370.MD&M 2026 Keynote: Are we innovating or iterating? $6.1B worth of advice from Ray Cohen and Tom West moderated by Omar M. Khateeb

In this episode, Omar Khateeb sits down with Raymond W. Cohen of Spiro Medical and Thomas A. West of Nalu Medical to unpack the real difference between innovation and iteration in medtech.Drawing from billions in exits and decades of experience, they explain why most companies fall into the trap of incremental thinking and why that approach is becoming harder to fund. The conversation highlights how venture capital behavior has shifted, why larger rounds are often necessary earlier, and how founders need to rethink how they approach building and scaling their companies.They also explore the importance of narrative, not just having a strong technology, but being able to clearly articulate the full journey from idea to commercialization, including reimbursement, manufacturing, and exit strategy.This episode challenges the way most founders think about growth and offers a clearer path to building something that actually stands out.Episode Breakdown:00:00 Why MedTech Innovation Needs a Reset01:34 Intro + The Big Question06:24 MDM West Opening10:28 Meet Ray Cohen and Tom West12:18 What Happens After an Acquisition?14:49 Why VCs Chase Faster Returns18:36 Raise More Capital, Not Less22:27 Why Great Boards Win24:52 Moonshots vs Incremental Innovation27:40 Why Big MedTech Buys, Not Builds30:08 Strategic Investors Are Back32:35 Think Bigger, Raise Bigger34:08 Why Me Too Startups Fail38:29 Building a Winning Market Narrative40:33 Design for Manufacturing From Day One43:09 Raising $67M for Breakthrough Innovation47:28 What Investors Really Want50:18 Reimbursement Can Make or Break You53:56 The New Fundraising Playbook57:52 IPO vs Acquisition Strategy01:00:21 Learning From iRhythm's Success01:03:05 Audience Q&A01:08:45 AI, Big Tech, and the Future of MedTech01:12:05 Final Advice for Founders01:14:00 Helping Millions of Patients01:16:00 OutroAre you a medtech CEO in need of some marketing help attracting investors, growing sales pipeline, and more? Go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠GrowMyMedtech.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to book time for a free analysis.Subscribe to our Youtube Channelhttps://www.youtube.com/@thestateofmedtechSubscribe to our LinkedIn Newsletterhttps://www.linkedin.com/newsletters/state-of-medtech-pod-7328860752952352770/Follow The State of MedTech onLinkedIn https://www.linkedin.com/company/thestateofmedtech/Instagram ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/stateofmedtech/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TikTok ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.tiktok.com/@stateofmedtechpodX https://x.com/stateofmedtechFacebook ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/stateofmedtechFollow Omar M. Khateeb onLinkedIn ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/okhateeb/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/omar.m.khateeb/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TikTok https://www.tiktok.com/@omar.m.khateebX ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https: https://x.com/OmarMKhateebFacebook ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/OmarMKhateebThis podcast is for informational and educational purposes only and does not constitute financial, investment, legal, or medical advice. The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of State of MedTech LLC. Nothing discussed on this podcast should be interpreted as a recommendation to buy, sell, or hold any investment or security. Listeners should conduct their own due diligence and consult with a qualified financial advisor, attorney, or other professional before making any financial or investment decisions#medtech #healthcareinnovation #medicaldevices #healthtech #startupfunding