"We grow ourselves – our personality and our skills."
Myriam Lingg is one of three founders of Macu, a start-up that manufactures forearm prostheses. After her studies, she worked in many different countries and cultures. During this time, she once worked as a product manager for bone cements in Mexico.
Myriam Lingg, born in 1981 in Wiesbaden, Germany, studied business administration in Passau before entering the medical technology field.
After working for Heraeus and Smith & Nephew in Germany and Mexico, she completed in 2017 her PhD at the University of Basel on orthopedic medical devices in Mexico.
In 2021 she founded macu4.
Lingg lives in Zurich with her husband and three children.
macu4 AG is a Swiss start-up that automates the production of personalized prosthetic arms for children and adults, primarily for the sports sector, using
3D printing technology in an automated and cost-effective manner.
Macu4 takes a completely new approach to personalized prostheses. This enables users to perform their favorite activities, such as sports, with more ease.
"I never wanted to be a founder of a start-up. Then suddenly it clicked."
Myriam Lingg, thank you for wanting to philosophize with us about growth. But first the question: Who are you?
I am one of three founders of Macu, where I take on the role of CEO. Macu is a medical technology company that manufactures forearm prostheses for sports and leisure applications. I studied business administration in Germany and then went straight into the medical technology industry. First in the role of product manager for bone cements, then as a sales representative for Latin America. There I joined one of the best customers in Mexico as Marketing Head for trauma and orthopedic products. I was working in quite a few different cultures. As a product manager, I dealt with Chinese, with Americans, with Italians. That was very exciting. What shaped me heavily was the "easy going" attitude in Mexico. That was a culture shock, a language shock and a new role shock. The company in Mexico was no longer this cushioned corporate environment.
How did you then come to found a start-up?
After moving from Mexico to Switzerland, it was clear that I didn't want to go back to the corporate world. My husband was already very absorbed, we had two children and a third on the way. I could have looked for something local, of course, but I didn't feel like it.
That's why I have continued my education. I thought I would learn something, which would then give me a boost in my career when I wanted to get back into it. But my profile confused the companies: product management, head of marketing, international experience, a doctorate. They perceived me as a hybrid between management and research. That's when I thought I would familiarize myself with digital health and mobile health and automatically came into contact with start-ups. I got to know more and more start-ups, went to trade fairs, and suddenly found contact with a project in the prosthesis field where I was working at ETH.
That's when it suddenly clicked. On the one hand, I noticed, whew, you guys are disorganized and unstructured. On the other hand, the technology was positioned in a totally boring way. I realized that was exactly what attracted me, how I could package it differently.
I never wanted to be a founder of a start-up. But when I saw that I could impact and transform something, I jumped in. The space was there and also the open-mindedness to say to the team, okay, let's do this together. Unfortunately, the initial project failed, not because we did it wrong, but because it was linked to another thing that didn't give us any space. I then wanted to let it go and thought, that's it now. There was this hard cut, which was a failure for us. We failed. A colleague in the team then insisted and asked if we shouldn't continue.
From the team?
Yes, he was one of the project team members and always fully involved. I was hesitant at first, but then I said, okay, I'm in, here are my conditions and values. I never wanted to become self-employed because I saw too often, among other things with my parents, how quickly many things can go wrong. Including debt, insolvency, and therefore I always believed that self-employment is something very bad.
Tell me, what is Macu?
Macu is an approach to prosthetics, at its core with a B2C model in an area where B2B is otherwise predominant. Our first product is a prosthetic forearm that is configured web-based and then 3D printed. We can measure remotely because we don't need scanning technology. We have automated design and production, our custom sizes are cheaper thanks to 3D printing and design automation.
Macu does this because there are many different classes of products in the forearm prosthetics field: Movable variants, cosmetic ones or, very important for us, the passive functional products that don't move but are functional when in contact or used with something else. You can ride a bike or kayak with it. We started with this because there is little innovation in this area.
When everything is brought up directly in the B2C model, certain margins that you normally have in that process fall away. Of course, that leads to resistance, which we have to deal with. That's why we also offer a B2B model, where an orthopedic technician can also use and sell the parts we print.
What role does growth play for you and in your company?
For me, growth means: We ourselves grow, e.g., in terms of personality and the skills we acquire. If Macu doesn't survive as a company, we will still have grown a lot. And nobody will take that away from us. It would hurt me for a while if we failed, but the growth in ourselves has been achieved. And I tell you honestly, how we've grown as a team, it's bombastic. It's so beautiful to watch.
So you see growth very much on the personal, human side?
Very much so, I grow as part of the team. In addition, I personally and the company as a whole have a big impact on others, for example on our partners. We have a supplier for 3D printers in France. This is the first time he has really worked with a small medical technology company in the field of prosthetics. We are showing him what we require in quality management, how we specify products. It is an established supplier, and we are learning from each other. We are working with another partner in the area of digital marking of our print files. We are a start-up, and the partner is more used to corporates. They've told us many times that we have great specifications and that they haven't seen it like this from big customers. So here, too, we learn from each other, and that's totally nice and exciting. The partner system learns along with us. Of course, they can only learn if we put in a lot of effort. We are sometimes over-perfect, and then also say, no, that's enough now, 80% is also acceptable sometimes.
You have talked about yourself, about the team, about the suppliers. But you haven't talked about the customers yet. What importance do they have for you?
