Let's talk about the importance of two-way doors versus one-way doors.
A one-way door decision is nearly impossible to reverse and requires deep deliberation because the stakes are so high.
A two-way door decision can be easily changed or undone if it doesn't work out, meaning you can act quickly.
One-way door decisions can kill a young company. Most ortho startups die not because of bad tech, but because they treated every decision like a “one-way door”—permanent and unchangeable.
In the garage-to-growth phase, the name of the game is speed. You don’t have time to wait for perfect information. You need to move, test, learn, and adjust—fast. That only happens when you treat most decisions as reversible.
At the end of this article, I will detail 5 illustrative examples that contrast 1-way and 2-way decisions in these 5 areas:
Regulatory Strategy: PMA vs. 510(k) Predicate
Operations: In-House Infrastructure vs. Contract Manufacturing
Product Development: Core Implant Mechanism vs. Instrumentation
Commercialization: Sales Channel Architecture
Clinical Focus: Flagship Indication Selection
Two-way doors.
I learned this the hard way (and the right way) at Ellipse Technologie...
