The founder who loses a Market Access Director candidate to a larger company tends to blame the brand gap.
They're right that the gap exists. Wrong about what it costs them.
Medtronic has a Glassdoor page with thousands of reviews, a campus recruitment operation, a careers site built by a dedicated team, and an employee resource group for every demographic. A Series B cardiovascular startup has a LinkedIn page, a deck, and a CEO who is still personally closing every commercial hire. Competing on brand terms is a category error. It's the wrong game entirely.
The larger company also has something else: a Market Access Director who is one of forty, reporting into a structure three layers above the commercial decision, working a reimbursement pathway that was mapped years before they arrived. A function that is, in every meaningful sense, already built. A payer strategy they inherited from someone who left.
The candidate who wants that role is a different archetype from the one you need.
Market Access Directors are among the most genuinely scarce commercial hires in the medical devices sector. The profile that can navigate a novel reimbursement pathway from limited clinical evidence, build the health economics argument when the data is still thin, and own the payer strategy at the moment it actually determines whether the product reaches patients: that profile exists in small numbers. It is not sitting on job boards. It does not respond to standard job adverts. It evaluates opportunities differently from every other commercial hire you will make.
What it evaluates is not your brand. It's your story.
Specifically: what is the device, and what is the reimbursement challenge? How strong is the clinical evidence behind the health economics case? What is the payer landscape, and how much of it is genuinely unsolved? What access does this person have to the CEO when a coverage decision needs to be made at speed? What does owning this function from scratch mean for their market profile in five years?
A Market Access Director who has spent six years inside a large organisation has built expertise within someone else's framework. The candidate considering your opportunity is asking whether this role puts their name on something. The reimbursement pathway they navigate, the coverage they establish, the health economics model they build: that's the career-defining work. It doesn't exist at Medtronic. It exists at your company, right now, because you haven't done it yet.
That's not a consolation prize for not having a brand. That's the employer brand, if you know how to say it.
Most founders aren't ready for the conversation a strong Market Access candidate will have with them. They pitch the device. They describe the role. They mention the salary. The candidate leaves with a clear picture of the job but no clear sense of why this is the most important Market Access role they could take right now.
The employer brand for this hire isn't a careers page or a Glassdoor score. It's the answer to one question, given specifically and honestly: why does this function matter more here than anywhere else you could go?
If the answer is good (and for most post-clearance medical device companies, it genuinely is) you don't need Medtronic's budget. You need the right candidate in the right conversation, with a founder who knows what they're offering.
If you're about to brief a Market Access Director search and that answer isn't ready yet, that's the right place to start. I'm happy to work through it before the search begins.