Tibor Zechmeister - MedTech and Entrepreneurship

So, if you have a bad feeling about the project, but maybe you get a lot of money early on because there is a good salary, a startup salary or something like that, or you get a lot of shares, it will turn out after some time that it's still not what you would like to do. I think it's better to say no in the beginning and say, hey, sorry, that's not aligning with my values or, hey, sorry, I don't see myself in the team than going down the road together for half a year and one year and then tell the people, hey, sorry, I never really appreciated

at how you work, therefore, I'm leading the project.

Our featured speaker today is an experienced entrepreneur in the healthcare and medtech sectors, passionate about helping startups and established companies alike. With over 10 years of experience in the medical device space, he is constantly seeking new ways and innovative ways to solve problems and make a positive impact on the world. Tibor, it's a great pleasure to have you joining us as our guest today. Thank you so much for being willing to share your journey with us.

Thank you so much for having me. It's a great opportunity I was really looking forward to this session today. And I'm also curious about the questions and I hope that I can provide a little bit of insight into the crazy world of the Mettex startup ecosystem, but also my personal experiences about my entrepreneurial journey.

We're very open to whatever you would like to share today. I was wondering if you had to take us back a little bit beyond what I can see on LinkedIn and talk about some of your experiences growing up. And if you feel like there are any particular life events or people in your life that really stuck out that you feel were influential in shaping those first choices you made.

Perfect. Yeah, absolutely. Yeah, you're right. My LinkedIn profile is more of a quick snapshot of what I've been doing. But maybe let's go back to the beginning of my entrepreneurial journey, which was in 2012. At that time, I was just finishing my bachelor's program in biomedical engineering. So, yeah, I'm a biomedical engineer by background. Being an engineer focusing on technology and innovations was, I say, a bit of a destination for me going that way. At the end of my bachelor's program, I was thinking about, yeah, do I want to do some generic bachelor's thesis where I don't focus on any given topic or do I want to invent something or look for something new?

And I chose the latter one. After that, I was coming up with an idea in the field of Parkinson's disease, because what I've seen, my great -grandfather had Parkinson's, other relatives in my family too, and a lot of many people worldwide have and have Parkinson's. And I was seeing that if these people go to the doctor and they're having their symptoms like shaking, for example, so they have these tremors in their hands, the doctors would only look at them and visually and subjectively assess how strong this shaking is. So for me, as a biomedical engineer, that was something unacceptable saying, hey, how can you use your human behavior for assessing or measuring something which could be quantified? But that was really my idea back then saying, okay, I know millions of people have these tremors. And it's really important to assess these tremors because on the one hand, it helps you with providing a differential diagnosis, if you don't know yet what the tremor is causing. On the other hand, if you have your disease like Parkinson's, for example, the tremor is a great indicator to see if medications are properly working or not. And that was the first idea for my startup. So I said, I want to develop a medical device, which is quantifying this tremor subjectively really easily in a few seconds. And then the doctor and the patient get quantitative and not qualitative data anymore. How the situation is, what the diagnosis could be, and on.

That was, I would say, my main project and also passion project for about 10 years, I would say. I started out with absolutely nothing. I had no connections, no money available, no funds, no team, nothing, just this idea. And I can tell you back then, yeah, approximately 12 years ago, I remember telling myself, how hard could it be to start a medical device startup? I would just do that. That would be really simple. I mean, if I could now travel back in time and have a discussion with my previous past team member, I would maybe tell him a few things, so it's not that simple to start a startup on its own, especially a medical device startup, but yeah, things happen and I was a little bit more naive on that. Yeah, going into the years, I really managed to build a startup out of that. So I found co -founders, I could raise approximately $2 million in public grants, but also in investors' money. I managed to certify and develop the medical device, so it was publicly available in the European Union, but also in Japan and also in Australia.

And that was, I say, really my passion project for many years. And that was also the possibility where I could learn so much from the startup ecosystem. Because I had to do many things, not only biomedical engineering, but of course, fundraising, investors relations, clinical trials, regulatory affairs, but also marketing sales. Of course, if you're in the startup, you're involved in almost everything. And me, that was really an excellent experience because even though later on, we had approximately eight full -time employees, so it was growing to approximately 10 people, I was always involved in everything. So I saw the daily challenges, what the solutions might be, and that was really helpful. Moving on, I would say that was my initial entrepreneurial knowledge I was building. But what I've seen is that I've done a lot of trial and error testing.

And that was maybe also one big mistake I did because during these 10 years, I made a lot of major mistakes. For example, at the end of the company, the shareholder structure was much too complicated. We had so many small shareholders and a few big shareholders. For the certification of the medical device, since I didn't know better, our approach of certifying it was too complicated. We could have done it in a fraction of the time. Also regarding market access, we tried B2B first, but then COVID -19 hit. We to simply switch to B2C, which didn't work at all, of course, because we've built a B2B product that was a business model, and just tried to copy -paste it to a B2C approach altogether. Absolutely impossible to do that. But I would then also say that these were the learnings, in my opinion, and all founders or startup entrepreneurs should at least experience once in their lifetime. So I wouldn't wish them to go through all the bad things that also happened to me.

