Inside Orthopedics: Six Hiring Mistakes that can Kill an Orthopedic Startup (Podcast 22)

Brought to you by Tiger Buford. Hello, orthopedic friends. Welcome to Inside Orthopedics. My name is Tiger. I'm an orthopedic industry insider and retained recruiter for early-stage orthopedic companies. Thanks for listening. This is episode number 22 titled 6 hiring mistakes that can kill an orthopedic startup. This one is for those who are building a new orthopedics company, and I want to help you avoid some of the costly and potentially fatal hiring mistakes that I've seen. So let's jump in. So you're building an orthopedic company one way or another. You may be the CEO, hiring manager, or just an interviewer. Regardless, you have a voice in who gets into the company. The first 5 to 10 people that you hire in a startup will, will either set your company up for success or actually break your company. Each person you add is a key building block to the foundation. You need to be generous with equity in the early days keep the company flat, be quick to fire if somebody doesn't work out, but most of all avoid hiring mistakes. Once you reach 20, 30, 40 employees, the recruiting process is really out of the hands of leadership. The first hires will now be in charge of the recruiting and hiring. If you hire poorly at the start, then you will create a weak link in your company's Recruiting DNA Forever. I've seen orthopedic startups make these 6 specific hiring mistakes that I'd like to share with you. Here we go. Hiring mistake number 1: settling for a B player. The rule is don't ever, ever, ever let a B player into your company, especially in the early days. If you let a B player in, then you will gradually be surrounded by C players and your company will rot from the inside out. I've seen it happen. The old axiom is true: A players hire A players, B players hire C players, and C players will kill your company. Why? Because A players are not intimidated by smart, hardworking people, so they tend to hire A players. They hire up. B players, on the other hand, don't want to be challenged, so they hire C players. They hire down. So actively screen out all B candidates. All right, hiring mistake number 2: using consensus hiring. Unfortunately, I have seen that most Orthopedic startups still use consensus-based hiring, and the reason for this is obvious. It's all about cultural fit. The CEO and leadership wants everyone to be comfortable before making an offer to a candidate. In a small office, going from the 10th employee to the 11th is a really big deal. And after the candidate finishes meeting with everyone, this The leadership will take everyone's temperature, and if everyone is mostly positive about the candidate, then an offer will be made. This hiring by consensus process is dangerous because the group can accidentally hire someone that is really lukewarm, and no single employee is responsible for making the mistake. It's groupthink at its worst. This is called consensus-based hiring. We've all seen it. I recommend a better system. It's called Champion-Challenger hiring. In a Champion-Challenger system, any one employee can stand up and challenge— or, and sorry, champion the candidate and recommend making the offer. They must feel strong enough to stake their reputation on the individual. The only check and balance in this system is that any other employee can also veto the offer. This is the Challenger part of the name. So try it. I promise you that the Champion-Challenger system will deliver more A-players to your company than the consensus hiring. Hiring mistake number 3 is trying to convert a big company hire. I've seen startups hire individuals who are just not really wired for work in a startup. I talk with startup CEOs each week and they usually say things like, "I don't want anyone who's been brainwashed at Stryker or Zimmer for years." And they're really good people at Stryker and Zimmer, obviously. But what they're really saying is they fear hiring an individual who isn't cut out for startup life, even though these individuals are smart, driven, and capable. Many big company people have done well in a big environment, but then again, they have had far-reaching resources to lean on. Without knowing it, these individuals have become institutionalized. You may have read my FROG article to learn why good people gradually get stuck in big orthopedic companies. So sometimes leadership tries to make an exception. They fall in love with a big company candidate from Stryker or Zimmer. They take a chance on bringing them in and teaching them the startup way. Rarely does this work out. Unless the candidate has an innate entrepreneurial spirit that you will find sprinkled in, in their resume, in their past, back in school, or moonlighting business activities. A good rule of thumb is to stay away from big company lifers in a startup, kind of, period. Okay, hiring mistake number 4 is— this is simple— hiring attitude last. Often startups get fixated on skills, past accomplishments, pedigree of the candidate, and overlook their attitude. Check the candidate's attitude. In startups, an employee may sometimes work 16 hours a day, 7 days a week. If the employee doesn't have the right attitude, they will not survive. Nothing beats attitude. Hire based on attitude first. Okay, number 5, hiring mistake number 5: Hiring before understanding motivations. If you don't understand an individual's motivations for joining a startup, then you may get stung later on. I've seen individuals who joined for the initial euphoria with expectations of fat bonuses, a chance for rewarding creative work, maybe a magical IPO in the first year, and then when it didn't happen, they left. And this is a problem. This attrition is devastating to a startup. The employee is part of a cohesive team, and at the critical hour when he or she leaves, it does more damage than you can imagine. It affects the morale and spirit of those who stay, and this morale problem can stay for weeks or months to bounce back from. And all this because you hired a person whose motivations were not in sync with the company's plans and culture. So figure out what is motivating the individual to join your company before making the offer. And finally, hiring mistake number 6 is force-fitting into a budget. I've seen startups say, "But this is all we can pay for this position right now." This is short-term, small thinking. It can really hurt later on. I understand that most startups are bootstrapped and have to watch their cash very closely, and most run in the red. The mistake here is to evaluate only those candidates who fit within the given budget while screening out the best candidates with the true skills and accomplishments. While I agree you need to be pragmatic about budgets, you need to find motivated people who value passion, creativity, experience, and learning for what is really beyond the money. There's no purpose in winning the battle and losing the war. So my advice is to delay the hire until you can pay for the rock star that you want. So that's it. Those are the 6 things to look out for hiring in a startup. I hope that these pitfalls are helpful to you. As always, don't forget to subscribe. Think Tiger Buford for your next key hire. Keep innovating, my friends.