Medsider: Learn from Medtech and Healthtech Founders and CEOs - 3 Signs Your Medtech Idea Could be a Viable Business: Interview with Prana Surgical CEO Joanna Nathan

Episode Date: August 6, 2025

In this episode of Medsider Radio, we sat down with Joanna Nathan, CEO and co-founder of Prana Surgical — a startup developing image-guided surgical platforms for precision oncology.  Joanna's career spans translational research at Texas Heart Institute, product development at Saranas, and portfolio management at Mercury Fund and Johnson & Johnson's Center for Device Innovation. She mentors founders through her not-for-profit organization Enventure and teaches entrepreneurship at Rice University's Jones School of Business.In this interview, Joanna shares her framework for evaluating which medtech ideas merit pursuit, revealing three critical signals every founder should look for: clinical urgency that requires no convincing, favorable asymmetry between value and technical risk, and optimal market timing. Joanna also demonstrates how systematic grant applications and strategic resource allocation can extend runway while building investor credibility, and addresses the unique psychological challenges of building life-critical devices.Before we dive into the discussion, I wanted to mention a few things:First, if you’re into learning from medical device and health technology founders and CEOs, and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.Second, if you want to peek behind the curtain of the world's most successful startups, you should consider a Medsider premium membership. You’ll learn the strategies and tactics that founders and CEOs use to build and grow companies like Silk Road Medical, AliveCor, Shockwave Medical, and hundreds more!We recently introduced some fantastic additions exclusively for Medsider premium members, including playbooks, which are curated collections of our top Medsider interviews on key topics like capital fundraising and risk mitigation, and 3 packages that will help you make use of our database of 750+ life science investors more efficiently for your fundraise and help you discover your next medical device or health technology investor!In addition to the entire back catalog of Medsider interviews over the past decade, premium members also get a copy of every volume of Medsider Mentors at no additional cost, including the latest Medsider Mentors Volume VII. If you’re interested, go to medsider.com/subscribe to learn more.Lastly, if you'd rather read than listen, here's a link to the full interview with Joanna Nathan.

I think voice of clinician is everything, especially when you are evaluating, joining something or taking something on. I think if there isn't that clinical urgency or clinical interest that doesn't require convincing, then I would have pause about getting involved with something like that. For me, the signal with Prana was, you know, talking to a thoracic surgeon that was completely outside of the project and, you know, wasn't connected to my co-founders or anything like that. And he said we had lightning in a bottle, quote unquote, and then ended up in dusting. Welcome to MedSider, where you can learn from the brightest founders and CEOs in medical devices and health technology.

Join tens of thousands of ambitious doers as we unpack the insights, tactics, and secrets behind the most successful life science startups in the world. Now, here's your host, Scott Nelson. Hey, everyone, it's Scott. In this episode of MedSider, I sat down with Joanna Naked. CEO and co-founder of Pranisurgical, a startup developing image-guided surgical platforms for precision oncology. Her career spans translational research at Texas Heart Institute, product development at Serranas and portfolio management at Mercury Fund and J&J's Center for Device Innovation. She mentors founders through her not-for-profit organization, Eventure, and teaches

entrepreneurship at Rice University's Jones School of Business. Here for the key things that we discussed in this conversation. First, test for clinical urgency before the going all in and look for physicians skin in the game. The strongest signal that an idea is worth pursuing is when doctors are so enthusiastic they invest their own money, not just offer advisory equity. Combine this with favorable asymmetry between the clinical pain you're solving and the technical risk you're taking on, plus optimal market timing where your space is ripe for transformation. Second, diversify your fundraising strategy beyond traditional VC to extend runway and build credibility. Systematic pursuit of non-dilutive capital, such as grants,

builds organizational rigor while giving you credibility and a head start with venture investors by demonstrating external validation and reducing their risk. Modern tools like LLMs make grant writing more accessible and the psychological impact on VCs is significant. They see execution capability in the potential to double their dollar. Third, accept the tension between precision and speed and develop practices to manage the emotional toll. Building devices that go inside the human body demands uncompromising rigor, but startups still require speed and iteration. This discomfort isn't temporary. It's part of the job, and managing it well is just as important as the technical work. All right, before we dive into this episode, I'm pumped to share that volume seven of