But at the same time, I think in some cases, people only learn if they really feel something. I can definitely tell you, because I'm also mentoring and consulting startups, if I'm looking at the faces of these first -time founders and I tell them, guys, you will need two to $3 million to get in the market, you really need to be sure about the product market fit, They say, yeah, yeah, we will work it out on the way in. I'm like, no, you shouldn't do that.

Three years or three years into the project, that should happen immediately at the beginning of the project. And yeah, what happened to the first company? So we originally gained excellent traction in the first few months of entering the market, but that was right before COVID -19. So that wasn't really helpful because our complete sales strategy was going to hospitals and to doctors and show our products and sell our product. Of course, with COVID -19, in all the specialists and hospitals said, I'm sorry, but I don't care about Parkinson's right now. I need disinfectants. I need breathing machines and so on. So that's the main focus right now. We then tried to pivot to a B2C approach, but of course that also didn't really work out because people had simply other problems than during COVID times than to then to focus on Parkinson's. And maybe one interesting thing, because we mentioned the bootcamp earlier, that was really a big revelation for me. Because at the end of my startup, I went to the leadership bootcamp at MIT. I think it was Bill Olet, but I'm not sure anymore.

I think he created some kind of mini checklist, what would be red flags for your startup? And I went through this list and I checked one red flag after the other. The product market fit wasn't too good, our funding wasn't too well established, the team fit wasn't really given because after so many years, some of the founders didn't want to work anymore on the project. There was no passion anymore. And I was like, oh no, that's not a good sign. I checked almost all the red flags from the system you could have on a startup. And really a few months later, I decided to shut down operations because I saw it wouldn't work out anymore. But the interesting thing is, and this is maybe one really big learning I had, when I had this first shutdown, for me, this was some kind up existential crisis. I have built all my life into this one startup. I wanted it to fly. I was really passionate about it because I wanted to help people and also people with Parkinson's.

But then from one day to the other, I had to shut down operations. But two really interesting things happened. Even though, yeah, maybe let's start with the first thing. I thought people would see me as a complete loser and say, hey, you tried to find something. It didn't work out, you're a loser, you don't know how to do that. But that didn't really happen. And I know in the United States, that's not kind of the mentality, because people only take you seriously if you have at least founded one or two projects, then you're a real entrepreneur. And not only if you're a first time founder, but in Europe, it's completely different. So in my home country, Austria, for example, if a business is failing publicly, usually you're a complete loser, because winning is everything, and failing at something is absolutely unacceptable. But even in my network and in my community, nobody said something like this. So was really relieved that this is not

the thing that somebody would think that I'm a loser. And the other thing is, what was another big revelation is that I thought the only way that I could succeed with this project is by my original company, my original team, and the original setup. But interestingly enough, one month after shutting down the operations, I was approached by a German medical device startup, which was much better funded, had more people altogether, and they asked me, hey, how about we transfer the assets? How about we buy the company, take the assets into our startup with a new team, new people, and would you like to join us as a co -founder and regulatory expert in that. And for me, that was the big insight about, yeah, okay, maybe there are multiple ways to pursue the same project or goal you're having. And that was really interesting for me, because from then on, I saw, even if a project is not working on plan A, you can create any other plan, B, C, D, E, F, G, and so on, and it could still work out. So that was what happened to my startup. We moved the assets. We integrated the technology in their medical device, which was also focusing on Parkinson's and that was a perfect fit. I was also spending there approximately one and a half years focusing on that. And since then, I've been always in the startup game because next week, yeah, I think it will be in two weeks approximately, there will be a big announcement

for my next startup program I'm joining or the startup company I'm joining. So all together, I have been in the startup space for 12 years now, maybe not in the same project all the time. We already talked about this topic of serial entrepreneurship. And I would definitely say, yeah, I have this special path of not being the one entrepreneur for one project, but being a multiple project. At the same time, I was really dedicated for my first project. So it was not like, Oh, I'm bored after one or two years, but I really invested all my resources and time into that one project for 10 years. And what else? So that was my entrepreneurial journey altogether. But at the same time, I somehow also became a regulatory affairs expert for medical devices. And it really started out of a random situation. Back then in my first startup, of course, we had to do these certification procedures for medical devices in Europe. And my team members came to me and said, hey you studied biomedical engineering, you should know how to do that. And I was like, okay, I maybe had one lecture at university where we briefly talked about that, but I have no idea how to do that. So that was one topic I really focused on and said, okay, I have no idea how to do this, but I will learn how to do regulatory affairs for medical devices. And it seems like I was really weak about that because it not only worked with my company that we got all the certifications, but later on other startups came to me. Hey Tibor, how did you do that? Or what was your approach? How do you do that?

