For early-stage MedTech startups, key milestones for investors are not just regulatory successes. They are fundamental proofs of concept—showing the device works in a model and demonstrating how it would function in a clinical setting. This builds an investor's vision of the product's future.

After a successful trial showed GIK could halve cardiac arrest and mortality, researchers were surprised it wasn't adopted. Pharmaceutical companies refused to manufacture the simple glucose, insulin, and potassium mixture because it didn't fit their business model of patenting a new drug and marketing it heavily. This forced the researchers to form their own company.

Traditional academic promotion criteria, which prioritize publications, disincentivize clinicians from pursuing innovation. Dr. Power argues that for universities to truly support medical invention, they must update their standards to grant patents and industry consulting equivalent academic weight to research papers.

Institutional ownership of intellectual property can stifle a clinician's motivation to commercialize their idea. Dr. Adam Power advocates for an 'inventor-owned' IP model, arguing that no university department or tech transfer office will ever match the round-the-clock drive of the inventor themself.

In MedTech, the regulatory environment neutralizes a startup's key advantage: speed. Intellectual property becomes the critical defense, protecting the company's innovation from larger competitors while it navigates the mandatory, slow-moving approval process required for market entry.

Successful MedTech innovation starts by identifying a pressing, real-world clinical problem and then developing a solution. This 'problem-first' approach is more effective than creating a technology and searching for an application, a common pitfall for founders with academic backgrounds.

Inflammatics initially tried to license its technology but was rejected by major diagnostic firms. The pitch—to build new capabilities and a new platform to displace their own multi-billion dollar microbiology tests—was a classic innovator's dilemma. This refusal by incumbents to disrupt themselves forced the founders to start their own company.

The most critical role for a physician co-founder extends beyond the initial idea. They must act as the primary evangelist and validator, sharing the engineering progress with their peers to ensure the device's design and function align with the broader clinical community's needs and vision.

Frontline Medical chose to develop the Cobra OS not because it was their most revolutionary concept, but because it was manufacturable with limited resources. They prioritized the idea that 'checked all the boxes' for feasibility, market success, and patient impact, ensuring they could bring a product to market.