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How to be a Terrible CEO of a MedTech Startup - a step by step guide


In my career I've seen great CEOs of startups - often the founders that have a drive and passion. That understand the problem and understand the "business". They get the tech - they get the culture - they get the main thing... the people.

Then I've seen the worst of the worst CEOs of MedTech startups (often replacement CEOs) - and here are some of the traits and failings. If you're a CEO of a medtech startup - here's some thoughts on how to be a terrible one...


Be a tyrant of a CEO

Nothing speaks louder to a team than detached tyrannical behaviour. Letting people know "you're the boss" - "It's my way or the highway" is how you will endear and get the most from your team. It's 2024 and people have no other options - especially good people - so they love nothing more than coming to work for tyrants. They haven't joined a start up to be part of a journey - they are here to be a cog in a wheel of a tyrannical machine you are building.


Appeal to the board not the market 

If you want to set your startup in the right direction - then simply ignore the feedback of the market and massage all your messaging to your "pay masters" the board and Investors. Ensure that at the last minute every quarter you get your team to "do their updates" for the board - rather than focus on the needs of the customer. Pander to the whims of the detached board members that are coming in like Monday morning coaches - and make sure you do what they want - not what the company needs. Your team will respect you for it.


Assume as much as you can

Why have smart people with in depth knowledge when you can just assume you know it all. Have dogs but bark yourself! Make sure that you hear the teams but don't listen. Make sure you ask for ideas but don't take them in and act on them. Why? Because you're a legend in your own mind, and your assumptions can beat all in depth knowledge and real world insights. Assume Assume Assume - hell - you're the CEO the big head honcho.


Be out of touch with your team

Young talented teams love nothing more than to be dictated to by out of touch - yesteryear leadership teams with no sense of the real issues that they are struggling with every day. They thrive under a CEO that applies historical, outdated business tactics to a vibrant whitespace company. So try your best to ignore fresh thinking and resort back to what worked yesterday. Because of course 90's philosophies will work in MedTech in 2024. You get a bonus point if you can also just not read the room when your internal surveys and Glassdoor scream at you - "You're doing this wrong." Just say you'll improve... then don't. They love that lip service.


Apply big company thinking

Vibrant young startups need nothing more than process and red tape to make them excel. (That's what they've been missing). As the CEO bring all your baggage of the past and dump it right in the lap of the startup team. If you're a relic of a big company - placed in by the board - who assume that the former CEO "was the issue" - you can actually bring all those historic game plans that worked for you as a big company manager and apply them again in the startup. Teams love it when bureaucracy and process take over from innovation - motivation and experimentation. They love to hear your old anecdotes of your old company and how it was amazing in the "glory days." Keep repeating those stories over and over as if you've never said them multiple times. 


Cut n Paste motivational snippets into emails

You will never win the hearts and minds of your team faster than clobbering together motivational snippets and "smart quotes" from across the internet. Cutting random parts from the emotional understanding of Simon Sinek and combining it with hard hitting war paradigms of Sun Tzu is the utter winner. Obligatory is to just cut and paste and have 12 different fonts, and 3 different colours to show hard core that it's just cut n paste with little thought (you don't need thought) - "take it or leave it". Motivated young teams love nothing more than 90's style "who moved my cheese" stories to show them how connected you are as a CEO - understanding and communicating to them as 2024 individuals is not the plan to use.


Fire the best people - let the rest walk out

The best of the best terrible CEOs will come in with their 100 day plan - and start to chop the very heart out of the company. Cost cutting, blame game, and every other internalised bias you have should be brought out to say "There's a new sheriff in town". If this loses the best people and then the other great people walk out - kick the door in their ass saying "We don't want your kind here anyway. Your loss." Try everything to keep the snivelers and "yes" people - that know that they would never walk out because they are unemployable elsewhere. That way you can get rid of the know how that made the company the failure it was - and keep a good level of incompetence that will do what ever you tell them. Consequences be damned - your way must be better.


Bring in your mates and cronies to fix the issues

Now you've cleaned shop - and got the old devotees to the old CEO out - the people that clearly failed. You can start to bring in your own cronies. Irrespective of if they have any competency that is essential to that start up - pick people from the old school. They'll work it out. I mean how hard could it be? They know medtech... they know you... they know big companies... of course those skills are 100% transferable. So bring them in to leadership positions and ignore your good solid middle managers that have built the shoulders of the company you now stand on. Nothing motivates them more than to have a newbie "boss" come in and ask dumb ass questions in monthly meetings while you burn through your cash at an alarming rate.


Cut the heart and soul out of the company

Companies are about Investors and hard core management right. Culture, fit, sense of purpose, mission are all road blocks that take focus away from increasing shareholder value. Cut everything to the bone - heads, budgets, projects - and just focus on the bottom line. Startups are not built by people with a mission - they are built by P&L sheets - so make sure you get to a quarterly mini big company routine as fast as possible. Have company meetings about the sincerity of the management caring about the people - then "F*ck em." and just make sure the remaining people get double duty on work (take on the work of those that left) - because before you arrived they were just lazing about doing nothing. Now you are here it's time for everyone to get to work and get serious. Nothing will motivate your team harder than you stepping in and showing them what hard work really is, and reminding them how the "old team" were the issue and now things have changed.


Blame the continued downward trajectory on the old team

It can never be the product - or the market - or the competition - or the strategy. It has to have been a failing of people not doing their jobs or just tincompetence. Don't fix the actual underlying issues - instead just continue to blame the old guard and hope that the new people - with no real understanding, combined with the remaining old team that are struggling - can just "pull it around." Just keep going as it was in the past and don't pivot - do more of the same - but just dole out blame that your poor performance today is a legacy of the old management. Nothing motivates a team more than to continue in a nose dive but feel the comfort that they can blame people that have moved on.


Be you a new CEO of your very own startup - or more likely an incoming CEO to take on a struggling start up... make sure you do everything in your power to be that terrible CEO that everyone loves and respects. 








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