And of course, for starting out, I just gave them the information and the feedback. And after some time, people told me, yeah, you should be a consultant about that because you built 10 years of knowledge, which is probably worth a little bit of money to provide consulting. And then I saw that really a lot of startups in this ecosystem were having the same struggles. They have a great technology, they have a great idea, but they don't know at all how to certify and bring their products onto the market. So that was a second focus I was having regarding my community engagement, because through my consulting activities, I could, I'm just thinking about how many companies I supported. I would say since starting my consulting company in Austria, it I over 30 companies, mostly startups, starting from maybe one or two people, but also going to maybe eight to 10 people, but also established companies that want to certify new medical devices. And that was a different kind of engaging in the community because I said, okay, maybe these are not my medical devices but I help these teams to get to their goal as fast as possible so that they don't lose three

or four years like I did with my first startup. But I told them, hey, we can do the same thing in one year, for example, one and a half years. So that was the second level of engagement in the community. And third, what I still really love to do is to if I'm having some meetings, for example with founders in my community and so on. And they really have some basic questions about I'm a first -time founder. What were the biggest mistakes you did? What did you learn from your first company and so on? I really love to share that knowledge and really give back to the people because that's one point where I don't really see myself as a consultant, but that's somehow my way of giving back to the community. Because of course I could do that for consulting and say, yeah, I can tell you all the tips about how to become a better entrepreneur. But at the same time, I remember that there were also many people during my first startup who gave me information for free and provided me valuable lessons of information. So I thought, yeah, let's give back, not only take, but also give back also to the community.

That's so good to hear. Thank you so much.

I would love to understand a little bit more. You've worked with so many different companies, so many different startups in this time and especially in this space. Whilst you're working with them, do you get a feel for which companies you think like this is a great founding team or maybe this founding team is lacking in this particular way? Do you have an idea of what traits or characteristics you think are necessary for a successful entrepreneurship startup?

Absolutely. Yeah.

So first of all, I know this is a little bit harsh to say, but if the team consists of already veterans or serial entrepreneurs, I generally see huge differences. So sometimes I see excellent rates also in first -time founders, but more often if I see that the company is comprised of people that had already their startups or had their experience in the previous years, I usually have a much better feeling why. Because they made mistakes, they know how to do certain things or not do certain things. And I would also say they don't think about basic questions like, how do I get funding or should I hire somebody or do something with a consultant and so on, but they know exactly how to do things because they already experienced that. But of course, not everybody is a veteran. Many people are first -time founders, so let's go to these people. What I can tell you from looking at teams is, for me, that the first green flag or red

flag is if they're really open for feedback, even if it's critical. Some people or startups where I see that the management is completely open, and even if they had assumptions or ideas, maybe about how funding works, who they should hire, or if their product market fit is available or not. And if you honestly tell them, okay, this point is good, but I'm really sorry, you have no clue about that point. This is not how things work. They're either the founders who say, okay, well, this is really great input. Could you provide me more information so that I better understand that? But unfortunately, you also have the founders who say, no, I don't know. I think my world will still work. And that's working around. So I think openness for feedback and constructive feedback, I think is a really important trait. Because I had even in startups where I was working and evolved, I had sometimes, I don't know, CEOs and people who always thought that they knew better. No matter how much feedback they got, they always said, I don't believe this feedback. No, I saw it from their opinion. So I think that's number one, which should be really important. The other thing that was really helpful for a good founding team was that they understood that they at least need a CTO and a CEO in combination. Because it doesn't help me if I have three excellent scientists and researchers in my team who have no idea about how to generate a business plan, what scale strategies or marketing strategies to approach. I sometimes see that, especially if you're having spin -offs from universities, for example, or if these people come from technical universities or something like that. Excellent people, great minds, and they for sure know their technology. But what they really sometimes don't understand, and that was one of my biggest learnings during my first startup, nobody cares how innovative or how high -tech your product is. The main question is, or the two main questions are, does it solve a real problem?

them? And can you make money out of that? This is for most engineers, and I'm an engineer myself, I made this mistake too. I have this misconception of the more high tech, the more AI, the more software I pack into that solution, the more the market will love it. And unfortunately, this is not the case. So this is maybe a second thing I would really point out that if there's not at least a CEO, CTO combination somewhere, I usually doubt that there would be any good progress on the project. And maybe a third thing, what I've also seen is how well connected these people are. Because even if you're a first time founder, but have an excellent metric for raising money, finding investors maybe, or hiring the right people, you will be probably much more successful than if you maybe are good in what you're doing, but you don't have the right connections and the access to maybe the market and other stakeholders that would be relevant. So these are definitely three points. But if you would ask me, what's number one, I would definitely say openness for critique, constructive critique, and being able to learn and listen to other people who already went through these situations.

That's such good advice. And it sounds so simple. But I know that we can, you know, come into things like just having this perception of, you know, what it should look like, or, you feel like in some sense, and you can get married to the solution you created, rather than getting married to the problem. I don't think that's like the actual analogy I'm looking for. But when you really are that passionate about solving the problem, then you're open to kind of seeing the universe of solutions and opening yourself to that critique, I think.

Hello, all. I hope you're enjoying this episode with Tibor, I wanted to ask you, our listeners, if you could give us a review in your podcasting platform of choice. We don't have sponsors and don't run ads, but we are looking to grow. So if you feel we bring value to your listening experience, please drop us a review when you get a chance. Thanks so much.

You said some really great things that I actually wrote down. So when you said people only learn when they feel something. I completely agree with you. I think people feel things in different ways, which is what makes teaching and mentoring challenging, but also exciting. But I think it's really great that you realize that as a mentor. And I love that mentality that you have that, you know, because people helped you along the way, you want to do that too. And you had also mentioned like, as a new founder, you don't have that much money. You don't have money to like hire a consultant.

