Neil Patel

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In a recent episode of the Dealmakers’ Podcast, Nick Damiano, a seasoned entrepreneur and visionary in the field of healthcare technology, shared his journey from being born into a medical family to becoming a founder of groundbreaking startups.

His experiences, setbacks, and triumphs offer valuable lessons for aspiring entrepreneurs and healthcare innovators.

Listen to the full podcast episode and review the transcript here.

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Embracing Change: The Early Years

Nick’s upbringing in a medical family, with his father being a surgeon, instilled in him a resilience to adapt to change. Moving around the East Coast taught him the invaluable skill of building anew in unfamiliar environments.

This early exposure to the medical field, combined with witnessing the impact of startups on healthcare, shaped his path toward entrepreneurship.

While familial pressure nudged him towards a career in medicine, Nick’s fascination with the burgeoning startup scene on the West Coast led him to pursue engineering at Stanford.

This pivotal decision offered him a faster route to building innovative solutions, steering him away from the prolonged journey of medical education.

The Allure of Startups: A Shift in Perspective

Transitioning from the East Coast’s traditional medical culture to the dynamic world of entrepreneurship was a transformative experience for Nick. Witnessing founders and startup employees revolutionize healthcare inspired him to forge his own path.

Despite early setbacks, his desire for autonomy and accountability drove him towards founding his first company, Avail MedSystems, a company that reached $1B in valuation.

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Telepresence in the Operating Room: Avail’s Inception

Avail, originally named Nurep, introduced a groundbreaking concept: telepresence for the operating room. This innovative approach aimed to streamline medical device support and marked a significant leap forward despite initial resistance and technological challenges.

The idea stemmed from Nick and his co-founders’ observations of medical device representatives spending excessive time shuttling devices between hospitals and navigating credentialing processes. Avail’s telepresence solution promised greater efficiency and support for medical professionals.

The biggest barrier Nick faced was MedTech companies being hesitant to shift their case support model to remote. The lack of efficient and reliable Wi-Fi was another hurdle. People were just not used to digital health products and interfacing them with Wi-Fi. Even so, the team went ahead with building the product and convinced a few med tech companies and hospitals to get on board.

Pivoting and Persevering: Lessons from First Ventures

Nick’s entrepreneurial spirit persisted, leading him to his next venture, Zenflow. Through this experience, he learned the importance of careful co-founder selection, equity ownership, and structural planning. Most importantly, he learned not to overindex.

Along with his co-founder, Nick built a device to treat Benign prostatic hyperplasia (BPH) or enlarged prostates with a minimally invasive technique. Their company became the first medtech company that the Y Combinator ever funded.

Nick recalls their demo day at the Y Combinator and what an incredible experience that was. Although their idea wasn’t the hottest in the room, they acquired adequate seed capital to start their company. They also secured around $6M in funding through the initial clinical data for the implantable device. The next round A raised $26M in funding.

After facing board control challenges and leaving the company, Nick emerged wiser and more resilient, setting the stage for his subsequent endeavors. He emphasizes that for founders on the verge of relinquishing board control, meticulous vetting of potential board members is crucial to ensure alignment of vision and values.

Robotics and AI: Shaping the Future of Surgery

Nick’s latest venture envisions a transformative shift in healthcare, leveraging robotics and AI to enhance surgical outcomes. His unique approach, drawing from experiences in various fields, highlights the power of cross-disciplinary innovation in med tech.

This approach led to the building of Andromeda Surgical, a company dedicated to Autonomous surgical robots. Once again, Nick took his idea to the Y Combinator and became the first second-time med-tech founder and raised over $5M on demo day.

By combining his expertise in robotics with insights gained from observing surgical procedures, Nick aims to revolutionize the way surgeries are conducted, ultimately leading to improved patient outcomes and more efficient healthcare delivery.

Storytelling is everything, which is something that Nick Damiano was able to master. Being able to capture the essence of what you are doing in 15 to 20 slides is the key. For a winning deck, take a look at the pitch deck template created by Silicon Valley legend Peter Thiel (see it here), where the most critical slides are highlighted.

Remember to unlock the pitch deck template that is being used by founders around the world to raise millions below.

Lessons Learned: A Founder’s Wisdom

Reflecting on his journey, Nick emphasizes the critical importance of strategic decision-making in entrepreneurship. From co-founder selection to board control, he advises founders to approach these pivotal choices with meticulous care.

At the same time, he encourages a balance between cautious deliberation and the need for swift, calculated action. He believes this measured approach is essential for navigating the complexities of building a successful startup.


Nick Damiano’s entrepreneurial odyssey exemplifies the transformative power of innovation in healthcare. His experiences offer invaluable insights for founders, emphasizing the significance of adaptability, strategic decision-making, and a relentless pursuit of groundbreaking solutions.

As the future of healthcare continues to evolve, Nick’s visionary approach promises to leave an indelible mark on the industry, paving the way for a new era of surgical innovation and improved patient care.

Listen in to the full podcast episode to find out more, including:

  • Embrace change and use it as a catalyst for growth and innovation.
  • Consider diverse perspectives and experiences when forming a founding team.
  • Telepresence and technological solutions can revolutionize traditional industries like healthcare.
  • Careful co-founder selection and equity planning are crucial for long-term success.
  • Maintain a balance between cautious deliberation and decisive action in critical decisions.
  • Cross-disciplinary innovation holds the key to transformative advancements in healthcare.
  • Strive for outcomes that lead to improved patient care, efficiency, and reduced costs in the healthcare industry.


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Neil Patel

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