Most early-stage companies don’t fail because they lack ideas. They fail because they try to do too many things at once.
More features. More partnerships. More hires. More “strategic initiatives.” All before they’ve nailed the basics.
I’ve spent my career inside healthcare and health-tech companies at different stages, first as an operator and now as a fractional leader. The pattern is consistent. The companies that scale well are rarely the ones doing the most. They’re the ones that are ruthless about focus.
Early on, there’s a strong pull to look like a “real company” before you actually are one. That usually shows up as hiring too early, launching multiple go-to-market motions at once, saying yes to partnerships that feel validating but don’t materially move the business, and optimizing for optics instead of traction. None of that builds leverage. It builds noise.
Early-stage success is boring. It’s picking one motion, repeating it until it works, and then repeating it again.
If you can’t reliably explain who you’re selling to, why they care, how they buy, and why you’re different, nothing else matters yet. Not the org chart. Not the perfect roadmap. Not the next market expansion. Too many teams try to solve go-to-market problems with product changes or new hires, when what they actually need is clarity and repetition.
Hiring is another place where good intentions go wrong. Hiring great people too early can be just as damaging as hiring the wrong people. Senior hires without clear ownership get frustrated. Junior hires without structure get lost. Everyone gets confused. The strongest teams I’ve seen grow deliberately: one clear owner per function, explicit expectations, and fewer people doing more for longer than feels comfortable. A small, aligned team will always outperform a larger, misaligned one.
As companies start to grow, scaling looks less like addition and more like subtraction. Removing side projects. Removing fuzzy ownership. Removing legacy decisions that no longer serve you. Scaling doesn’t mean doing more things. It means doing fewer things better, with discipline.
I started writing here because I see these same mistakes repeat, especially in health tech. The complexity of the space makes it easy to hide a lack of focus behind regulation, stakeholders, or long sales cycles. This is a place to write honestly about go-to-market from the operator seat, early-stage operations and what actually matters, team building and timing, and how to prioritize when everything feels urgent.
No hype. No generic playbooks. Just lessons from inside the work.
If you’re building something in healthcare and trying to decide what to focus on next, you’re in the right place.