And this is to me how we make that greater change in the world that you are helping the generation that's gonna help the next generation of scientists. So I really appreciate maybe not just mindset but that heartset. And then the last thing you said that I was kind of laughing at is, you if you're failing, you're a loser Because you're right, in Silicon Valley, and probably in New England, in the U .S. too, there is this mentality that you need to just keep going and almost like don't even worry about the people, just keep starting something new and drop it before it gets cold. I actually don't know if that pervades throughout the U .S., and I have really struggled to adopt that because I care about people and I feel like if I abandoned this idea, am I abandoning all these people that believed in it? So going off of that, I love that you've allowed yourself the freedom to try working on so many different projects. And how do you decide when an idea is worth continuing to invest your time, energy, and money? And how do you know when you need to move on personally?

Yeah, so this is such a great question. And believe it or not, after my first startup, I created a checklist for myself for future projects because I saw so many things I loved in my first startup, but I also hated in my first startup. So I really created a checklist that I don't want to go through each and every point because it's really a long one.

But if you're really asking me, what are the signs where I say this, this is a great project, or this is a project where I say, sorry, I passed. First of all, the project really needs to align with my personal values. So, if tomorrow I get the offer to join, I don't know, any military startup or working in the tobacco industry or something like that, that's simply not aligning with my personal values. Not that I condemn people working in these industries, I don't say bad or good or anything, but my personal values are about helping people and also in this medical realm of helping people. So, I want to have patients having a better life with better technology. I really want to improve that sector. If I see that the project is really aligning with these values, I can help people. It has a positive impact on society. It's also maybe in the medical or medical device realm. That's definitely one green flag where I say, yeah, that looks good. The second thing, what I'm really looking for is what about the team? So that's the second thing, because I really have learned that if you have a great team, you can even put bad products on the market successfully. But if you have an excellent product with a bad team constellation or a combination, it won't work out.

But the next thing for me is really looking for, where are the people, do they have the same values? What about the experiences? Is it a diverse team? Because I don't want to have, I don't know, five business people or five scientists in the team. I want to have a combination of somebody with, I don't know, entrepreneurial skin, someone with a special expert skills and so on. So that's the second thing I'm looking for. And the third thing, and this has become really important for me in the last few years, I want to see at least some signs of product market share. So I really go by the sell first and build later on approach. I want to see that there are customers out there that even if we show them a PowerPoint or I don't know, a napkin with some information on that, and they say, I would be really interested in that, let's talk about business, then I'm really open to that. Because having a great team and having great values doesn't mean that you have a product -market fit. Therefore, for me, it has to be a combination of all of these three, and all of these three has to be aligned. I got many, many, many offers in the past to join startups and those projects, and I declined most of them because at least one of these factors were not aligning altogether. And I think this is also a good thing because if you try to skip your own values and your priorities and think that it would work out somehow later on. At least in my experience, that's not true. So if you have a bad feeling about the project, but maybe you get a lot of money early on because there is a good salary, a startup salary or something like that, or you get a lot of shares, it will turn out after some time that it's still not what you would like to do. I think it's better to say no in the beginning and say, hey, sorry, that's not aligning with my values. Or, hey, sorry, I don't see myself in the team. Then And going down the road together for half a year and one year, and then tell the people, hey, sorry, I never really appreciated how you work, therefore I'm leaving the project. So these are, for really important aspects to look for. And as I said, I declined many, many, many projects simply because I said, maybe, wrong time, not the right people, or I'm not really interested in the project altogether.

Absolutely. I think it's so good to have that full alignment in all those spaces, especially when you're

about like selling first, building later in those hard tech businesses, which seems to be from my understanding where you work, it's like you can't dedicate that much time to building something complex and really, really intricate and not have already some reason to believe that it'll actually sell to people. I that's absolutely an excellent point. Thank you very much for sharing that.

This is also something that we discussed before. I think a big problem could be that you fall in love with your project or technology and not with the problem. Because for me, I want to help people. If this is now with a certain medical device or a software that the programs are the medical devices, or even, I don't know, a platform that can connect doctors and patients with each other, it's always the same goal. And if I fall in love with the technology and I did with my first startup, so I made that mistake that I was completely falling in love with the technology, then you can't pivot anymore. Pivoting means killing your own baby. You have been working on for so many years and then you're not objective anymore. You become subjective, you get emotional if you're getting criticized by something. And I think this is really challenging altogether. And it's really so important to focus really on the problem and saying, Hey, I want to help people and there are a million ways how to get there and we will sell first so we check out which is one of these 1 million ways to go on. And I fully agree with you. And if you spend, I don't know, three to five million dollars into a tech project, you want to be really sure that there's a product market fit. Because the first thing would be to spend all that money, be on the market after three years or something like that, and then everybody says, nice technology, but I don't need that. I'm not interested in that.

Absolutely. I feel like you're singing the exact same song of like my journey through my startup where I fell in love with the product. I, like, worked on it in the background without talking to anyone about it or trying to sell it. And then I finally got to the point where it was built, and I was trying to sell it, and I was like, oh, I can't convince anyone to pay money for this. I know the exact tune you're singing there.

