Congratulations! You are helping to build a growing orthopedic company.

The first 5 or 10 people that you hire will either set you up for success or break your company. Each person you add is a key building block to the foundation. Be generous with the equity at this stage. Keep the company flat. Be quick to fire if someone doesn’t work out. But most of all… avoid hiring mistakes.

Once you reach 20 or 30 employees, the recruiting process will be out of your hands. Your early hires will now be in charge of the recruiting. If you hire poorly at the start, then you will create a weak link in your company’s recruiting DNA forever.

I have seen orthopedic startups make 6 hiring mistakes that I would like to share with you.

6 Hiring Mistakes to Avoid

1) Settling for a “B” Player

Don’t EVER EVER EVER let a B Player into your company! If you let the B Player in, then you will gradually be surrounded be C Players and your company will rot from the inside out. I have seen it happen.

The old axiom is true: A Players hire A Players. B Players hire C players. And C Players will kill your company.

Why? A Players are not intimidated by smart hardworking people, so they hire A Players. They hire up. B Players don’t want to be challenged, so they hire C Players. The hire down.

Actively screen out all of the B candidates.

2) Using Consensus Hiring

Unfortunately, I have seen that most startups use still using consensus-based hiring. The reason is obvious. It’s all about cultural fit. The CEO wants everyone to be comfortable before making an offer to the candidate. In a small office, going from the 10th to 11th employee is a big deal. After a candidate finishes meeting with everyone, the CEO will take everyone’s temperature. If everyone is mostly positive about the candidate, then an offer will be made.

This hiring by consensus process is dangerous because the group can accidentally hire someone that everyone is “lukewarm” on and no single employee is responsible for the mistake. It’s “group think” at its worst. This is called a Consensus-Based Hiring.

I recommend a better system – Champion/Challenger Hiring. In the Champion/Challenger system, any one employee can stand up and “Champion” the candidate and recommend making the offer. They must feel strong enough to stake their reputation on the individual. The only check-and-balance in this system is that any one employee can also veto the offer, a “Challenger”.

Try it. I promise that the Champion/Challenger system will deliver more “A” Players to your company.

3) Converting a “Big” Company Hire

I have seen startups hire individuals who are really not wired for work in the startup.

I talk with startup CEOs each week and they usually say the right things, “I don’t want anyone who has been brainwashed at Stryker or Zimmer for years.” The fear is hiring an individual who isn’t cut out for the startup life even though these individuals are often smart, driven and capable. They have done well in the big environment but have had far-reaching resources to lean on. Without knowing it, these individuals have become “institutionationized”. Read the frog article to learn why good people get stuck in the big orthopedic companies.

Sometimes CEOs try to make an exception. They will fall in love with the “lifer” candidate from Stryker or Zimmer, then take a chance on bringing them in and teaching them the ‘startup way”. Rarely does this work out unless the candidate has an innate entrepreneurial spirit that is sprinkled throughout their past, in school or moonlighting business activities.

A good rule of thumb is to stay away from the “lifers” at the big orthopedic companies.

4) Hiring Attitude Last

Often startups get fixated on skills, past accomplishments or pedigree of a candidate and overlook their attitude.

Check the candidates’ attitude. In startups, an employee may sometimes work 16 hours a day, seven days a week. If the employee doesn’t have the right attitude, they will not survive. Nothing beats great attitude. Period.

Hire based on attitude first!

5) Hiring Before Understanding Motivations

If you don’t understand an individual’s motivations for joining your startup, then you may get stung later on.

I’ve seen individuals who joined for the initial euphoria with expectations of fat bonuses, the chance for rewarding creative work, and maybe a magical IPO in the first year. When that didn’t happen, they left.

I know attrition is a reality of life, but the exit of an employee from a cohesive team at a critical hour does more damage than you imagine. What gets affected most are the morale and spirit of those who stay, and that can take weeks, if not months, to bounce back from. All because you hired a person whose motivations were not in sync with the company’s plans and culture.

Figure out what is motivating the individual to join your company BEFORE making the offer.

6) Force Fitting into a Budget

I have seen startups say, “but this is all we can pay for the position right now”. This small thinking can really hurt. I understand that most startups are bootstrapping and have to watch their cash very closely, and most run in the red.

The mistake here is to evaluate only those candidates who fit into the given budget while screening out the best candidates with true skills and accomplishments. While I agree that you need to be pragmatic about budgets, you need to find motivated people who value passion, creativity, experience and learning for what it really is beyond money. There’s no purpose in winning a battle but losing the war.

Delay the hire until you can pay for the rock star.