Medsider Mentors is now live. This latest edition highlights key takeaways from recent Mediator interviews with incredible entrepreneurs like Bill Hunter, CEO of Canary Medical, Brian Lord, CEO of Pristine Surgical, Don Crawford, co-founder of Safion and current CEO of Corvista Health, and other proven MedTech founders and CEOs. Look, we get it. Keeping up with every Medsider interview isn't easy. That's why we created Medsider mentors. These ebook volumes distill the best practices and insider secrets from top founders and CEOs,

all in a downloadable, easy-to-digest format. To check the latest volume out, head over to MedsiderRadio.com forward slash mentors. Premium members get free access to all past and future volumes, plus a treasure trove of other resources. If you're not a premium member yet, you should definitely consider signing up. We recently revamped Medsider with swanky new features, especially for our premium members. In addition to every volume of Medsider mentors, you'll get full access to our entire interview library dating back to 2010. You'll also get Medsider Playbooks, curated guides packed with actionable insights and topics

like fundraising, regulatory challenges, reimbursement strategies, and more. And if you're fundraising, don't miss our exclusive investor database featuring over 750 life science VCs, family offices, and angels. We've even created three custom packages to help you with your next fundraise. Learn more about Medsider Mentors and our premium memberships by visiting MedsiderRadio.com forward slash mentors. All right, without further ado, let's dive into the interview. All right, Joanna, thanks for coming on Medsider Radio.

Appreciate your time. Yeah, thanks for having me. All right, very much looking forward to, for the discussion. And I'm assuming you're in the inside, right? The hot weather down in Houston is pretty warm this type of year. But with that said, I recorded a very short bio at the outset of this episode. But let's start there. I always kind of love to hear your journey kind of in your own words. So if you can give us like a two, three minute kind of elevator style overview of your background

leading up to co-founding Prana, that'd be great. Yeah, definitely. So I, like a lot of folks in this field, am a bioengineer originally by training. I, you know, kind of knew even in high school that that was something I wanted to do. I wanted to be in health care, but not be a physician necessarily. I knew that wasn't necessarily my path, but wanted to be in that field in general. So I really started my career in this kind of MetTech Innovation world in the academic kind of translational research setting. So I started working with a physician and electrophysiologist named Medi Rosabi here in Houston, you know, as an undergrad and then went to work for him full time

at Texas Heart Institute. Texas Heart is, you know, kind of the home of huge kind of giants of innovation, you know, Debakey, Kooley, all kind of had associations there. The total artificial heart has been kind of the history of that has really been tied to Texas Heart. And so I learned a ton in that role. And I got to be, you know, in a really interesting field with EP, just a lot of really exciting new tech in that field and a lot of physicians that are excited about tech and like new toys, right? And that really kind of was my introduction to the medical device world. So even though I was really doing more kind of translational research, we, one of the projects I was working on ultimately spun out into a company, Storonis, and kind of the vascular bleeding detection kind of world.

And so I helped kind of launch products there and then went back to business school and then spent some time really on the investor side of innovation, first in kind of traditional venture at a fund called Mercury Fund here in Houston and then with J&J Center for Device Innovation here as well. And that J&J was really where I kind of went back to the idea of potentially being a founder. So, you know, I'd kind of started out as an engineer and on the technical side and transition kind of into more of this investor kind of portfolio role. And then Prana really began as an internal J&J concept.

And I got to know kind of the project, got to know my co-founders who were thoracic surgeons themselves and worked with them ultimately to, you know, spin Prana out of J&J out of our kind of incubator at the Center for Device Innovation to solve, you know, what I believe was a real gap in early stage lung cancer innovation. So, you know, we started as really a whiteboard sketch at CDI and worked through all of the early prototyping issues. And, you know, ultimately, I knew this kind of needed to live beyond J&J's walls and worked with J&J to spin it out. That's a super cool overview of your background. You could probably spend a whole other like 15, 20 minutes kind of diving into each role for the sake of trying to keep this to an hour or maybe a little bit less than an hour.

before we get to prana, and kind of the knees that you try to solve, you know, in the space, I got to think that, like, your involvement, even in the very earliest days, like, translational research, I mean, was incredibly impactful because the reason I bring this up is, you know, I'm sure you have the same conversation with younger men tech entrepreneurs as well that are like maybe in, you know,

in, I don't know, name your state, like Florida, Tennessee, you know, like aren't around like an ecosystem. And one of the things that I always encourage them to do, if they can do it is like move to one of the hubs, right? Move to a Houston, move to Minneapolis, move to Silicon Valley, move to Boston. Somewhere close because like you can't, it's hard to like quantify how much that will like move your career forward by just being close to kind of that action, so to speak. Yeah, definitely.