Thank you so much. This could be just because I don't understand the medtech space, but I've read that personalization is going to be something that's a very big aspect of medtech going forward. Do you think that's sort of just not realistic or what do you see as being sort of the future of the medtech space going forward?

So I can tell you that we are thinking about the same technologies as any other industry. We're thinking about software solutions, home monitoring, remote solutions, software as a service, even artificial intelligence, deep learning aspects and so on. So all the same technologies we see also in other industries. We also see in the medtech industry, there's only one big difference. We're having quite a conservative market because regulations are so hard and strict that you simply cannot adopt a new technology and get it on market in two to three weeks because most of the regulations are lagging behind on a technological level. So let's take really just a brief example. In Europe, we have quite a strict medical device regulation, which is really hard for startups in Europe to bring their devices to the market. And it doesn't even touch the topic of artificial intelligence. But it's talking about how to document your software, how to check usability, how to do clinical investigations and so on. But there is not a single word

about artificial intelligence. But of course, many startups want to use AI because of course you can improve diagnostic procedures. You can go through thousands of patient cases and create, as you mentioned, individualized solutions for them. instead of having a one -size -fits -all approach, but then regulations come in and say, hey, we didn't define anything but it seems like a quite risky technology you're adopting here. We need to have really special proof that your devices are safe and effective on that level. We have the situation that we would like to use a lot of state -of -the -art and top -notch

technology because it would be meaningful and maybe white would be meaningful because if you go to an average hospital, and I think it doesn't matter if it's a European hospital or a US hospital, you usually see these big medical devices with old monitors, they are having even cable connections, and you're asking yourself, but why, why not Wi -Fi? Why not Bluetooth? Why not having a modern monitor or something like that? And regulations is the answer. Because changing a small detail in technology in this space needs to have so much paperwork and documentation approaches that many manufacturers say, I know that my technology is not state of the art for the last 20 years, but I won't change it because it's too much effort and work to have an innovator. And startups are the solution because they say, I don't care what was state of the art 20 years ago. I want to have a disruptive technology here. And at the same time, this is the funny thing that the times are changing before, I would say 10 years ago, if you started the MedTech startup, you mostly want to develop it on your own, certify it on your own, bring it on the market on your own, and so on. Nowadays, with restrictive regulations, if I talk to 10 startups, eight will ask me, people, what are exit scenarios? How far do I need to develop this project? Have a good exit to a big manufacturer or provider to buy this technology? And on the one hand, it's still good, because I would say the disruptive technology is still coming to the market because the big ones will bring it to the market because the small ones don't have the budget. At the same time, it's a little bit of a shame because your startups are turning into R &D companies that simply develop IP prototypes, maybe some clinical data, and then push it away and say, yeah, let's make a few millions with that and then move on to the next project. So that's maybe a long answer to that question, but yeah, innovation is there. However, startups are leading drivers of this medical device innovation and also medical innovation altogether. But times are changing from, I want to build and sell it, to I want to exit because I know it's too hard to do it on my own.

I mean, that makes so much sense, you know, what you're explaining too, because I mean, to be able to make it at a cost that people can afford it, or then, you know, I don't understand how medical insurance works in each and every part of the world, but in the US, if you want your medical insurance to be able to pay for it, then most likely it's going to be put out through, you know, a big recognized organization that can produce whatever it is at sale at a pretty cheap cost, you know, to your medical provider. I mean, that's a huge

I actually admire that you took on the challenge of becoming a regulatory expert, because that's one of the biggest barriers that I see in any medical startup, you know, even if it doesn't involve a physical device, just not understanding those regulations. Is your knowledge more based in where if I know you said you do travel internationally for work? Or have you become like a regulatory expert in other parts of the world?

So, first of all, I don't believe that there is any expert out there who could be an expert on every jurisdiction, law and regulation worldwide. I can tell you, I'm focusing mostly on the European regulations. And even those are so complicated and new guidance documents standards are coming out every week and every month. It's even hard to keep up to date with

one regulation. And I cannot imagine somebody saying, Oh, I'm doing that for Europe and the United States and Japan and India, maybe. So some people I see maybe on LinkedIn claim that, but I really doubt that, that there are an expert in 20 or 30 fields altogether. So I'm definitely focusing on Europe and saying, if somebody, for example, really needs US based expertise, then I can provide them some basic information, what the FDA is, what's the difference between a 510k procedure or a PMA procedure. I can help them with the basics, but if they need to know more, I then have a network in the U .S. saying, hey, these are the experts living in the U .S., giving and understanding the U .S. ecosystem who can help you much better than I could from Europe. And vice versa, these people sometimes call me saying, I have a client, I have a project in the United States, they would like to come to Europe, but please give them some basic understanding. What does it mean to come to the European Union? Which country to choose, what languages to choose, how's the certification procedure. So I would never claim to know everything about every jurisdiction. I simply think it's impossible because they're too complicated.

But at the same time, I'm really focusing on Europe, meaning that if a startup is located in the European Union and wants to make the devices here, I'm the right person or somebody worldwide would like to come to the European Union. That's also the situation where I'm the right person. But if somebody would tell me, we want to enter the U .S. market in 15 months, how can we work together? The answer will be, I tell you how, I will connect you to the right people in the U .S. who can help you. That's how we're working together, because otherwise it wouldn't make sense altogether.

