Paying Customers Is Proof
It’s the only proof you created wealth.
Intro
Paying customers are the only proof you have that you created wealth.
If you want wealth, and people aren’t using your products or services, maybe it’s not because you suck at sales or marketing.
Maybe it’s because you haven’t built what they actually want.
This matters in the $1.1 trillion-a-year drug and device industry where deals take years, pilots stall, and enthusiasm rarely turns into new business.
Why Deals Die
For the last few weeks, I’ve been talking to CISOs, product managers, hospital leaders, MedTech executives, and people who’ve sat inside more procurement meetings than anyone should have to endure.
I went in with a hypothesis that in this age of rampant ransomware, cybersecurity can be turned into a sales weapon, like this:
Security reviews slow deals.
If we speed them up, revenue speeds up.
I’ve found that this hypothesis is wrong.
• Yes, security assessments are annoying.
• Yes, they’re bureaucratic.
• Yes, they waste time and rarely create a more effective security countermeasure plan.
But security is part of IT internal positioning, not a deal killer for acquiring MedTech.
I asked people - “From your perspective, what’s the biggest thing that slows down or blocks MedTech sales today?”
Here’s what they told me.
The Three Things That Kill Deals
One of the cleanest framings came from Gary Levit, who’s seen MedTech deals from the inside for years:
Lack of reimbursement
Lack of clinical understanding
Lack of strong clinical data/evidence to support claims
Heather Andrews at NAMSA sharpened it further:
Reimbursement is addressed last — if at all
Sales teams don’t understand real clinical workflows
Key decision-makers are often not clinicians
Drug reimbursement logic is wrongly applied to devices
Departments that pay are not the ones that benefit
The picture is stark -
MedTech Deals don’t fail because products are weak.
They fail because customers don’t understand their revenue logic.
Why Cybersecurity Isn’t a Lever in Healthcare
Hospital IT teams are drowning in ransomware risk.
That doesn’t make them innovation buyers.
Their mandate is defensive:
Protect operations
Avoid outages
Minimize downside
Security is a cost center — necessary, but not value-creating.
Even when security reviews are painful, hospitals don’t look at them and think:
“This is where we should innovate.”
Otherwise, the Excel checklists would have been replaced a billion stolen credit cards ago.
IT thinks:
“This is something we have to survive.”
That’s why speeding up security reviews doesn’t speed up deals.
It’s a marginal reduction in friction in comparison to a MedTech vendor without reimbursement codes.
Where your Deals Die
Your deals die in back rooms.
They die when:
A clinician is convinced — but reimbursement doesn’t exist
A purchasing manager optimizes for unit cost while outcomes live in another business unit
A sales pitch addresses the wrong clinical work flow
A non-clinical decision-maker vetoes a deal they were never spoken to
A device is sold like a drug — and paid for like furniture
None of these are security problems.
They are revenue system failures.
Hospitals Are Not Rational Actors
This is a hard truth for MedTech and Digital Health founders to accept.
Hospitals don’t behave like a single buyer with aligned incentives.
They are collections of departments:
Clinical teams optimize for outcomes
Purchasing optimizes for price
Finance optimizes for predictability
Operations optimize for flow
If your product benefits one group and costs another, you won’t close.
Your deal will die quietly in a back room.
The Real Gap: No One Owns Revenue Logic
Most MedTech and TechBio companies have:
A Head of Sales
A VP of Product
Regulatory assurance/QA experts
Clinical advisors
What they don’t have is the ability to answer one brutal question:
Why is this deal rationally correct, yet economically impossible?
Point decision-maker objections handling doesn’t close complex MedTech deals.
You need the full decision system in your heads-up display.
Introducing OpenCRO
The Open Chief Revenue Officer
OpenCRO diagnoses why revenue is blocked — and tells you how to unblock it.
It helps you:
Diagnose why sales are blocked
Surface misaligned incentives
Identify missing stakeholders
Expose reimbursement dead ends/clinical data vulnerabilities early
Security and privacy still matter.
But they are constraints — not the drivers of a deal.
A Different Question
Most risk management tools tell you:
“Are you compliant?”
OpenCRO tells you:
“What you have to change to do the deal”
OpenCRO takes you from a defensive perimeter to the offensive edge of revenue and speed to deal.
What Comes Next
This essay isn’t a launch.
It’s a line in the sand.
If you’re building in MedTech or TechBio and wondering:
Why pilots don’t convert
Why sales cycles stretch endlessly
Why enthusiasm doesn’t turn into contracts
The answer is not because you suck at sales and marketing.
And it’s definitely not a better threat model.
It’s broken revenue logic.
I’m building OpenCRO to help you fix that.
Jump on a call to learn more. I’m happy to share my learnings. Grab a time that’s convenient for you here.
This Week on Life Sciences Today
My guest this week was Philip Poulidis, CEO of Odaia AI in Toronto.
Odaia AI is a real-time AI platform for pharma commercial teams (sales reps, MSLs, marketers).
Spun out of University of Toronto and University of Lausanne research in 2018, Odaia ingests disparate data (prescriptions, claims, market access, digital engagement) and, via its Sherpa engine, automates cleaning, labeling, and feature creation—no customer data warehouse needed. The platform builds patient- and HCP-centric profiles and delivers real-time targeting and next-best-action guidance, replacing crude decile rankings with dynamic, context-aware insights. It orchestrates true omnichannel engagement (field + digital) to avoid oversaturating HCPs and is sold on a per-brand, per-indication basis with unlimited seats and data, encouraging broad adoption and a data flywheel. Odaia measures impact via adherence to its recommendations and Rx lift across therapeutic areas including immunology, respiratory, neurology, oncology, and rare disease, integrating seamlessly with Veeva, Salesforce, and data partners like IQVIA.
Visit Odaia here
You can see the episode here - Real-time pharma insights
About me
I’m a writer, host of Life Sciences Today podcast, ex-pharmatech founder, father of 4.
I’ve been building in tech, cyber, privacy, and clinical data for 25+ years across Israeli medical device startups, Verily, Amgen, and the Fortune 1 company. I work at the intersection of engineering, AI and clinical data.
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