I think, you know, what we're building at Prana is really only possible because we have those deep relationships with clinicians and engineers here in the Houston ecosystem. And I think being at the intersection of med tech, you know, major healthcare institutions and kind of surgical innovation, that's not by accident, right, that we've ended up building here. So, yeah, I definitely take. Yeah, no doubt. Even like small things, right? Like you mentioned kind of the CEO Happy Hour thing that you were kind of working on before

hit the record button. I mean, just the ability to like go meet in person with other people that are building. I mean, it really, really is like impactful. So again, I guess anyone, anyone listening to this that's kind of in not. in one of those hubs. If you've got the opportunity presents itself, if you've got the ability to kind of relocate, highly, highly encourage you to do that. So with that said, I'm looking at the website, which is actually great website, by the way, pranasurgical.com. So pran-a-surgical.com. We'll link to it in the full write-up on Medsider. But if you don't get there again, pranasurgical.com, give us a kind of an

idea of like, you know, what the major need that you're trying to solve for, what the, you know, what the device, you know, is and does and kind of where you're headed. Yeah, definitely. So initially, you know, this really started as a precision surgical platform for excision of lung nodules. So early small potential lung tumors. It's a single port image guided tissue sparing solution. So I think what's interesting about the need that we solved is, or the need that we're trying to solve is, you know, lung cancer is kind of where interventional cardiology, for example, was a few decades ago, right, where it was kind of ripe for transformation, ripe for innovation. And, you know, know, things like the stent and angioplasty came in and completely transformed how we treat patients

in that field. Lung cancer is still kind of in a lobectomy or bust for the most part mindset, but that's changing for a variety of reasons, but a big one is we're starting to screen for lung cancer for the first time. And so finding earlier things and needing to meet patients at where their disease state is and right-sizing kind of intervention for them. I think that's, that's really the need that we're trying to solve with our tool. Okay, got it. So basically, this device, the prana system would allow a surgeon, right, to intervene sooner, right, in advance of, like, you know, cancer, you know, progressing to too late at a stage where you need to do like something a lot more invasive. Yeah, definitely. And, you know, we're starting with kind of the diagnostic biopsy piece, but we've been want to build a one and done tool. So from day one, we're really building, we've been building prana to involve with add-ons to potentially make this a diagnostic slash therapeutic kind of combo system. So, yeah. Very cool. Give us a sense for kind of where the, where the company's at terms of a lifecycle.

Yeah. So this has maybe been the most intense and most chaotic six months of Prana. So design freeze is complete. We're building, which, you know, any CEO that's been involved with builds knows how, you know, how all consuming that can be for the whole team. And then in parallel, we're hoping to kick off first and human outside the U.S. and actually in Australia towards the end of this year and submit to FDA. So submitting, we have kind of our 510K submission on deck right now. So all of that is happening this year. A lot of the work that we've put in for the last several years is kind of coming to a head. And then from a funding perspective, we've raised now, including some good, you know, some interesting grants from the state of Texas.

We have about $12 million in. And yeah, so it's a great kind of really interesting time for product and really hoping will be in a good place towards the end of this year with clinical data and a signal from FDA on, you know, hopefully clearance. Yeah, wow. I mean, I think every, every stage of a startup is like, you know, incredibly busy and full of activity, but you're at a pretty, pretty, pretty fun stage right on the precipice of like getting into into patients and your design's that far along, right? Where it's, you know, I think you said it's frozen, right? I mean, yeah, it's pretty, pretty cool, pretty cool times. Okay, good start. So with that said, let's maybe the next 20 or 30 is kind of talking about some like key kind of functional areas that every, you know, every,

you know, MetSec founder or CEO is going to have to kind of navigate through on their way to hopefully eventual eventual success. And first one I want to kind of tackle is sort of rooted in, and really your, I would say, you're kind of broad, early kind of stage experience, right? From like transitional research to then spending time at a startup yourself and to change ADC, et cetera. So you've got like a lot, a lot of experience that maybe other other MetTech CEOs don't have. And so with that said, you mentioned earlier, even Prana, like the, the company was kind of spun out of a concept or idea at J&J. So give us a kind of a, you know, a framework for how you approach ideas, right? You've probably seen a ton in your, in your career