That makes total sense to me. I think it's such a complex sequence of systems to get agreement from all the different bodies to let your medical device in. I don't see how you could possibly have one person fully understand all of it.

I think it's like having one person in a startup who knows everything, that's almost impossible. That's why you need a team. And it's the same with regulatory affairs. You have your experts for Europe, for the US, for other jurisdictions, then you have your expert on, I don't know, clinical investigations, biocompatibility, it's just like in a startup. You cannot rely only on yourself because you will never know everything. You always need people who support you and improve your weaknesses all together.

Absolutely. I particularly like the invitation on your LinkedIn profile for others to reach out to

you to work together to create a better world through digital health and medtech. What do you envision a world made better through these things, digital health and medtech, to look like say a decade from now? Do you see any particular barriers that are like the biggest things that we need to overcome?

Yeah, definitely. There are more than enough problems we are struggling with, with the healthcare systems worldwide. So I'm not only talking about a particular country, but really worldwide. And I think one barrier we really have to overcome is this traditional way of how you get treated or diagnosed in our society. And you can take any country here because, first of all, not a single country, in my opinion,

is really looking for prevention. There would be so many opportunities to prevent disease because the idea is not to treat disease, it should be preventing disease. So we're having so many technologies right now at home. Smart watches, smart rings, your smartphone. These are devices that are already absolutely, I'm also having one, and these are already the devices to provide you so much valuable information. How's your sleep? How's your calorie intake? How's your pulse, your blood pressure? So you get all this information already available. Somehow in this world of prevention, we still did not get this as a society to the point where we get subsidized for doing that. Because in Europe, for example, or in Austria, where I live, I don't get any subsidies. If I buy such a ring, if I go to the gym, for example, exercise regularly or buy healthy foods, no subsidies. But if I get a heart attack, or if I get cancer, or because I was smoking for 20 years, then I get the full program in the hospital. I get the doctors, I get the hospital, I get the treatment, I get follow ups and so on. And I think this is one big challenge we have to overcome. This mindset of we just treat patients if they become patients to preventing disease altogether. The thing is we already have the technology. It's already available with all these smart devices, even in vitro diagnostics where you could have a lab on a chip at home and just do, I don't know, once per month a blood test with a little chip at home where you can provide your blood sample and it gives you all the information.

Are you sick? Is there any risk for cancer, for example, and so on, please visit your doctor because there might be an issue. We already have the technology, but somehow we as a society don't appreciate that. We're not on that step saying, you know what, let's move from treatment to prevention. And the other big point I'm also seeing, which is not really working right now, is personalized and individualized medicine. Everybody is talking about that, saying in a few years,

your drugs and your medications will be personalized to you, but it's still not state of the art. The same with treatments. You get some generic information. Okay, if you're male or female, you get this treatment or that treatment, but what about your genetics? Some people are highly allergic to certain medications or treatments due to their genetics and other factors. Other ones are really taking, for example, drugs well if they take them, aspirin, for example, or other things, or painkillers and so on. The same painkiller could really help one person or make a situation worse for another person, and we're still not at this point of having this personalized approach. Then again, my question is, is this really a technological issue? Because I remember back in university, I learned that the first project to really analyze the human genome with the Human Genome Project cost, I think it took over 10 years to do so and cost over $1 billion to do that. I would have to double check that, but I think these are the numbers if I remember correctly.

Now I can provide my DNA to any startup company. They give me all the important information in two weeks and for $250. So it's not that hard anymore to do genetic analysis on yourself and really see what's working or not. So I don't think it's a technological challenge because it's already here. And even with AI, we could have so much more new information gathered and synthesized. I think it's a challenge that you have to convince the society that the old way how how doctors operate, how hospitals work, how insurances work and so on, that's not feasible anymore. We have to introduce a new system, but nobody wants to introduce that system because the first mover is always the one where probably there will be made, some mistakes will be made. If the first one is not working out, the others say, no, no, no, no, that was a bad idea. We stick to the old system. Maybe as a last point, I do believe that we have to do these changes because people are getting older, our demographics are changing. So it's not like that there are more and more young people available who maybe also finance the system. On the contrary, we have more elderly people who need more care because we have more complex diseases we didn't have before. Let's say 100 years before Parkinson's wasn't a big deal. High blood sugar, cholesterol levels, and so on. That wasn't diabetes. That wasn't a big deal altogether, which are coming more and more right now, obesity and so on, lung cancer and so on. We have these situations we didn't have 100 years before, but this also means that we have to adapt as a society. Long story short, I think on a technological level, we are already ready and could do so many changes. But I think as a society, nobody really wants to make this first step and say, forget about the old system. It's not working anymore.

We have to do this disruptive change. So it's getting better for everybody altogether.

