In the third installment in a series on women in medtech, Maria Sainz talks about the challenges and missions of her prior roles as a division president at Guidant/Boston Scientific and president/CEO of Cardiokinetix.

Maria Sainz, former division president of Guidant/Boston Scientific and former president and CEO of Cardiokinetix, is no stranger to taking risks in her career. She started in medtech in sales and quickly became the France country manager for IVAC & Physio-Control when they were divisions of Eli Lilly. After a move to Guidant in 1995 as manager of Emerging Markets EMEAC, she rose to president of the Cardiac Surgery Unit of Guidant in 2003 and then successfully led Guidant's Cardiac Surgery through its acquisition by Boston Scientific (BSC) in 2006. Remember that merger? As the first of its size in medtech, approximately $27 billion, it was unbelievably controversial, and had long-term impact on the value of Boston Scientific stock. It would take nine more years for Medtronic to beat this price by acquiring Covidien for $49.9 billion.

After our first article on Marlou Janssen, President of BIOTRONIK, Inc., was so well-received, the team at Medi-Vantage decided that the Women in Medtech series was of enormous importance to the medtech community. A second article, on Luann Pendy, EVP of Medtronic, was published in June 2017. Female leaders have made a significant contribution in medtech (we can only imagine what a nail-biter it was behind the scenes at Guidant during the BSC acquisition), yet a survey done in 2016 of 24 medtech women executives reported that only an estimated 14% of their executive peers are women. That's below the 25% of executive/senior level positions in S&P 500 companies that are filled by women. Why the difference?

Cardiokinetix, a startup medtech company based in Menlo Park, CA, was developing a novel transcatheter implant called the Parachute® Ventricular Partitioning Device, designed to improve cardiac function for the estimated 26 million global patients that suffer from this disease. The economic impact of heart failure is enormous--direct and indirect costs in the United States were estimated at $39.2 billion in 2010. Heart failure is one of the biggest contributors to 30-day readmission rates and is under the radar of hospital administrators and clinicians around the world.

Maria is an advocate and sponsor of developing female leadership in medtech. She has mentored many of the founders of MedtechWomen, a West Coast based organization with an impressive annual meeting each September. I attended the 2016 event, Medtechvision 2016: Global Medtech, and found the agenda to be business focused and strategically valuable.

Learn how to advance your career at MD&M Minneapolis, November 8–9, 2017.

Tell me about your involvement with MedtechWomen.

MS: Many of the MedtechWomen founders worked with me at Guidant when we launched GROW (Guidant Reaches Out to Women). I think it's fantastic the way they have embraced the power of the team. They have not only focused on diversity and women, but engage a group of women that really care about the fundamentals and new trends that are happening in healthcare. They have something great and unique going on.

I agree. It was standing room only at the meeting, the speakers were vibrant and there was a lot to be learned there. The last speaker was a woman from Médecins Sans Frontières who shared the most important global health challenges she sees. Those challenges are very different from what we see in the US and Europe.

MS: MedtechWomen gets the content right. It's always an inspiring event, an educational event, a good networking event. It's just good all around.

With all this great support, why is medtech employment of executive women so much lower than the national average?

MS: I don't pretend to have the answer. Medtech is very male-dominated. Most of the time it is men doing the hiring, and they may be uncomfortable hiring diversity, even if it is the right "political" thing to do. We are a relatively lean industry; the teams are not big and a position in leadership is a critical role that is very results-oriented. Those positions may not have the flexibility to accommodate the more ebb-and-flow career progression that some female professionals would prefer. For example, if you're the head of R&D, it's about launching ten products this year, and improving the vitality index by so many percentage points. If you are in clinical, it's about getting the clinical trial enrolled. There are no senior positions in medtech that have a lower level on the pressure cooker scale. I think that's very different than the banking industry, or even pharma, or other industries.

Because the structure is so lean, in most of our leadership positions, we can only hire for immediate "plug and play," 24/7 assignments. There's no grooming into these positions. So, it's a self-fulfilling prophecy. If middle management is not a deep bench, there's not going to be a large talent crop ready to plug into a director or senior leadership role to yield immediate results. I was having a conversation at one of my boards (Maria serves on four boards) about hiring a head of a business unit. We discussed the timing of the hiring and a very important business deliverable, and whether we could afford to develop a candidate and resolved that we needed a proven/ready to perform individual--and this had nothing to do with diversity, it could have been a he or a she, right?

Yes.

MS: So, we discussed if we could afford any kind of disruption risk to the business deliverable by the fact that this person would be developed into this leadership role and be in learning mode for some time. Were we going to do the company a disservice or compromise the business needs by doing the right thing for the longer term or from the talent side? Those conversations reinforce the imperatives in our industry, everything needs to be "plug and play" with proven talent, "hit the ground running," and always deliver. I think these are high stress and dedication jobs, with a very low degree of flexibility and work/life balance. There are many people who want to have more flexibility, even more so now as millennials are progressing into and upward in the workforce.

That's a very interesting perspective. Leaner teams, higher risk in offering a job to somebody who might not be immediately plug and play. Has the medtech culture always been different from other companies?

MS: I think innovation and fast growth and drive are characteristics that drive this culture. Also, many senior medtech leadership positions are hired via the network. It's a very male-dominated environment, so the network's going to primarily yield male candidates, right?

Right. So how did you get developed? Did you have mentors, sponsors?

MS: My managers became sponsors and mentors because they challenged and pushed me to deliver at higher levels, and those results afforded me opportunities to move laterally and upwardly quickly in the earlier years of my career. I was also willing to say yes to all opportunities that were presented to me, even if they required taking risk; for instance, changing product lines or geographies while being promoted within the organization. They were not always comfortable moves, but I was not intimidated and was up for the challenge every single time.

