I often write about how working in a Startup Ortho is better for your career than working in a Big Ortho.  However, I don’t want to throw Big Orthos entirely under the bus.


First let’s review the differences between Big Orthos versus Startup Orthos. 


Review of Big Ortho

  • Focus is on short-term profits while avoiding risk.
  • Work culture is that you are cog in a giant system.
  • Teams of thousands of people in different locations.
  • Execution of business processes for growth.
  • Huge cash available to fuel business.

Review of Startup Ortho

  • Focus is on risk with big returns in the long-term.
  • Work culture is more human
  • Small “tribe-like” team in one location.
  • Innovating to survive.
  • Little cash flow to fuel the company. 

After reading these contrasting points, you may see Big Orthos as boring monsters and Startup Orthos as exciting risky ventures.  However, the existence of both is vital for our industry.

Good people need to work for Big Ortho monsters, while risk-takers need to innovate inside the Startup Orthos. To clarify, the Big Orthos may not be innovative in their new product development, but they are extremely innovative in their acquisition strategies. 


Big Orthos and Startup Orthos need each other. 

Startup Orthos are the R&D fuel for the Big Orthos. I have found that 90% of the acquired companies in orthopedics are startups (read the entire list here).

Stryker acquired MAKO because they weren’t doing enough in robotics. Wright Medical acquired Cartiva because they weren’t doing enough in cartilage.  Startup Orthos have become the R&D platform for the Big Orthos.

The orthopedics industry would not grow without Big Orthos working at scale.  Big Orthos service the surgeons, hospitals, ACS, distributors and patients worldwide with a massive scale of products, sales professionals, warehouses, etc.  They also stockpile cash that enables them to acquire startups without affecting their quarterly earnings performance. 

Hug a Big Ortho today. They make the orthopedic world go around.


Let’s be grateful for each other.