I notice trends.
After decades of startups, recruiting, podcasting, and pattern-matching across thousands of conversations in this industry, I’ve realized that most orthopedic careers aren’t a ladder—they are an orbit.
We all start with high velocity, but eventually, the gravity of "the machine" changes our trajectory. Whatever your role (sales, technology, R&D, marketing, clinical, regulatory, ops, etc) you are likely sitting in one of these five distinct stages right now - Wow, More, Scratch, Stagnation, Flight.
Let's look at each stage in more detail.
Play along at home and to see where you are.
1. Wow (The Entry)
This is the honeymoon phase. You’ve just entered the inner circle. You’re holding a revision hip or watching a robotic-assisted TKA for the first time, realizing your work actually changes human mobility. The "Why" is effortless.
2. More (The Ascent)
Competence has kicked in. You have "bagged" wins, hit quotas, or launched products. Now, the hunger starts. You aren’t just happy to be here; you want a bigger territory, a broader portfolio, and a seat at the table. You are optimizing for growth.
3. Scratch (The Friction)
This is where the industry tests your res...