Can you give an example?

MS: Yes. There were colleagues that said as I was taking new assignments, "I think you have a lot to lose there." And, I never saw it that way. I always thought I had something to gain because if it didn't work, I was always going to have a richer set of experiences in my background.

For example, I was offered a promotion to be the VP for Europe of an entity that we were acquiring in relatively hostile circumstances. It was a business that I didn't know very well and I would be leading a team that didn't want to be acquired, and saw us, the acquirer, in very negative light. I was very comfortable in my position at the time, and this new role was presented to me as, of course, a wonderful opportunity to do something I had never done. But, the risk was high because of people and business retention issues. It was no doubt a very challenging environment to move into.

I embraced the challenge, thinking: how many times in your career are you going to experience and lead one of these difficult business integrations? How many times in your career are you going to be part of something this demanding that will teach you the tougher lessons?

So, I took on the challenge as a way to professionally grow. The optics of how everybody was positioning the risk of this role weighed a lot less to me than how I felt I could actually contribute to the position, and what I could get out of it.

To me, there was a scarcity of opportunities; how many times in my career would I get an assignment like this offered to me? There's probably fifteen or so times that you can get offered a director of marketing job for a new product line, right? So, to me, I felt I had nothing to lose. The richness of the opportunity extraordinarily minimized my perception of the risk.

Right.

MS: This was a mission, a project that may be a one and done for all I knew at that time in my career. I knew I may never be asked to do it again. As it turned out, I did have to do it again, but I didn't know that at the time.

It is a rich opportunity to grab a challenge that doesn't come up often. So, what did you learn from that, Maria? You said there was a learning experience. Were there any specific things that you could take away from it?

MS: Yes, so one of the bigger lessons was that it taught me the value and the importance of employee and customer engagement.

Tell me about that.

MS: I wasn't responsible for the new strategy, but I was the person that needed to win the team over to wanting to be part of the new strategy going forward, despite how new and hostile it all felt. Bringing it down to, what is in it for you? How can I make this something that you can feel proud of? How can I get the team past the optics and pressure of, "This has to be bad, this is bad, there's nothing good here."

We had the same situation with the customers. Engaging them was important: ". . . you love this product, why would you move away from it . . . because there's been a corporate transaction? Don't you care about patient care, how comfortable you are with the features of the devices?" It required bringing it down to very personal conversations, trying to get them to want to be part of something going forward that had very poor optics and much negative public buzz.

So, the customers were hostile also?

MS: Yes. The transaction was hostile because the company taking over was almost entirely eliminating everything other than the book of sales of the previous company; the research and development efforts were halted, the brand was being phased out. It was a dismantling of the history and the strategy of the previous entity which had a good reputation and market share. I was not responsible for the strategy. I was responsible for trying to retain as much of the business that existed. My job was to lead a team that felt good about going forward together under the new ownership.

So, how did you do that, Maria?

MS: Communications, individual engagement, a lot of flexibility, and making sure that I wasn't taking things personally. There were many very uncomfortable moments with people. My goal was to try to not take that personally and work with what remained that was salvageable. Working with the customers, recognizing their passion for medical innovation. Transparency and communication were key. I had town hall meetings, I walked the hallways, and most doors were closed. I would knock on the doors, I would not let a door stay closed. I would knock on the door and talk and check in or just say, "Good morning, how are you?" I'd leave the door ajar.

Good for you. How did you apply those lessons learned in future roles?

MS: I always feel that your legacy and your value is in the team you assemble. It is not just how individuals perform as in their areas of expertise, but the way that the team performs, the "right people on the bus" and with that, the culture you create. I strive for a culture of accountability, highest ethics and unwavering commitment to improving patient care. The acquisition situation was vulnerable and we needed to develop a new culture for the combined entity, loyalty, and a sense of purpose.

That was a valuable lesson.

MS: Oh yes, it was. Changing gears to diversity . . . I am proud of it and want to share with you that in my prior role my senior leadership team was 50% women, my director/manager team was 40% women.

Wow! That's great.

MS: It was a small organization, but those are the facts.

How did you do that? How did you get 50% women on your senior management team, 40% directors/managers? Did you force the issue? Did you know women who were developable?

MS: I have a network where I know many women . . . and in that case, I think the network works the opposite way as compared to the dominance of male medtech decision-makers and the fact that their network is more male than female. Honestly, it was purposeful and it was not purposeful. I needed to restructure, I went for the person that I thought was the right person to lead a lean organization forward. In one situation, there were three men and a woman, and my confidence was highest in the woman. I felt she would be the one who could roll up her sleeves and be a leader/doer. And I am convinced that in the smaller medtech companies, you need leader/doers. You don't need people who only perform as leaders.

Right.

MS: You have to be a leader/doer, and I personally think that women have greater capacity and ability to be leader/doers than men. I think in general, our professional egos are smaller. To be an effective leader/doer it is important to be comfortable leading smaller teams, performing tasks at many levels, rolling up your sleeves to tackle any task at hand, being a player/coach.

So, you said you have a network of women and you had a purposeful plan.

MS: I would say the network and the fact that the roles were leader/doers made me see a better fit for women candidates in those roles.

That's great. Anything else besides that?

MS: I wasn't necessarily designing the organization to be 50% women. I look for talent agnostic to gender. I've chosen them because of the fit for leader/doers, primarily.

Maria, thank you so much.

Maria Shepherd is the president and founder of Medi-Vantage, a medtech marketing and product development strategy consulting firm.

[Image courtesy of MARIA SAINZ]