In this solo podcast episode, orthopedic industry insider and recruiter Tiger Buford advises founders of orthopedic startups on the critical first six hires that can set the trajectory for success or failure. He emphasizes that early hires must be cultural fits, transparent, and willing to challenge the founder. The hiring sequence he recommends is: 1) a trusted partner or co‑founder with complementary skills and blunt honesty; 2) a hands‑on senior engineering leader who can execute design and later oversee technical operations; 3) a junior engineer willing to take risk and handle detailed CAD work; 4) a quality, regulatory, and clinical lead (initially covered by the senior engineer but eventually a dedicated function) to build a robust quality system before regulatory filings; 5) a marketing and sales leader who owns the value proposition, messaging, and commercialization strategy; and 6) a finance/HR/operations/legal function (initially outsourced) that will later drive financial strategy, corporate compliance, and contract management. Throughout, Buford stresses the importance of hiring for judgment, flexibility, and the ability to voice dissent, warns against relying solely on resumes, and notes the need for cash compensation alongside equity for technical hires. He concludes with encouragement to founders to build the right team, follow his content, and pursue their vision.
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Brought to you by Tiger Buford. Hello, orthopedic colleagues. Welcome to Inside Orthopedics. My name is Tiger. I'm an orthopedic industry insider and retained recruiter for emerging orthopedic companies Thanks for listening. This is episode number 7. The title is 6 Early Hires That Will Breed Success in Your Orthopedic Startup. Let's get right into it. I get calls from startup CEOs who are looking for advice on the kind of people to bring in and in what order. I will share my thoughts here with that question. Let's, uh, so let's assume you're the founder or CEO of a promising new orthopedic startup. So as you begin your journey, you already know that the odds are against you. 90% of all startups fail, and you really want to be in that rarefied 10%. You, you probably have some early funding, some good product some concepts, some patents, websites, key surgeon inventors, but you really haven't built out your team yet. The first people that you bring in will either set you up for success or cost you valuable time and burn precious capital that you just can't get it back. So you absolutely have to have the right team. The common thread with your first hires is a cultural fit and a shared passion for your vision and journey. Each new person that you add must have good judgment and flexibility and communicate with you with transparency. Look for individuals who are doers and who are real and practical and clear. A word of caution: it's difficult to evaluate a doer by looking at past experience sometimes. All the resumes look alike. Look for people who aren't afraid to voice their opinion. You need them to not only be smart and driven, but also be vocal and unafraid to disagree with you. What I like to say is It's okay to tell me I'm wrong, but bring me some options or a proposed solution. Otherwise, it's just complaining. So here we go. Let's look at the first 6 people. Alright, hire number 1 is a partner or co-founder. This person is a trusted friend, usually, who will keep you honest. He or she must have a complementary skill set to yours You can talk to your partner about anything and receive unfiltered feedback. Your partner will be more interested in doing right than being nice to you. Your partner could be a board member, a CFO, lead any one of the C-level roles. I would recruit this person from your trusted career contacts. Blunt trust is paramount. And your partner or co-founder. That's the first one. Alright, let's look at hire number 2 and 3. This is in the engineering technology areas. Likely these will be your first real hires. You will need cash to add these people. Equity alone will not be enough to attract them. You need an engineer who can do the technical work, then transition into a leadership role Often this is referred to as a hands-on engineering leader. It's not easy to find an engineering veteran who has the right stuff for, for startup. This individual may have to go back to CAD modeling and detailed design work that they performed earlier in their careers. If you're a technical leader yourself, this person will be the person that executes the design. Ultimately, this experienced engineer may grow into your technical operations role as well, initially responsible for managing all the quality and regulatory consultants. They will also manage your outside manufacturing processes. The third hire will be less experienced engineer willing to take a risk with the startup. This person will share the engineering load with the veteran engineer above and could be developed into the person that does the lion's share of basic CAD work and documentation. So that's 1, 2, 3. Hire number 4 is quality, regulatory, and clinical. Initially, this role will be filled with your engineering lead. As your business becomes more complex, you will need to hire someone to head up all of your regulatory and quality functions. This person will manage all of your outside manufacturing, inspections, packaging, testing, sterilization, and clinical studies if you're in that mode. These functions will initially be performed by consultants until the day you grow large enough to support these roles internally. Always think quality first. A quality system must be built well before your regulatory filings are in order. All right, person number 5, hire number 5 is marketing and sales. Surprisingly, this ad should come earlier than you think. You will need to hone your value message and your company story early. What problem is your startup solving? Be careful here because you may think that you know marketing, you may even have a sales background, and think you know how— the marketing skill set. Too bad, forget that, it's not your job anymore. So stay out of the way and get someone who can do both. Your job is leading the orchestra, not being the lead of one of the sections. Find someone during your career who has impressed you with their marketing and sales performance and recruit them to join your team. You can help them formulate the marketing and sales plan, but they must own it and lead it. Once you find the best person, they can execute your strategies for you. They need a keen eye for solutions that work in the operating room. They should fine-tune the message and prepare the first products for commercialization. Remember the adage: if you can't sell your products, you will fail quickly. And finally, hire number 6: Finance, HR, Corporate Operations, Legal. This role will be outsourced initially, but there will come a time for a day-to-day financial strategic mind inside your company. Initially, he or she will be putting together board materials, helping with corporate identity, corporate entity compliance, Managing key contracts with suppliers, consultants, surgeons. Later, this person will be instrumental in developing the long-term financial strategy for your company. So that's it. That's how I see your first 6 hires. Good luck with your startup. Go out and change the world. Remember to follow me on OrthoStreams.com or on Twitter @TigerBuford. Don't forget to subscribe. Be safe out there.
