How Every Medtech Founder I've Interviewed Has Made the Same Healthcare PR Agency Mistake

Every medtech founder I've interviewed about hiring a healthcare PR agency has made the same mistake.

They walked into the engagement expecting the agency to produce press releases, media pitches, and a longer Google News page. They walked out twelve months later with more press hits and no market position, and they didn't understand the miss until they compared notes with a founder in an adjacent category who had done the opposite.

The mistake is the healthcare PR agency category itself. Or more precisely, the way medtech founders assume the category means one thing when it means something completely different in the shops that really produce market position.

The healthcare PR agency conversation is one of the most consistently misframed decisions in medtech marketing. Founders expect press coverage. What they need is category definition, market narrative, and the point-of-view discipline that turns a company into the recognized voice of its segment.

Great companies don't wait for markets to form. They engineer them through consistent narrative work, and the healthcare PR agency that produces that engineering is a completely different shop than the one that produces press releases.

Over 400+ episodes of State of MedTech, the pattern is consistent.

Every founder I've watched hire a traditional press release shop ended up with the same disappointing result twelve to 18 months later. Every founder I've watched hire a category-and-narrative shop compounded market position that shortened sales cycles and lifted round valuations.

Takeaways

• The healthcare PR agency medtech founders think they're hiring produces press releases. The one they need produces category definition, market narrative, and category authority that compounds.
• Bruce Cleveland is direct on the show. Category definition, messaging, and positioning are what matter in a market with a cacophony of voices. Press hits alone don't move a category.
• A strategic narrative is a specific worldview medtech founders repeat until the market adopts it. Vanilla PR content doesn't earn attention in a saturated medtech news cycle.
• Novelty and a strong point of view are what get attention. Great companies don't wait for markets to form. They engineer them through the narrative discipline a real medtech PR strategy delivers.
• The compounding curve of medtech PR is 12 to 18 months of consistent point-of-view work. After that, the phone rings on its own.

Why Category Definition and Positioning Beat Press Coverage Every Time

I made this exact point in an episode about how market engineering helps medtech startups raise capital:

"Messaging is your positioning, your differentiation, your proofs. Narrative comes down to thought leadership, your point of view market education."

That is the actual scope of a healthcare PR agency built for the market realities medtech founders operate inside.

Messaging is the first output layer.

Positioning against competitors, differentiation on specific proofs, and the exact language the founder uses when describing the company to a physician, investor, or acquirer. Every press release, LinkedIn post, and interview should reinforce the same messaging spine.

Narrative sits underneath messaging. It is the point-of-view market education a healthcare PR agency should deliver as its primary work product.

A specific worldview about where the category is going, why the incumbents are wrong about it, and what the founder is doing that will bring the market closer to that view.

Press hits without narrative underneath are unattached impressions. With narrative reinforcement, they compound into category authority across the 18-month window. That difference is what separates a medtech PR strategy that produces category leadership from one that produces a longer Google News page.

Bruce Cleveland on Why Positioning Beats Volume in a Cacophony of Voices

I interviewed Bruce Cleveland on an episode about the truth about product. His frame on category work is the one every medtech founder should sit with before signing a healthcare PR agency contract:

"Thought leadership, category definition or redefinition, storytelling, messaging, positioning. These things become critically important because you're dealing with a cacophony of voices out there."

Read that as the operating environment for medtech PR strategy.

The medtech news cycle is saturated. Every week there is a new FDA clearance, a new funding round, a new pivotal trial readout, a new AI-enabled device announcement. A press release from a Series A medtech company enters that cycle and disappears within seventy-two hours. Volume alone doesn't earn attention.

What earns attention is a specific point of view repeated consistently until the market recognizes the founder as the voice of the category. That is category redefinition work, and it is different from press release production.

A healthcare PR agency built for that work has narrative strategists, editors, and category thinkers on the team. A traditional PR agency has media relations specialists and press release writers.

The two teams produce fundamentally different outputs. Founders who assume they're getting one and end up with the other burn twelve months of runway before they see the miss.

A Strategic Narrative Is a Specific Worldview Repeated Until It Becomes the Category

That distinction came up in an episode about 2024 medtech growth marketing strategies:

"They have a very strong opinions but they have a strategic narrative right like they have a specific world view that they're sharing that their ideal customers will latch on to and because of how they're promoting it how they're talking about it the constant repetition like this is the world it should be through our eyes."

