Every week I talk with orthopedic founders who are asking the wrong question: How do we get big enough?
Big enough for the next raise.
Big enough for a national distributor.
Big enough to look credible next to the majors.
Big enough for the hospital committee to stop treating you like a science project.
That question will kill you.
If you have spent any time on OrthoStreams, you already know the rule: Business Model > Product.
Most startups do not fail because the implant is useless. They fail because they chase thousands of lukewarm surgeons while ignoring the few customers who would actually keep the company alive.
The contrarian move is simple: Stop hunting national share. Build a small circle of true fans.
The Sacred Cow
The deck always says the same thing: “We need broad adoption.”
No you don’t. You need depth.
The big orthos are built for breadth. Every tray. Every hospital. Every “just in case” size. That model needs an army and a balance sheet.
Your startup is not that company. Play their game with 18 people and a Series A, and you will drown in instrument sets, stale inventory, and “maybe next quarter” accounts.
You do not need 5,000 surgeons. You need a few dozen who...