Yeah, and I totally agree with you. I think that's more of a behavioral barrier and a mindset barrier. U .S. healthcare, it really is kind of like every person for themselves. It's not that like, we don't have group classes for certain things, but people don't think in the minds. Well, I will say, you know, I was in the trial for Novavax in the U .S., like just the final one for the COVID -19 vaccine. And there is definitely this mentality that like, Oh, yeah, I want people to make it better for me. But I don't really want to be one of those people. All you're talking about is like, just knowing how many people who are out there that are pre diabetic that we could incentivize to go to the gym. Unfortunately, I know that, you we could talk about

this at length, but like the dark side to that is that someone will then want to sell that information, saying like, oh well you should start pitching diabetic products to these households. I mean that already happens. I like the world that you're talking about and I would like to figure out how to help people to get there because we if we all work together we can age better together for sure. Getting through the behavior challenges I feel like is and I say this more as a behavior specialist and not a technical person but I feel like it is so much more complicated sometimes than technology and I'm not a technology person so I don't know how you engineers feel about that but we'll have to work together to

change society.

I fully agree with that and honestly I don't know why this is still not common knowledge especially for governments and politics that you can have a much better impact in society if you reward people, or give them positive rewards and punish them on certain situations. Because maybe let's take another example in my country, Austria, of course, healthcare is not free, because you don't have to pay a lot if you go to the hospital, but you pay 27 % of social security taxes on your income. So almost a third of your money is going away just for this tax, no matter if you're living healthy or unhealthy. But everybody has to pay the same. So if there would be a positive incentive, the government is saying you're starting at 40%. But if you're a non smoker, if you prove that you're having good basic values, if you're using a smart tracker,

for example, at home, showing that your blood pressure, your pulse and so on are okay, we could bring that down to 25 % or even 20%. Because on average, it will cost us much less than somebody who is a chain smoker obese and then eating hospital all the time. I think it would be such a great incentive for many people to say, you know what, I quit smoking because then I have to pay less taxes and then I get more money to spend on, for example. But then again, I know that many, many, many hospitals, but also the medical device industry is partially building on that, that you have sick people. And I can tell that from my industry, because I'm in the industry, it makes much more money to treat the cancer patient who has cancer for several months or even years, I can make many, many hundreds of thousands of dollars with that. But if I do a prescreening and I have one intervention, a surgical intervention that costs maybe $50 ,000, unfortunately, I'm making less money than with the chronic intervention.

And I think that's also one challenge we somehow have to overcome. The governments, but also the industry, make money out of sick people and not healthy people. And I think that's one big challenge we have to solve. And honestly, I don't know what the best solution for that is, because you need the industry, you need people and companies who innovate, but for innovation, you also need to pay money for that. At the same time, we should somehow also incentivize this topic of getting healthy, keeping healthy and staying healthy altogether so that you don't get cancer, or diabetes or anything else. I fully agree, it's a highly complex topic. And if somebody would ask me, well, what's the obvious solution? I say there is no obvious solution, because otherwise we would be already doing that. Everybody would be doing that.

I see more incentives that come from employers because they want healthy employees. But they're still not that substantial. Like they might reimburse a gym membership or they might, you know, give you credit for going to the doctor.

But you're right. It's a complex issue. I feel like we're gonna have to have a You're back, I had to ask you some more questions because I realized that we're running close to the end of the hour. Do you have time for a couple more questions right now?

Yeah, absolutely.

All right, well, we'll keep it on the brief side. I really wanted to ask, with all your experience, what prompted your interest in attending the MIT bootcamp? And did you really find that there were things that were new to you? And do you use any of the tools from the Disciplined Entrepreneurship Framework?

Absolutely. So I can answer everything with yes. Maybe starting out, what really interested me, it was really funny because I joined an Austrian version of, yeah, Shark Tank is the name of the series. We also have it in Austria.

It's just called Two Minutes and Two Millions, where you can get up to $2 million if you're pitching for two minutes. And after doing the pitch there, one of the guys said, and the investor said, hey, you know what? I have connections to the MIT bootcamp and you're a pretty smart guy. I would like to give you the possibility to join there and apply there. So that was the first time I heard about that. But after looking that up, I was like, okay, that's really interesting. And I can tell you why. Because when I had my first startup, I thought this is always a trial and error process. Because if everybody would know how to do a startup properly, everybody would be successful. And then I said, the bootcamp claim, I would say, yeah, structured approach of how to do startups, what to do first and second step, first step and so on. And I was not skeptical, but I was wondering, okay, is there really a secret formula to do that? And that would be really interesting to check the formula. And it turned out that during this bootcamp, there is a formula, the disciplined entrepreneurship you have mentioned. Of course, it will not guarantee that your startup is working out because there's never 100 % guarantee that something is working. But at the same time, I had the feeling that these steps that were introduced during the bootcamp massively reduced the risk of failure. Because if you start out with the product market fit, the problem, assembling the right people and the team, the probability is much lower that your venture will not work out, then if you start with the technology, then you go into development, then you try to find the team and maybe the right problem to use. So still today, I can tell you that the most important lessons learned for me were find the problem, find the real world problem, and it has to be a painful problem for people because we are having many, many problems in our lives. Also, I today, for example, if I look back on my day, there will be two

to face more problems, but I'm not willing to pay for solutions for them, because they're not really annoying me. These are small problems, but there are so many other problems out there where people would literally throw money at you so that you solve these problems. And that was one big learning for me. Really focus on the problem first. Nobody cares about what your solution is unless you don't have the proper problem matching to that. And I think one of the biggest risks, and that was also mentioned by the view count was it's quite risky if you first have a solution like a new technology and then you try to invent or find a suitable problem. Because then again, you love your technology, you've spent so much time on that and now you try to find a suitable market, which isn't impossible to do. It's still a viable approach, but I think it's much easier the other way around. This one information about finding the problem first and build everything upon that, that was so important to me. And also these early