thus far. And so when, you know, are there a few things that you typically look for when you decide to like go all in on a potential, potential, you know, idea and think it's, think it's worthy to devote, you know, time, you know, capital, et cetera. Yeah, definitely. I think, you know, voice of clinician is everything, especially when you are evaluating joining something or taking something on. I think if there isn't kind of that clinical urgency or clinical interest that doesn't require convincing, then I would have pause about getting involved with something like that. For me, the signal with Prana was, you know, talking to a thoracic surgeon that was completely outside of the project and, you know, wasn't connected to my co-founders or anything like that. And he said we had

lightning in a bottle, quote, quote, and then ended up investing. And actually we have, you know, half a dozen thoracic surgeons that invested as angels in the early part of the company. So to me, that signaled, you know, that that KOL kind of interest was really there and that we had something. I think that's one. A second, I think to look for is like an asymmetry in value versus technical risk. So is the amount of pain that we're solving way bigger than the amount of tech we're adding and the time it's going to take to, you know, bring that tech to market? and the work it's going to take to get that tech, you know, paid for, cleared and in, in physician's hands, that's a lot of work, as, you know, you all know.

And so is the amount of pain we're solving really bigger than that? I think that's an important evaluation to do. And then lastly, I kind of mentioned this, but I think the timing of the space, you know, lung cancer being kind of ripe for transformation and being at a really interesting point. I think those three things kind of intersected to make Prana a really interesting opportunity for me. Yeah, those are three really good things. I mean, we could probably spend the rest of our time actually kind of diving into each of those. I mean, honestly, but the first point you made about, like, clinical urgency, I love the way you phrase that. Like, that's so, so crucial. And, you know,

I think any startup that sort of begins to sort of have lift, you always get physicians that, like, you know, there's always going to be inbound of, like, physicians that want to become advisors, right? Or, you know, and typically there's some sort of equity play there as well. Not to discount that, right? But if you can get them instead, if they're so interested that they're so interested that they, actually want to write a check at like a seats. Right. That's a big, that's a really, really strong signal, right? And so I think that's probably a good, like a really healthy framework.

Is the physician interest so high that they'd actually be willing to write a, you know, a $25,000, you know, $50,000 check, right? Which obviously is beneficial at that stage, for sure in and of itself, but really, really strong signal. I love the way you kind of phrase that clinical urgency. Yeah. And I'm thinking about the second point you made, too, is like the asymmetry, right, between technical lift and like, you know, market in essence, right, or need. And so that's a really,

that's a really healthy framework too, because the reality is like there could be this huge, huge need, right, that needs to be solved. But if it's, if it's going to be like a 15 year, you know, window to eventually get to market with loads and loads of clinical data, with no reimbursement and there's a bunch of technical risk right early on, I mean, that's just, you know, you need to go into those projects eyes wide open, you know. Yeah. And that's a science project, not a company. right? There's a framework for those kinds of projects and it's grant funding and, you know, academia. And I think what's really hard is figuring out when something transitions from science project to like truly like a

company, something with commercial value, you know, something that can get there. So yeah, trying to figure out where your tech or your idea lies is can be challenging. Oh, 100%. Yeah. Those are really good, really kind of like baseline kind of foundational kind of frameworks to think through. If you're, if you're listening to this and evaluating different ideas, I mean, you know, the reality is like timing is crucial for every, every startup. It's hard to, sometimes hard to control that. But those first two, those first two points you made are like so, so valuable. It kind of reminds me. I was rereading the interview I did with Nitten, Saloon-K, I think that's how he pronounced his last name. Nitton, if you're listening,

I apologize for pronouncing your last name. But he's the CEO of Sapira. They just raised like, I don't know, $120 million, series D or something like that. It was a monster round. But technology is really cool. But he, you know, he was basically really emphasizing, like, look, don't take on, ideally, you take on one kind of bucket of risk at a time, right? So don't take on reg risk and clinical risk at the same time. Or don't take on technical risk and clinical risk at the same time. Sometimes it's unavoidable, but ideally you're kind of like, you know, you're throwing resources at one bottleneck, you know,

or one risk kind of category at one time versus, versus spreading yourself too thin. So that's really good stuff. Let's transition a little bit to kind of early stage development, right? So like, let's say you honed in an idea. Maybe it's whether you want to kind of use product. as an example or maybe just another company that you've been involved with or been engaged with, you know, over your career, a lot of the most difficult work early on, right, is you're trying to iterate quickly and make meaningful progress, but oftentimes with, you know, very limited

