Becoming a surgeon is a long and arduous process but one that leads to great security and prestige. It’s not a career most people would step away from, especially not for the tenuous position of start-up founder. 

Greg O’Grady isn’t most people.

O’Grady is co-founder of two biotechnology start-ups, Alimetry and The Insides Company. He’s CEO of Alimetry, which recently gained U.S. Food and Drug Administration (FDA) approval for its flagship product, Gastric Alimetry, a high-resolution, non-invasive device that can diagnose disorders of the gut. He’s also a director of The Insides Company, which develops devices to help patients with intestinal failure. 

How did he get from surgeon to serial entrepreneur? It’s been a journey involving a sense of purpose, some help from the tech ecosystem surrounding the University of Auckland | Waipapa Taumata Rau, and a lot of hard work.

The entrepreneurial spark

O’Grady’s first exposure to entrepreneurship came when he was doing his PhD in surgery and bioengineering. Prior to that, he’d been focused on medicine, but his studies led him to compete in the University of Auckland’s Velocity $100K Challenge in the early 2010s. His team pitched a much earlier and invasive precursor of the Gastric Alimetry device and won a prize.

O’Grady was also exposed to the entrepreneurial mindset at the Auckland Bioengineering Institute (ABI), which has a long track record of spinning out companies.

“That combination of experiences fostered the idea that companies can be a great way to have impact through your research,” says O’Grady. 

While Velocity does run programmes to help turn prize-winning ideas into businesses, neither Alimetry nor The Insides Company are the direct result of these programmes. Nonetheless, he credits Velocity with helping him learn skills such as developing a business plan and planting the seed that led to Alimetry. As a professor today, he often points students to the programme.

Developing products instead of papers

After completing his PhD, O’Grady went on to become a surgical fellow, first in Auckland then in Australia. It wasn’t long after he returned to New Zealand in 2017 as a fully-fledged consultant general and colorectal surgeon and associate professor of surgery that he co-founded Surgical Design Studio, which would become The Insides Company.

“When I came back to Auckland, I started to feel a bit dissatisfied with publishing results in engineering journals about medical devices but not having them go anywhere,” says O’Grady. 

“So I pitched this idea to the University that I would start a surgical engineering lab where we would develop products instead of papers.”

The University saw it as “a bit of a curve ball” but ended up supporting the idea, says O’Grady. ABI gave him access to rapid prototyping facilities. One of his lab’s first projects was to partner on a pump for intestinal failure. Through the research commercialisation process assisted by the University and UniServices, the project later evolved into The Insides Company.

The Insides Company builds a medical device for the treatment of patients who have complex colorectal wounds or have had colorectal surgery and need their gut contents – chyme – to be diverted away into a bag to allow the wounds to heal. The chyme is typically disposed of, which doesn’t allow patients to eat normally and can lead to intestinal failure or kidney injury. 

The Insides System takes what’s flowing out and pumps it back downstream, allowing patients to return to eating and drinking normally. This can dramatically reduce hospital stays, improve quality of life and save on treatment costs. 

Traditional ways of examining guts, such as endoscopies and colonoscopies, look at the structure of the gut, not the way it functions. O’Grady and his collaborators wanted to create a device that would measure the electrical activity of the gut – a difficult proposition because the electrical signals of the gut are far weaker than those of the heart.

By 2019, collaborator Armen Gharibans, a biomedical engineer (and now Alimetry’s CTO), had developed a prototype and had tested it on patients. His results showed clear correlations between the data the device collected and patients’ symptoms.

“Seeing that data was the moment of knowing we had to pursue this – not just making a research tool but a product,” says O’Grady. “And if you make a product, you also have to offer a commercial vehicle.”

As a surgeon, O’Grady didn’t have a background in business. So he and his co-founders tapped into support from UniServices to help them develop these skills.

UniServices, the research commercialisation and impact company of the University of Auckland, offers support and expert advice in areas such as protecting intellectual property (IP), pitching to investors and securing funding. UniServices has been a great partner not only in going through these steps but in learning to think like an entrepreneur, says O’Grady.

“I learned as fast as I could by being very engaged, asking a lot of questions and getting great mentors, some of which have come through UniServices,” says O’Grady. 

UniServices also runs the Return On Science investment committees, which provide expert advice to entrepreneurs and potentially access to the capital needed to progress a project. The UniServices-managed University of Auckland Inventors’ Fund bases its investment decisions on the investment committees’ recommendations.

O’Grady was used to being busy – but starting a second company put his workload over the top. He stepped away from being CEO of Surgical Design Studio in 2019, but with Alimetry, he knew his place was in the driver’s seat. Medical devices are different from other innovations, he explains, and building the team, the company and the products required his full attention.

Last year, O’Grady made the difficult decision to step away from surgery and reduce his academic role at the university to part time.

“It was an extremely difficult decision to make because I love surgery and trained for a long time to do it, but I felt like I had to follow these opportunities,” says O’Grady.

“What I’ve discovered is if you’ve got an invention that can make a meaningful difference to patients, you have to take that further and build it into a product so people can use it. And the painful journey of building a product and company requires a champion, and ultimately if its your baby, that has to be you. So that’s the path I’ve chosen.”