That is the market narrative test.

Every founder-led medtech company that compounded authority into a real exit did the same thing. They had a strong opinion, they built a strategic narrative around that opinion, and they repeated it across dozens of channels for years until the market adopted the frame.

Ray Cohen at Axonics did this on sacral neuromodulation before Boston Scientific bought the company. Mark McKenna at Prometheus did it on the IBD category before Merck bought the company.

Every medtech acquisition that closed at a real multiple was preceded by years of the founder repeating a specific worldview until the acquirer's market understanding shifted to match.

The healthcare PR agency that supports that discipline is running narrative repetition as a system, not one-off pitches. Every LinkedIn post reinforces the worldview.

Every podcast appearance restates it, every media placement extends it, and every internal sales enablement asset carries it forward. The narrative is treated as infrastructure, not campaign work.

That is what medtech PR strategy looks like when it compounds. Anything less produces impressions without market position.

Novelty and Strong Point of View Are the Only Things That Earn Attention

The same conversation gets into this in another 2024 medtech growth marketing strategies segment:

"The only way you get attention is through things that are very novel and that are very they're rooted in like a strong point of view otherwise it's just vanilla."

The healthcare PR agency default is vanilla.

The default press release is written to avoid offending anyone. The default media pitch is written to be picked up by the widest possible range of publications. The default LinkedIn post is written to accumulate broad likes rather than deep resonance with the specific ICP.

All three defaults produce content that goes nowhere because it doesn't cut through the cacophony Bruce Cleveland described.

A medtech PR strategy that produces attention takes the opposite approach.

Every asset is written with a specific worldview embedded. Every press release opens with the founder's frame, not the industry-standard "leading medtech company" template. Every media pitch leads with a claim the founder is willing to defend publicly.

That approach reads as risky to teams that came up in traditional healthcare communications. It reads as necessary to the companies that have watched the alternative fail.

The market-product fit at the PR layer is a founder-and-agency pair willing to say something that could get pushback, because pushback is the price of the attention that compounds.

FDA clearance is the starting line, not the finish line. And the traction gap between clearance and commercial adoption is exactly where a strong point of view either compounds inbound authority or produces vanilla content that generates nothing.

Clinical validation ≠ commercial traction, and the healthcare PR agency that treats that reality as its operating principle produces the market position that closes commercial adoption.

Awareness Compounds Into Inbound Across the Eighteen-Month Window

I made this same point in an episode about the 2022 medical sales holiday special:

"If we keep people informed we will develop awareness that can lead to thought leadership that after thought leadership the phone will be ringing."

That is the compounding curve for medtech PR strategy in one sentence.

Awareness is what consistent narrative work produces in the first six months. Category authority is what awareness compounds into over the next twelve. Inbound is what category authority produces after roughly 18 months of the healthcare PR agency operating as a category-and-narrative shop rather than a press release production line.

Most medtech founders quit at month six. The curve hasn't compounded yet because the audience is still recognizing the founder's name and hasn't yet formed the association between the founder and the category.

Medtech leaders who stay in the game past month twelve find the curve. Companies that quit at month six are pulling out three months before the phone starts ringing.

The compounding is why the healthcare PR agency conversation matters at the strategic level. A traditional shop optimizes for the metrics visible in the first ninety days: press hits, impressions, media mentions.

A category-and-narrative shop optimizes for the metrics visible at month twelve: physician champions referencing the founder's frame unprompted, investors bringing up the founder's category name in cold conversations, competitors starting to respond to the narrative the founder built.

The metrics diverge sharply at the twelve-month mark. The operators who hired the wrong healthcare PR agency don't see this until the misalignment has already burned a year of runway.

Why Most Healthcare PR Agencies Deliver Press Hits and Zero Market Position

Most healthcare PR agencies are structured to produce press releases. That structure is a legacy of an era when medtech news cycles moved slowly enough that a well-placed press release could shift market perception on its own.

That era is gone.

The medtech news cycle produces dozens of comparable stories every week. A press release that would have moved the market in 2010 disappears inside seventy-two hours in 2026.

Yet most agencies still bill on press hit volume, still measure success against media pickups, and still write releases in the industry-standard language that reads identically across every company in the segment.

So the founder pays for a service, receives the outputs that were promised, and ends up with no market position because the outputs never had the use to produce one.

