinguishable from magic.
- Arthur C. Clarke

Say what you will about Musk (and I have a lot to say about him), Neuralink is pretty damn awesome.

Keep going.

🎧 Apple’s earworm

Yeah I’m still going to accidentally drop this down a drain

Apple recently filed a patent for earbuds containing biosignal sensors:

The biosignals measured by the wearable electronic device may include, but are not limited to, an electroencephalography (EEG). In some embodiments, other biosignals may be measured, such as an electromyography (EMG), electrooculography (EOG), an electrocardiogram (ECG), a galvanic skin response (GSR), a blood volume pulse (BVP), etc.

Basically everything your smartwatch, headband, wristband, or chest monitor might have - all in one earbud.

It appears to be intended to monitor brain activity:

Measuring of the brain activity using electrodes placed in or around the outer ear may be preferred due to benefits such as reduced device mobility and decreased visibility of the electrodes when compared to other devices that require electrodes to be placed on visible areas around the scalp of the user.

So far there is no indication about what the accompanying software might look like. There’s nothing in the patent regarding diagnostics or anything else requiring regulatory approval.

Part of me wonders if this is how Apple expects your AI chatbot will interface with your emotions and mental state.

Creepy? Awesome? I’m beginning to realize that in many regards, the future is looking both pretty awesome… and pretty creepy.

👩‍💻 Telemedicine vs Texas (et al)

Thousands of women are using telemedicine to access abortions in restricted states.

According to the #WeCount survey, approximately 8000 women are using telemedicine to receive abortion medication in the mail from states where practitioners are protected from prosecution.

Fantastic. Usually when I write a sentence that contains only the word “fantastic” followed a period, I’m being sarcastic.

I’m not being sarcastic. I’m not going to comment on the politics of abortion other than to say that this and this and this and this and this are unacceptable and I’m glad people are finding a workaround.

But.

This doesn’t seem sustainable to me. There are crusaders in every single one of the restricted state legislatures and courts who will bang on until this reaches SCOTUS.

I don’t know where it goes from there.

🦠 Pandemic preparedness has great ROI

The Canadian Pandemic Preparedness Hub (CP2H), a joint effort by McMaster University and the University of Ottawa, has received 115m in federal funding.

We can’t spend enough on pandemic preparedness. At the extreme end, the ROI is literally our GDP in perpetuity. Pandemics can bring down societies.

The CP2H will use the funding to build expand both universities’ biomanufacturing capabilities. That’s a great use of 115m. I’m all for it.

I wish we would spend that much on repairing the damage Covid did to our collective understanding of pandemics. Covid was a trial run for the real thing. We tripped over our own feet.

Jobs for you, maybe

Nova Scotia Health is hiring a Senior Director Research in Halifax. Salary is $132,455 - $165,569 CAD.

The City of Toronto is hiring a Superintendent Pharmaceuticals in Toronto. Salary is $102,155 - $135,815 CAD.

The Children’s Hospital of Eastern Ontario is hiring an Executive Director, Knowledge Institute.

Imagen Technologies is hiring a Clinical Services Manager for a remote position. Salary is $110,000 - $130,000 USD.

Hinge Health is hiring a Regulatory Affairs Manager ($144k – $216k USD) and a Medical Director, Commercial ($272k – $408k USD) in San Fransisco.

Kindbody is hiring an FDA Compliance Coordinator in New York. Salary is $80k – $90k USD.

Alto Pharmacy is hiring a Head of Compliance in Washington, California, Nevada, Colorado, Texas, or New York. Salary is $146,400 - $183,000 USD.

Arine is hiring a Health Outcomes Data Scientist for a remote position. Salary is $130K - $150K USD.

The Mayo Clinic School of Health Sciences is hiring a Chief Digital Officer in Rochester, Minnesota.

That’s it for this week. Thanks for reading.

- Clark

Magic or Medtech