The doctor as innovator: what’s in store for the physician/inventor?

What does it take for a physician to develop and launch a medical device company? Dr. Brian Courtney – a clinician scientist and interventional cardiologist at Sunnybrook Health Sciences – says first and foremost, starting and running a company isn’t a one-person job.

The doctor-inventor may have a great idea, but transforming a novel concept into a product is time-consuming and takes a wide range of expertise. “You need complimentary skills to make these things move forward, no one can do it on their own,” he said.

Dr. Courtney should know. He has devised many medical technologies but is perhaps best known as the creative force behind Conavi Medical, a Canadian producer of a catheter system that provides two kinds of imaging of lesions in coronary arteries – optical coherence tomography and ultrasound.

The idea is to give clinicians more information about a lesion, which leads to a better treatment – such as improved stent sizing. As cardiology becomes increasingly non-invasive, catheter-based technologies like Conavi’s ‘Novasight Hybrid System’ are becoming increasingly important.

“We were the first to do a combined ultrasound and optical system,” said Dr. Courtney, speaking at the INOVAIT Medventions conference at Sunnybrook in June. “It’s kind of like the PET/MRI of interventional cardiology, because you can see something well with ultrasound, and something else well with optical, and sometimes one augments the other.”

Toronto-based Conavi Medical was founded in 2007 and was listed on the TSX Venture Exchange in 2024. The technology has been approved in Canada, the U.S. and Japan and has over 30 US patents.

Speaking about physician founders of companies, Dr. Courtney quipped that the acronym MD is sometimes said to be short for ‘management dysfunction’, but on a more serious note, added that managerial abilities will vary from one person to another.

It’s very important, he said, to have a variety of skills in the company. He mentioned the Apple Computer founders, Steve Jobs and Steve Wozniak, noting that one supplied the sales and marketing brains while the other was the technological wizard.

If a doctor is also in charge of sales, he observed, in presentations he or she might focus only on the technology and the clinical aspects and forget about the business opportunity.

“By having a non-expert in the group when you’re presenting, you can change the tone of the discussion to more of a business focus. And that’s important when you’re doing the fundraising,” said Dr. Courtney.

Overall, physicians must be wary “to avoid the land of unchallenged assumptions,” he said. Having other people providing input can help validate the usefulness of a product idea.

Experts are needed to search and discover whether the idea is unique as intellectual property, and they can also identify new features that are needed through research and development.

At the same time, it’s important to develop the right corporate culture, said Dr. Courtney. In hospitals and other medical settings, people are used to deferring to physicians. That’s why it’s incumbent upon physician-founders to encourage other views.

“If you don’t actively invite them, it won’t happen. People will be afraid to say things if you’re a sort of asymmetric power or authority,” he cautioned.

Being part of a hospital system is very useful, as the hospital will often help spread the word about the work that’s being done. “You can get some good publicity tailwinds in this way, with support that can help move the innovation forward.”

Interestingly, when it comes to sales, a physician may have success initially. But Dr. Courtney said, “Sales is such a heavy, intense activity in terms of time and complexity, and in terms of bureaucracy, that it’s best left to other people as soon as possible.

“But you can certainly have a strong influence on early customer adoption.”

He said that manufacturing, and the choice of product components, follows a similar pattern. The clinician can provide a lot of useful suggestions, but it’s best left to people with experience in this area.

Understanding regulatory environments is another big challenge. “This requires a lot of input from experts, especially in the U.S., and that is the market that matters most,” he said.

If the doctor-innovator can put all these elements together, said Dr. Courtney, it can be extremely satisfying.

“I really enjoyed when I was having team meetings at Conavi, and we had a clean room in the back,” said Dr. Courtney. “I used to say that for every 300 catheters that get built out of that clean room, we’re probably saving a life. And for every four out of 100 being built, they’re probably stopping a future admission or heart attack.”

That sense of helping others also resonates with employees and is a reason why they want to work at medical companies, he averred.

“That kind of culture is why they’re there,” said Dr. Courtney. “It’s why they stay there and why, when it gets difficult, they might be a bit stickier than they might otherwise be.”