capital. So, you know, for other, other maybe, whether it's a technical CEO or non-technical CEO that's maybe listening, right, you know, like, what, what are your, you know, one to two pieces of advice or words of wisdom for them to kind of be able to efficiently move fast in those early periods knowing full well that they just, you know, there's not a lot of resources to go around. Yeah. I think, you know, so much of my advice tends to be around, you know, I know there's definitely like actual, definitely things that you can do as a founder and those kinds of things around milestones. But a lot of my advice really is around the psychology of being a founder, I think, and like the mental burden of that. So I think one thing that I realized very quickly is

you have to be comfortable being uncomfortable. Like we're building a tool, right, a prana that will be inside someone's lung. That doesn't. demands a lot of rigor, but we're also startup. So we're always balancing precision, right, and care with speed. And that tension is very real, and you're experiencing it every day. And so that kind of mental burden is very heavy. And then kind of, you know, related to that, I think being a founder, especially CEO, can be fairly isolating. So you're translating between technical risk and clinical impact. You're the pressure valve for the team a lot of the time. and you're holding kind of that long view when no one else can see it yet.

And so I think for me, what's helped me most stay grounded is community, other founders, other mentors, you know, clinicians who believe in the mission. I think they really help me reset my headspace when timeline slips or something, you know, something goes wrong as it inevitably does. And hitting that milestone gets harder. So I always like to say you need people around you who aren't just asking you how your data is going, but asking you how your day is going, you know. So I think, you know, having that community and making sure you're not carrying the weight alone

is really important as well. I would have expected you to bring that up, especially considering your engineering background, but like you wouldn't believe that like the number of founders. You know, sometimes they're on, you know, it's on record, right? They're saying this. But even sort of off the record, they're mentioning that, right? It's so, so isolating. Even it, and it never really goes away, right?

Like, I mean, you certainly feel it at the early stages. But even at a, you know, commercial and maybe even, you know, potentially even publicly, traded, right? You're that part out of the path. It's always, it's always a pretty lonely environment. When you say community, are there a few things that have been especially helpful either to you or like, you know, even in talking to like other founders and CEOs, you know, in terms of tapping into some of that support system? Yeah, definitely. I think, you know, having a bunch of folks on speed dial, like literally last week we had, you know, some kind of testing issue. And I had eight different people that I could text at like 9 p.m. on a Thursday and set up halls with

everyone Friday morning and kind of have that brain trust kind of come together and, you know, problem solved together. And we, we did. We solved, you know, came up with a good solution of that Friday. But that takes effort and it takes discipline to, to build that community and to stay in touch with the community as your founder. It's really easy, I think, as a founder, to disappear into your company and disappear into what you're working on. And I think for me, continuing to invest and just having, you know, kind of built in things on my calendar, I have whine with a bunch of my female founder friends every couple weeks, for example. Having that kind of built into my calendar and there has been incredibly helpful with keeping kind of

that community piece going. Yeah. So it sounds like you've been actually, I mean, you're pretty proactive about, like, you know, really try to be a part or engage in an active community. Because to your point, there's like, there's a major difference between, you know, playing that, that sort of role versus, like, you know, a role where you're kind of, leaning back and because the reality is like most people aren't going to have the time to reach out to you right so you got to sort of like be actively engaged but yeah i'm glad you i'm glad you mentioned

that and we were we were kind of talking about giovanni laura sela right before i had the record but he's always a you know plug to giovanni he's he has a really really good job of uh i've really kind of build build a community right especially at the kind of the CEO founder level so um so very very cool so let's move on to okay we talked to a little bit about identifying an idea and whether or not to work on it you know how to maybe how to maybe handle right the the the ebbs and flows, right, early on as you're working kind of through development. Let's talk a little bit about capital. You've done, you know, what sounds like a really great job of kind of balancing non-dilutive funding with diluted funding with, you know, traditional kind of, you know,

venture, venture dollars. And so walk us through maybe a couple of like the key learnings, right, that you've experienced kind of getting this far, right? Because the reality is like there's not a lot of startups that have, you know, $10, $12 million into the company. I mean, that's a feat in and of itself. And so you've obviously had a good job there. But like, what do you, what do you know now, maybe, that you didn't know two, three, four years ago as a founder's CEO kind of raising capital? Hey there, it's Scott. And thanks for listening in so far.

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