If you’re exploring GTM roles at digital health startups, you might read the job description and think: I get it. Sales. Growth. Maybe a little founder enablement sprinkled in.
But what’s actually being asked of you is broader, messier, and more foundational than most people expect.
Especially in digital health, the first GTM hire is less a job title and more a diagnostic tool for the company. Can they commercialize what they’ve built? Do they know who their buyer really is? Are they ready to be in market, or are they still building conviction?
It’s not just about a skill set for you. It’s about what kind of grey areas you thrive in. Whether you want to be a builder, a closer, or a partner. And whether the founder’s mindset will let you do the job you were actually hired to do.
This article gives you a clearer picture of what’s really being asked of you — not just the tasks listed in a job description, but the mindset, adaptability, and decision-making required to succeed.
Digital Health GTM Isn’t SaaS GTM With a Lab Coat
Many GTM candidates come from tech or SaaS backgrounds, where cycles are often shorter, buyer personas are a bit more defined, and objections are mostly about features or pricing. But healthcare plays by different rules — and digital health founders need their first GTM hire to understand and adapt to that reality.
Here’s what changes:
- Multiple stakeholders: You’re often not selling to one decision-maker. You may need to win over clinicians, administrators, IT teams, compliance officers, and even patients — all with different priorities.
- Longer sales cycles: Even with strong interest, deals can take months. Approvals move slowly, legal reviews drag on, and budgets may be locked in for the year.
- Regulatory complexity: You’ll need to learn enough about HIPAA, clinical trials, or reimbursement codes to speak credibly — or know when to bring in experts.
- Trust is everything: In a clinical or patient-facing environment, it’s not just about showing ROI. Buyers need to know your product is safe, reliable, and respectful of the people it serves.
- Mission matters: Founders are often deeply committed to improving lives. You’re expected not just to sell, but to believe in the product’s value and show that belief in how you communicate it.
This doesn’t mean you need to be a healthcare expert on day one. But you do need to approach the space with humility, curiosity, and a willingness to learn fast. You may need to balance commercial instincts with sensitivity to a system that’s slow-moving for real (and sometimes good) reasons.
What founders are really looking for here is a commercial partner who can operate like a tech seller but think like a systems builder — someone who’s ready to take the speed and creativity of startups and apply it to a space where credibility and care come first.
Ambiguity Is a Core Part of Early-Stage GTM Roles
Early-stage startups, especially in digital health, are often defined by uncertainty. The product is still evolving. The customer profile isn’t always clear. Even the business model may shift as the team learns what the market really wants.
That’s the environment you’re stepping into as the first GTM hire.
When founders write that they’re looking for someone who can “figure things out from first principles,” what they really mean is: you’ll be building while flying the plane. You may not be handed a polished deck, battle-tested sales process, or a CRM with clean data. You’ll likely be the one creating all of those from scratch.
In some companies, the founder has a strong vision for go-to-market and wants a right-hand operator to help execute it. In others, the founder is looking to hand over GTM entirely and expects you to take full ownership, strategy and all. Most don’t state which version you’re walking into.
That’s why one of the most important things to assess before joining is what kind of ambiguity you’re expected to lead through:
- Is the product stable enough to sell, or still shifting underneath you?
- Are the expectations clearly defined, or open-ended?
- Will you get mentorship and input, or complete autonomy?
The truth is, ambiguity isn’t a temporary phase you’ll “get through.” It’s the job itself — for months, maybe longer. Success depends not just on your ability to move forward in the face of uncertainty, but to bring structure where none exists and make decisions without perfect information.
The First GTM Hire Is the Connector Across Teams
At this stage, a digital health startup doesn’t necessarily have dedicated departments for sales, marketing, customer success, and ops. What it has is you.
The first GTM hire often becomes the bridge between everything: product and market, customer and team, operations and outcomes. It’s not just about bringing in revenue, but making sure the company learns, adapts, and delivers value at every stage of the customer journey.
That means:
- Gathering insights from early users and turning them into product feedback
- Helping shape the company’s narrative and messaging
- Coordinating handoffs between sales and implementation, and
- Following up with customers to understand outcomes and drive retention
In practice, this role is often deeply cross-functional. You may find yourself sitting in on product standups one day, pitching a hospital network the next, then refining onboarding processes by Friday. You may be the one updating the CRM, writing case studies, and answering support tickets — because there’s no one else yet to do those things.
