I see trends. Some are obvious. Others are not.
The shrinking startup is really happening today, but it is subtle.
Because of the relentless force of technology, its takes less people to generate the same about of sales in a company each year. Exhibit A is the number of workers needed to generate $1M in sales in the S&P 500 over time. The same thing is happening in ortho… just latter.
The Premise:
The structure and agility of emerging orthopedic companies are on the brink of a major shift. This transformation isn’t driven by traditional factors like funding or innovation alone, but by the ability to bring new products to market faster and with fewer full-time employees (W2s).
Why is This Happening ?
Today, the smart emerging orthopedic companies are leveraging operating efficiencies in five key areas:
- External Experts
Specialized 1099 consultants across various fields such as R&D, patents, prototyping, testing, wet labs, and regulatory affairs can be brought in for specific tasks, delivering high-value work and then stepping aside. In late 2024, there is a significant pool of highly skilled orthopedic experts available at competitive rates, making this model even more appealing. - AI Software
New AI tools are transforming productivity, enabling a single employee to perform the work of three in terms of both output volume and speed. With these tools improving at an exponential rate—doubling their capabilities every few weeks—it’s hard to predict just how far their impact will extend into 2025 and beyond. - Global Arbitrage
Professionals and surgeons who are top of field (and maybe even trained in the US) live in more affordable regions of the world offer another avenue of operational efficiency. As I’ve previously discussed, startups should also consider conducting First-in-Man (FIM) surgeries in these regions to accelerate clinical feedback and product development. - Decentralized Workforce and Remote Work Models
With remote work becoming more normalized and supported by advanced collaboration tools (Slack, Zoom, Trello, etc.), startups can access a global talent pool without needing physical office space or large teams concentrated in one location. Remote-first models reduce overhead costs and streamline operational management, further minimizing the need for on-site staff. Additionally, the ability to hire remotely opens the door to specialized skills globally, often at lower costs due to geographic wage differences. - No Physical Office
The virtual office model has revolutionized how startups operate, making physical office spaces largely unnecessary. With tools like Zoom, Slack, and Asana, remote teams collaborate effortlessly from anywhere, eliminating geographic constraints and reducing overhead costs. This decentralized approach allows startups to access global talent, create flexible work environments, and scale without the expenses tied to traditional office infrastructure. By leveraging automation and cloud-based platforms, companies can streamline operations, increase productivity, and maintain agility—enabling them to achieve more with fewer employees.
I believe in this trend so deeply, that I am actively testing this premise with a new venture model called The Bone Factory. In the first few weeks, its working.
Currently we are working with two surgeon groups to efficiently turn product ideas into products.
Read more below to learn about The Bone Factory.
The Bone Factory specialize in transforming surgeons concepts into commercial products through a dynamic, agile approach.
Website – https://thebonefactory.co/
Why The Bone Factory?
- Speed: Quick design, testing and iterations with honest feedback.
- Expert Network: Access top-tier Engineers, Regulatory, Finance, Marketing, Sales experts who know how to convert your idea into a product.
- Lean: No need for large teams or big funding early.
- Virtual Model: Work seamlessly with us, no matter where you are.
- Surgeon is in control: You control how far to take your idea – egs: working prototype, patents, cadaver labs, mechanical testing, market testing, regulatory filing, commercialization, spin out a new company, etc.
If you are an orthopedic surgeon with an idea for a better treatment (product, service, diagnostic, etc.), contact Tiger at The Bone Factory – tiger@tigerbuford.com.
The BoneFactory core team will have with an introductory video call where you can share your concept and share what your desired outcomes are (patent, working prototype, testing, regulatory pathway definition, full FDA clearance, go-to-market commercialization plans, etc). We can turn your idea into a product.
👉 Contact Tiger Buford at tiger@tigerbuford.com to schedule an introductory call.