steps about sell first, build then, get your customers as early as possible. Who are your customers? Are they really willing to pay? Because one example is in Austria, we have this weird mentality that if you're a startup and you talk to customers, nobody will be rude to you. Nobody will be telling you in the face, that's a bad idea or that's stupid or nonsense, but they also won't tell you that they will never buy it. They usually say, this is something typical Austrian. Oh, that's interesting. This is an interesting technology and unfortunately startups and founders think, oh, that means that they will buy it. Let's be honest.

I find the Lamborghini interesting, but I will never buy a Lamborghini just because it's interesting. So that's the big difference between there, that you really have to know that your customers are also paying for your product. And I think Bill Ouellette was the one who really made that quote saying that the only metric for a successful business is paying customers. It's not how much money you raise, it's not how many patents you have. It's really about do your customers pay money or not. And that's still my more start when I'm looking for projects and also for startups. Do I really find people if they're willing to invest money or not on these products?

Absolutely. Thank you so much. And we do have one last question I do want to ask that we always like to ask. Is that all right with you? Yeah,

absolutely. Thank you.

This question, I want you to interpret it however it makes the most sense to you, because it is quite open -ended. And the question is basically, what do you think has been the best lesson or takeaway from your journey so far, slash, do you have any words of wisdom you might want to leave with us?

So feel free to take that, whatever resonates with you best.

Yeah, that's really a good question. I've learned so much in the previous years and also in the previous decade, and then And there were so many aspects where I say that really helped me or that were big revelations. But I think the biggest takeaway I had, and if I remember correctly, it was also a quote by Naval Ravikant, where I really enjoyed because his summary of how to become really a good entrepreneur with having still good ethics and working on projects was that the priority is, first of all, what people I'm working with, that's number one, then what project I'm working on, and then how much time and energy and so on I'm investing in that. Because if I have the right people, if I have the right project, the third option won't be that important anymore because I will be so passionate about working about the project that I even don't care if it's 80 hours a week or more or something like that. Do it always in this priority. Who are you working with? What are you working on? And then only the last one, how are you working on that? That's the biggest takeaway I've learned from myself. And also I saw that Navara was having similar experiences there. I was really amazed that it's sometimes so simple. It's not about, okay, here's a formula with 200 elements that you have to put into there. Here are steps and

so on. It's also great. But what I've really seen is that I really enjoy working with the right people where I know that they have the right mentality. And then I'm also passionate about the product, but I can tell you what was also one of the biggest issues in my first startup was that after some time, I wasn't feeling the founder fit anymore. And if you lose that one, I think you lose all the hope in your project. But that would be my biggest advice on my biggest learning, choose the right people and then talk about what you would like to work

on. That's amazing advice. Thank you so much. And thank you so much for everything you shared with us today and for taking extra time.

Really appreciate it. I'm really glad that we got to do this. Spencer and I and the whole team behind Founders Voyage feel really fortunate to be able to meet people like you and interview them. And if people would like to stay in contact with you, what is the best way for them to do that? Or if they'd like to learn more about your work?

So first of all, I would like to thank you guys, because it's one thing that people have this knowledge, but it needs a channel, a possibility to communicate that knowledge, to bring it really to the community. So I want to thank you because you're taking your time, you're preparing and implementing Founders Voyage, and you're really spreading the message, so nothing that should be taken for granted altogether.

So I also thank you for inviting me today and providing a possibility to talk about my experience but also thank you so much on your side because you propagate this information and knowledge so that more startups can be successful together. So I really appreciate that and to answer that question I'm always available on LinkedIn. I think that's the easiest channel for you to reach out to me so if anybody is having questions about my entrepreneurial journey or the bootcamp or any similar topic I'm more than open and happy to

talk about that via

LinkedIn.

That sounds great. Now, we look forward to having you back, hopefully, as a guest, but thank you again for your time and we hope that you'll join us for other inspiring conversations with others. And feel free to nominate others if you would like to. And then to our listening audience, you can listen to our edited podcast on our website or on your favorite podcast platform by searching for Founders Voyage. And if you'd like to support the podcast, you can do that through our Patreon, patreon .com slash founders voyage.

So thanks again so much for more. And I look forward to continuing to stay in touch and hearing more about your journey.

Thank you so much.

Thank you. It was an absolute pleasure talking with you.

Thank you. Same to you. And let's keep in touch. And I'm looking forward to further engagements in the future. Thank you.

Definitely.

Have a great afternoon. Have a great day. Thank you very much.

You've just finished another episode of Founders Voyage, the podcast for entrepreneurs by entrepreneurs. The team at Founders Voyage wants to thank you from the bottom of our hearts. We hope you enjoyed your time with us. And if so, please share this with someone else who might enjoy this podcast. You can also support us by leaving a review on Apple Podcasts and Spotify, and by donating to our Patreon. Outro Music today is Something for Nothing by Reverend Peyton's Big Damn Band.