The gap between what the agency delivered and what the founder needed is invisible until month twelve, when the compounding curve should have turned and hasn't.

By then the founder has burned a year of runway on the wrong service. And the healthcare PR agency contract renewed twice before the founder noticed the miss.

Operators who avoid this trap ask a specific diagnostic question before signing any contract. Does the agency produce category definition, positioning, and narrative infrastructure as primary deliverables?

Or does the scope of work read as press release production with narrative work as an add-on? The framing of the scope tells the founder everything about what they'll receive after the money has moved.

What This Means for Medtech Founders

The healthcare PR agency medtech founders should hire is a category-and-narrative shop, not a press release factory. It should deliver messaging, positioning, category authority, and category redefinition as its primary outputs, with press hits as the downstream artifacts that reinforce the narrative.

Every medtech exit I've watched on the show followed the same pattern.

Bruce Cleveland's discipline: category authority, category work, messaging, and positioning, applied consistently across 18 months. Strong opinions delivered inside a strategic narrative repeated until the market adopted the founder's frame.

This is the same discipline behind why hiring a healthcare marketing agency before defining your category burns 12 months of medtech runway.

The category has to be defined by the founder and the healthcare PR agency working together before any tactical media or content work can compound. Invert the order and you pay for the category work twice.

So the healthcare PR question isn't which agency has the best media list. It's whether the agency you're paying can name the category you're trying to own.

If they can, the engagement compounds into market position. If they can't, the engagement produces press releases that disappear in seventy-two hours.

That's what we built MarketCraft to solve. It's a market engineering practice that names the category first, then runs the narrative repetition that makes the category unmissable.

Medtech leaders who hire on that spec close rounds, land health system deals, and compound authority the medtech leaders who hire on the press release spec never build.

Why the Founder Has to Own the Category Even With an Agency

Even the best healthcare PR agency can't own the founder's category on the founder's behalf. Category work is founder-led work. The agency amplifies, sharpens, and distributes the founder's frame. It can't generate the frame in the first place.

That is where most agency engagements fail.

The founder signs the contract expecting the agency to figure out the positioning, the narrative, and the point of view. The agency writes generic content because it can't produce a specific worldview the founder hasn't already committed to.

The founder can't wait for the agency to hand them a category.

The founder brings the strong opinion, the strategic narrative, and the specific worldview into the engagement. The agency turns that raw material into infrastructure.

Medtech leaders who get this order right produce category leadership across 18 months. Commercial companies that get it inverted produce vanilla content and blame the agency for the miss.

Frequently Asked Questions

What Should a Healthcare PR Agency Really Deliver for a Medtech Startup?

Category definition, messaging, positioning, category authority, and narrative infrastructure. Press releases are a downstream artifact of that work. A healthcare PR agency that leads with press release production is optimizing for the wrong outputs in a saturated medtech news cycle.

How Long Does Medtech PR Strategy Take to Compound?

Twelve to 18 months. Awareness compounds into category authority across the first twelve months, and category authority compounds into inbound across the following six. Teams that quit at month six never find the curve.

Should a Medtech Founder Hire a Traditional PR Agency or a Category-and-Narrative Shop?

A category-and-narrative shop, if the founder is trying to build a defensible market position. A traditional PR agency optimizes for press hits and impressions. A category-and-narrative shop optimizes for the market position that closes rounds, lands deals, and shortens sales cycles.

What Metrics Should a Medtech Founder Track for Their Healthcare PR Agency?

Category signal instead of press hits. Physician champions referencing the founder's frame unprompted. Investors bringing up the founder's category name in cold conversations. Competitors starting to respond to the narrative. Press hits are downstream; category signal is the leading indicator.

Listen to the Full Conversations

• How Market Engineering Helps Medtech Startups Raise Capital
• Bruce Cleveland: The Truth About Product
• 2024 Medtech Growth Marketing Strategies
• 2022 Medical Sales Holiday Special With Omar Khateeb

Subscribe wherever you listen to podcasts.

About the Author

Omar Khateeb is the founder of MarketCraft and host of The State of MedTech, a leading podcast in the medtech industry.

He works with medtech founders and commercial leaders on market engineering, commercialization strategy, and revenue growth. Visit marketcraft.ai or subscribe to The State of MedTech for weekly conversations with the people building the future of medical devices.