Leadership Skills for MedTech Founders and CEOs

In today's fast-paced world, leading a MedTech startup presents unique challenges. It requires more than just technical skills or innovative ideas. The recent webinar, "Leadership Skills for MedTech Founders and CEOs," presented by Avio MedTech Consulting and led by executive coach Nirav Sheth, explored what distinguishes competent founders from truly effective and resilient leaders.

If you missed the webinar, you can watch a recording below

Avio Medtech and Nirav Sheth Present

The Startup Reality: Leadership Beyond the Technical

In early-stage medical device companies, the focus often leans heavily on technical aspects. This includes navigating regulations, achieving R&D milestones, and securing funding. However, the human and leadership elements are frequently overlooked. These elements are just as critical as a well-designed prototype. As Sheth emphasized, leadership in startups is fundamentally different from that in large, resource-rich organizations. Founders must operate with scarce resources, face relentless uncertainty, and deal with constant personal stakes.

Making It Personal: Where Are You Growing As a Leader?

Instead of relying on abstract theories, Sheth encouraged attendees to reflect on their most pressing performance goals for the coming year. He posed several questions for founders to consider:

• What is your most important goal for fiscal 2025?

• What is the biggest challenge you face in reaching this goal?

• Which leadership skill, if sharpened, would most move the needle for you?

  
  

Audience responses highlighted common dilemmas:

• Engaging and building credibility with investors

• Balancing urgent priorities with limited time

• Onboarding and motivating new team members

• Building resilience in tough fundraising environments

• Learning and scaling as first-time CEOs

• Hitting ambitious commercial milestones while maintaining product quality

  
  

The Most Universal Leadership Challenge: Mindset

Common startup pain points—capital raising, managing uncertainty, building high-functioning teams, balancing strategy and execution, and burnout—were not addressed as separate problems. Instead, they were viewed as different facets of a single challenge: mindset.

Sheth presented his hypothesis, informed by research in positive psychology and neuroscience. Almost every leadership skill can be enhanced by working on mental habits and mindset. He illustrated this with the well-known "two wolves" metaphor: every person has both negative and positive internal voices, and performance is determined by which one we choose to feed.

The Mental Models: Saboteurs and Sages

Central to the workshop was the "Sage vs. Saboteur" framework, derived from the Positive Intelligence model.

Saboteurs

These are self-limiting mental habits and stories that undermine performance. The principal saboteur is "The Judge," who tends to self-criticize, blame others, or fixate on what's wrong. Other common saboteurs for startup leaders include:

• Controller: The need to control all outcomes

• Hyper-Achiever: Overidentifying with success

• Restless: Constant dissatisfaction, chasing the next thing

• Stickler: Perfectionism taken to extremes

• Pleaser: Sacrificing personal needs to appease others

• Hyper-vigilant, Avoider, Victim, and Hyper-Rational each present their own traps.

  
  

Audience members candidly recognized themselves in several of these patterns—avoiding tough conversations, restless multitasking, people-pleasing, perfectionism, and more.

The Sage

This represents the higher-brain mindset associated with equanimity, curiosity, creativity, and resilience. Sheth described five “sage powers”:

• Navigate: Vision, purpose, and big-picture thinking

• Empathize: Self-compassion and empathy for others

• Explore: Curiosity and open-mindedness

• Innovate: Creative problem-solving and collaboration

• Activate: Laser-focused execution and flow

  
  

The “sage perspective” is summed up by the belief that every challenge hides a gift or opportunity. Sheth illustrated this with a memorable story about adversity unexpectedly turning into advantage.

Practical Applications: How Mindset Tools Build Real-World Leadership Skills

Sheth methodically tied each core startup challenge to specific elements of the sage mindset:

Investor Engagement

To engage investors effectively, use the Empathize power to build authentic relationships. Utilize Navigate to inspire with vision rather than just data. Finally, employ Explore to understand what truly matters to investors.

Managing Uncertainty

Use the Navigate power for big-picture thinking and anchoring to purpose. The Activate power helps in making focused decisions and executing effectively, avoiding paralysis.

Team Building and Motivation

Utilize Activate and Navigate to align the team. Use Empathize to delegate effectively and build trust, including self-compassion to avoid trying to do everything alone.

Balancing Strategy and Execution

The interplay of Navigate and Activate powers is fundamental to achieving this balance.

Preventing Burnout

Incorporate Empathize (self-care), Activate (prioritization), and the sage perspective to reframe stress and setbacks constructively.

Sheth's essential claim, supported by his coaching experience and behavioral research, is that leadership excellence comes from building “mental muscles” that default more often to sage mode and less to saboteur patterns.

Building Sage Muscles: Micro-Practices and Neuroplasticity

Awareness alone isn’t enough—change occurs through new habits. Sheth shared simple “micro-mindfulness” exercises, such as a 30-second focused breathing or tactile anchor (rubbing thumb and forefinger together). These can interrupt negative rumination and reinforce sage wiring. He referenced neuroscience: just as physical muscles grow through repeated reps, so do these brain circuits, thanks to neuroplasticity.

Consistency is key. Even tiny practices, repeated over weeks, can begin to tilt the balance toward more positive, resilient, and resourceful leadership responses.

Resources and Community

Sheth closed by offering free resources:

• A saboteur assessment to identify an individual’s dominant negative mental habits

• A “sage strength” survey to baseline current mindset habits

• Invitations to ongoing peer community gatherings for MedTech founders and CEOs to foster mutual leadership growth (all offered pro bono by Sheth as part of his practice)

  
  

Additionally, he described a formal leadership development program focused on reinforcing these mindset muscles in a structured, accountable way.

Real-World Nuance: Neurodiversity, Energy Management, and Accessibility

During the Q&A, one founder shared how neurodiversity (being on the spectrum/ADHD) created both strengths and additional internal saboteurs, especially under stress. Sheth acknowledged that “changing your mindset” isn’t achieved by wishing—it requires sustained, practical micro-practices. Even something as small as a 30-second mindfulness pause can measurably shift the internal balance and lower emotional reactivity.

Conclusion: "Be the Sage"

For MedTech founders and CEOs, technical or market insight alone is not enough. Leading in this field is a marathon filled with ambiguity, obstacles, and reinvention. The key message is clear: transcending recurring leadership challenges is less about acquiring new tips and more about fundamental shifts in how you think—about yourself, about challenges, and about opportunity itself.

The actionable takeaway? Be the Sage. Make time for small, often-overlooked mindset practices. Develop your self-awareness of "saboteurs," and deliberately strengthen your capacity for compassion, vision, curiosity, and focused execution. In doing so, you’ll not only grow as a founder—you’ll build the leadership stamina your company (and your mission) demands.

If you would like to connect with Nirav Sheth, you can reach him at niravsheth@stratosphere-llc.com or visit his website https://stratosphere-llc.com/