Blogs
Market analysis · FDA
The two recovery curves
The FDA cleared more devices this year, yet average premarket review time jumped nearly 200 days. A workforce event underneath the numbers, the 1981 air traffic controller precedent, and the commercial hire the fat tail actually rewards.
Market analysis · US policy
The surgery can wait. The insulin cannot.
One policy change, opposite quarters. HCA and Intuitive were hit while Abbott raised guidance, and the variable that sorted them was knowable in the autumn of 2025. Medicaid, tariffs and site-neutral payment are stacking up behind it.
Market analysis · Private equity
The rule changed overnight and nobody told the goalkeeper
Private equity is buying medtech at pace, and every deal quietly rewrites the commercial leader's job. Take-privates need an operator. Carve-outs need a builder. Confuse the two and it comes apart at month fifteen.
Market analysis · GLP-1
Three years watching the wrong thing
Novo Nordisk let a semaglutide patent lapse over an unpaid fee. The striking part is how little it mattered. Where the defensible value in the GLP-1 gold rush actually sits, and what it teaches every commercial leader.
Long Read · Strategy
The commercial engine that eats its own evidence
Vertebroplasty. Renal denervation. Metal-on-metal hip. What these cases share is not the science. It's a hiring brief written for a world where the evidence was about to confirm, not narrow.
Story · MedTech
Sheila Irvine: seeing the words again
She stopped reading fifteen years ago. Then a 2mm retinal implant at Moorfields gave her back the crossword on a Saturday morning.
Essay · Commercial leadership
The wrong team for the right mission
Scott versus Amundsen at the South Pole. The selection criteria that decided their fate, and what they reveal about post-clearance commercial leadership hiring.
Profile · Why we work in medtech
He couldn't save Kate. So he's saving everyone else.
Kate Gross died of bowel cancer at thirty-six. Her husband Billy built the early-detection breath test that might have caught it in time. The story behind Owlstone Medical.
Essay · Hiring & retention
The team you're hiring into isn't the team you think it is.
Gallup's 2026 data shows manager engagement at its lowest in over a decade. The team a new commercial leader inherits has been shaped by it, and most briefs do not account for that.
Essay · Talent pool
Before Julia Child changed the way America cooked, she was developing shark repellent for the CIA.
She was fifty-one when The French Chef debuted. The world spent twenty years not knowing what it had. The asymmetric hire most companies miss, and the cost of filtering experience out of the talent pool.
Market analysis · Tariffs
Medical device tariffs. How bad is it really?
Section 232 is now the primary instrument for securing US healthcare supply chains. The commercial leadership profile that handles this environment is different from the one that worked in the previous decade.
Founding note · Why I do this
My WHY: the device in the drawer.
My father died of a heart attack in 2017. The technology that might have caught it existed. That is why I do this work, and why the commercial hire after clearance is the one that matters.
Essay · Method
Why your VP Sales hire keeps failing. And it's not about ability.
Six months in, the numbers aren't moving. The pattern isn't bad candidates. It's the hunter/farmer mismatch buried inside the brief, and what to do about it.
Essay · Commercial architecture
The knowledge was never yours.
Five major medical device IP lawsuits in five years. The thing the legal commentary missed: the dependency that pre-dated each departure.
Essay · Leadership
The Board Meeting Nobody Wants to Have
The silence when someone mentions the CEO is still the scientist who built the product. The distinction between a scientific founder and a commercial operator, and why the companies that make this transition proactively are the ones that reach the exit.
Analysis · Regulatory
The Regulation Designed to Protect European Patients Is the Reason Some of Them Can't Get Devices.
The EU MDR raised the bar for device safety and created a capacity crisis removing proven devices from European markets. How a regulatory bottleneck became a commercial restructuring event, and why the US is now the fastest route to first revenue for a European company.
