“My advice for you is to use your very best judgment in making life’s major decisions; follow your passion and your heart as you embark on life’s wonderful journey that lies ahead of you. Pursue your dreams until the day you die. Don’t take yourself too seriously and laugh every single day. Live your life ‘The Carolina Way,’ with hard work, humility, honesty, integrity, caring and become the ultimate team player. Do this, and good things will happen.”
As a successful serial entrepreneur, innovator, angel and VC investor, CEO and board member, William (Bill) N. Starling, shared those words as the keynote speaker for the University of North Carolina at Chapel Hill Kenan-Flagler Business School graduation ceremony, and they ring true for professionals at any stage of their career.
As with many medtech entrepreneurs in Silicon Valley, his life has been touched by Dr. Fogarty, who was his first and enduring mentor. Their paths initially crossed when he was working at American Edwards Laboratories (Edwards Lifesciences) as a marketing manager for vascular catheters and instruments, where he first became familiar with Dr. Fogarty’s legacy.
Since then, his career has taken off. He first served as director of marketing for Advanced Cardiovascular Systems (ACS), which was acquired by Eli Lilly (Abbott Vascular) just over two years after he joined the company as its 14th employee. He later co-founded Ventritex, backed by Dr. Fogarty, which developed the world’s first microprocessor-controlled implantable cardiac defibrillator. The company became one of Silicon Valley’s biggest success stories as it was sold to St. Jude Medical/Abbott and today is a $2 billion contributor to its revenue. He went on to co-found and serve as chairman of the board, president and CEO of Cardiac Pathways (Boston Scientific), the first FDA-approved company to develop a minimally invasive system used to diagnose and treat ventricular tachyarrhythmias.
In 2000, along with Richard Stack, MD, he co-founded North Carolina-based Synecor, a company focused on generating new life science companies, and in 2006, he co-founded Synergy Life Science Partners, a $143 million VC partnership, where he remains active. Bill also has served on multiple boards, including iRhythm Technologies, InnAVasc Medical, Yorlabs, Senaptec, the Stanford Stroke Center and the Kenan-Flagler Business School.
We recently had the privilege to catch up with Bill to learn more about his career, his passion for founding companies, trends he sees in the industry and tips for early-stage entrepreneurs.
Q. How did you first get into healthcare?
A. After graduating from the University of North Carolina and heading west to attend the Marshall School of Business at the University of Southern California where I received my MBA, I was considering several job opportunities; the most intriguing was an offer from the American Edwards Laboratories (now Edwards Lifesciences) as its first sales trainee. At the time, I didn’t know anything about heart valves or catheters or even salesmanship, but their goal was to train a promising MBA graduate as part of a pilot program, which became a significant tool for hiring future territory managers.
Following the training, I joined the technical sales force and after two years in Milwaukee selling Edwards heart valves and Swan-Ganz catheters, I was promoted to the marketing management team where I was initially tasked to research, write and produce a Fogarty Embolectomy Catheter in-service manual for the domestic and international sales/clinical service organizations that distributed Dr. Fogarty’s devices.
After spending many weeks in the University of California, Irvine, Medical School Library, I came to realize the deep impact of Dr. Fogarty’s invention – prior to the Fogarty embolectomy catheter, approximately 50% of all acute arterial embolization cases resulted in lower leg amputation and/or death. Today, the Fogarty Embolectomy Catheter is still the “gold standard” for acute arterial embolization.
This made a profound impression on me that has lasted throughout my career as it demonstrated the significance of a single medical device invention on millions of lives (16 million since the Fogarty embolectomy catheter was invented) and motivated me to pursue a career in healthcare, pursuing a path of “finding a better way.”
Soon after the Fogarty in-service manual was completed, I met Dr. Fogarty and we have been steadfast friends and business colleagues ever since. He has been one of my most valuable mentors in both life and business.
Q. You have played many roles throughout your career — as an entrepreneur, CEO, board member and investor. Which has been most rewarding?
A. There are many valuable aspects of working in healthcare and in the medical device industry; first and foremost, of course, is the positive impact we have on patients.
In terms of what I have enjoyed doing the most during my 37+ years in this industry, it’s founding a company, running it for the first few years to ensure it’s on solid ground and then moving on to launching the next innovative medtech device startup. To me, the early stages are the most challenging and rewarding.
As a high school varsity football, basketball and track athlete in my native North Carolina, I loved winning. That competitive spirit has helped me immensely during my career, in terms of persevering during the tough times that medtech startups inevitably face and always keeping the end-goal in mind. In sports, that is winning, but in medical devices it’s getting a new, better therapy to patients.
I have been very fortunate in my career to be part of co-founding more than 11 companies, eight of which spun out of Synecor. Through partnerships with very talented and creative teams, we have been able to make a meaningful impact, I believe, in healthcare today. While I am considering formal retirement now, I still plan to continue contributing as a board member, mentor and investor in promising startups.
Q. What are some of the trends you are seeing in the industry?
A. I recently had the privilege of speaking at the Frontiers of Entrepreneurship Conference in Palm Beach, Florida, where I addressed this very topic. Unfortunately, medtech has not been the top choice for investors for many years now. The VC funding in this space now often takes place later, when startups are more established. Therefore, early-stage entrepreneurs are required to create more efficient business models and to seek funding from non-VC sources early on, including family and friends, angel/seed, family office investors, and non-dilutive grants and loans, among other sources of capital.
The cost of innovation today is too high: Prior to the 1976 federal law that created the FDA, it would take between two to 14 months from concept to first human use, with a maximum of approximately $30,000 spent on R&D (for example, the Tissue Heart Valve from concept to first human use). Today it can take between three to 17 years to get to market at a cost as high as $2 billion+ to commercialization (for example, the TAVR from concept to U.S. approval, which was the 42nd country to approve this revolutionary procedure in today’s $4 billion TAVR market).
With that said, while the headwinds are strong, this requires early-stage companies to stretch to figure out the right formula for success. That ultimately makes them more resilient and effective as it forces them to focus on delivering a higher-quality solution. To me, this has been a welcome challenge – while the bar is higher, the rewards are also higher for the patient, the startup and its investors, which in turn creates additional investment opportunities in medtech.
Q. What tips do you have for early-stage entrepreneurs who are striving to get their devices to market?
A. Having a strong, committed, and diverse team with an experienced CEO who can help you raise money is critical to the success of a startup. When I first started in this industry, I considered myself the least innovative person…but, I found a successful formula in partnering with bright engineers and innovative folks like Dr. Fogarty, then combining it with my business acumen. I truly believe this is the most successful way to move a company forward.
You also need mentors you can lean on and learn from. I was extremely fortunate to be mentored by Ray Williams, a superstar angel investor in Palo Alto, who taught me how to run a startup the right way. Young companies need to seek this kind of mentorship and expertise to get to the next level, and that’s one of the benefits that the Fogarty Institute provides. It’s the ideal place to leverage that kind of mentorship with its seasoned leadership team. In the future, I intend to spend more time at the Fogarty Institute helping mentor the next generation of entrepreneurs who will affect the future of healthcare – my way of giving back.
As I said in my commencement speech at the University of North Carolina, professional relationships that you develop will greatly affect your future. Nurture them and they will positively impact your career and personal lives.