You’re also the person who helps the company tell its story more clearly. Especially in healthcare, it takes work to translate technical details or clinical benefits into a message that resonates with buyers, whether that’s a health system administrator, a clinical researcher, or a parent looking for care.
What founders really want here is someone who can move across functions fluidly, spot patterns in the noise, and pull people together to create progress. If you think of GTM as a straight sales pipeline, this might feel frustrating. But if you see yourself as a connector, translator, and builder, you’ll thrive in the role.
Your Relationship With the Founder Matters Most
Founders often describe their first GTM hire as someone who will “work directly with the CEO” or be a “thought partner.” This sounds exciting — and it is — but it’s also a signal: your relationship with the founder will shape almost every part of your experience.
In the early days, you won’t just report to the founder. You’ll likely sit in on investor calls, draft decks for fundraising or board updates, field product feedback, and relay it in real time. You may help prioritize between partnerships, pilots, and revenue, and act as a sounding board when tough choices come up.
Depending on the founder’s background, they may have strong views on GTM — or none at all. Some will want to collaborate closely on every deal. Others will hand it all over to you and expect results without much involvement. Neither is inherently good or bad — but you need to know what you’re walking into.
You’ll need to know whether you work best with hands-on guidance or full autonomy, whether you’re comfortable having your work edited or challenged, and whether you can operate inside someone else’s vision while shaping your own over time.
This relationship is often what makes or breaks the role. Trust, communication, and shared expectations matter more than a title or comp package.
If you’re aligned with the founder’s way of working — and they’re aligned with yours — you’ll be able to move fast, adapt quickly, and build something powerful together. If not, even small disagreements can become major obstacles.
Your job won’t just be GTM execution. In many ways, it will be co-building the business with the person who started it.
What Early-Stage GTM Success Really Looks Like
Many job posts talk about closing deals, driving revenue, or “owning the sales pipeline.” But when you’re the first GTM hire at a digital health startup, success goes deeper than hitting a number. What founders really want is proof that the company can grow in a repeatable way. That might mean:
- Landing a few early customers who validate the value of the product
- Figuring out which messaging resonates and which doesn’t
- Building a basic CRM system that tracks leads, deals, and outcomes
- Creating a process for onboarding and customer success that doesn’t fall apart as the company scales
- Helping the team understand who their best-fit customer actually is
In some companies, you might bring in one key deal that unlocks a new market. In others, your biggest impact might be creating structure — so that future hires don’t have to rebuild everything from scratch.
In that sense, this isn’t just a sales job — it’s a design job. You’re designing the systems, feedback loops, and communication flows that make growth possible. And you’re doing it while actively testing what works in the real world.
Founders know they’re still learning. They want someone who can both act and reflect: close deals, yes — but also bring back what’s working, what’s not, and what needs to change.
Say yes only if you can measure impact beyond revenue, build while proving what works, and stay motivated when the answers are unclear. That’s the job.
So What’s The Upside?
All of this can sound like a lot — and in many ways, it is. But alongside the pressure comes a kind of opportunity that may be hard to find in more established roles.
You’ll likely have more freedom than you would at a larger company. You’re not stepping into a rigid structure; you’re helping build it. That means you may get to define your role, shape key decisions, and leave a mark early.
You’ll also be closer to the mission. In healthcare, the stakes are high — but that also means the work is meaningful. You’re not just driving numbers; you’re helping a product reach people who truly need it.
Career-wise, these roles can be accelerators. You might grow into a head of sales, chief commercial officer, or general manager faster than in more traditional paths — simply because you were there early and proved you could lead.
There’s also a steep learning curve. You’ll get exposure to different parts of the business, from product to ops to fundraising. If you’re curious and open, this kind of role can be a crash course in what it takes to build a company.
Finally, there’s a kind of camaraderie that comes from working through the messy early stages alongside a founder. When it works, it’s not just a job. It’s a shared build — and that can be deeply rewarding.
GTM Fit Is a Two-Way Due Diligence
It’s easy to frame early GTM roles as high-risk, high-reward. But that misses the deeper opportunity: these roles let you define how a company enters the world.
So when you’re considering one, don’t just ask if you can win. Ask if you want to win with them. Do you believe in the mission? Can you work with the founder? Is the ambiguity energizing, not draining?
The job descriptions will keep saying the same things. It’s up to you to read between the lines.
And if it all lines up — if the founder is ready, the story is credible, and the work feels like the right kind of stretch? Then jump in. There’s no GTM role more foundational, or more fulfilling, than the one that helps bring real care to the people who need it most.