Yes, of course, they grow with us. Yesterday I had another day like that. I got an e-mail from a customer who really wants the prosthesis, even though it is not covered by the health insurance. He said it was the only molded prosthesis he would accept. Then you think, if it makes someone happy, it's worth it. And then the next customer comes in, and she tells you the same thing. And another one.
It's a little difficult and sad sometimes to see that we're actually doing a lot of things right, but the traditional, established market doesn't really want to go along with it. So I ask myself from time to time: Are you giving up now because the old market is just too rigid, or are you sticking with it? Whenever the customers come and say that they are happy, the question is settled. So you grow with the customers.
You have an amazing view on growth. Because at first, people think about sales, profit and the exit. You didn't mention that at all.
That always has to be in the back of your mind, otherwise the investors don't think it's so great. We are totally different in the team. I'm not that interested in the exit. I'm interested in the fact that the technology is there and is successful. The exit is more of a wish. But we are different in the team. In the long-term, however, I think it's better for the product if it ends up in a larger construct and has a better chance of becoming established.
Let's get back to Macu. What will make the project successful?
The opportunity lies in the fact that we are not just optimizing a single element in the value chain, but that we are looking at the chain holistically and from a new perspective.
This approach of identifying potential along the entire chain is important and right. Logically, you then have to have a solution in the drawer for each step. And here's the funny thing: This creates a problem. In pitches, everyone says you have to focus on one thing. That's old thinking for us, but unfortunately it's still prevalent. The investors say you have three business models, but you're only allowed to do one. Then I always explain why: Because business model two is a B2B model with a signed contract and for my marketing the B2C model is no additional effort at all. Of course, I have a few hours of additional effort per month to write invoices. But the investors, the coaches, the mentors always say we should fixate on one business model, otherwise we'll get bogged down.
You've mentioned several times that you have to rethink what's already there. Why do you think that way?
I think starting from the systems and processes. In research, we call this health system thinking. You look at the structures, you look at where the problems are, and then it's about understanding what can be made simpler. And that's what we do. We look at the difficulties in the system, we look at how it could be made simpler, and we try to tie everything together. That takes time and an extreme amount of persistence.
What we do quite well is we ask an incredible amount of questions. We network like crazy. We bounce back and forth like a ping-pong ball and gather a lot of impulses, we analyze and consider individual needs. That gives us quite a bit of speed in between, but then we bump into each other again. Of course, we lack a bit of manpower to do that kind of groundwork. It's always a balancing act.
I find this picture with the ping pong very exciting. Could you say more about it?
Yes, that's how I see it. It's a constant balance between improvising and structure. I meet people, improvise, ask questions, questions, questions, and then we restructure. Now, for example, we face the challenge of mapping the socket of the prosthesis in our pricing scheme. The socket, after all, is personalized and made by the prosthetist, who then charges this to the insurance or the customer. He buys the socket as a semi-finished product, fits it and charges for the service. Many influential experts then tell us that our model does not fit into the reimbursement system of the health insurance companies. Of course, this is unfavorable for us. But others say that the insurers can be convinced and that there are loopholes. Now it's getting exciting: Can we convince the decision-makers, or will things stay the same? Will we find some who will get involved and push it through? That's then the ping that we respond to, to get a pong.
It's like an algorithm where you don't know when it's going to change, when it's going to get stronger, when it's going to mature. Then you think you've reached the goal, and then the algorithm grows again because it learns, and at the new point you find a bug again, and you have to "debug" again.
We collaborated on business coaching to bring customer focus to your market strategy. How did you perceive Vendbridge?
As a start-up, you have such a haze of issues that sometimes feel very clear and other times are totally unclear. What helped me in our collaboration was to see the issues from different perspectives. Mostly thanks to your questions. And we took the time and effort to clearly articulate issues. Thanks to Vendbridge, the haze was suddenly gone and the path was clear.
For example, we were working on the value proposition. It was one of those clouds of vapor around us. In our heads, it was clear to all of us what we were doing. But when it came to explaining the value proposition, we started here and there. That was difficult for the other party and not always equally effective. We then used your approach to sharpen the value proposition together, so that it fits the contact person and the channel.
Your work is very good at formulating a topic such as the value proposition, but also the sales process or the business model in a clear and simple way and getting to the point. At the same time, you consistently bring in the customer's point of view. For us, this is highly complex, but for you, with your approach, not at all. That is the added value.
Do you have other examples of how we brought clarity?
Yes, with the orthopedic technician. We had the challenge of not badmouthing his performance today but showing the added value if he used us as a solution. And the added value for him. That was difficult. Your recommendation was then to consider what he actually wants to achieve with his work and what his work process is. And that from the first to the last contact with his customers. Then we reflected on where in the chain we jumped in with which arguments. This logic made it much easier. It allowed us to understand the orthopedic technician's frustrations, concerns, and annoyances, and fit our solution to address his "pain points".
Behind this is our jobs-to-be-done method. We take the view of what goal the customer wants to achieve and how he proceeds. What was difficult about this?
We simply don't understand the job journey enough. For example, now in B2C. This "procedural journey" of the customer is hidden. Our big goal is to get the private customer to our website via various activities. If he searches via Google, we want to appear among the top 10. Then he clicks on it and takes a look. And what actually happens from then on? It's a different chain than in B2B. Once the customer or the client lands on the website, she wants to find out if this is a prosthetic for her to buy – yes or no. After that discussion with Vendbridge, we're already doing a few things differently today than before. We think much more from the customer's point of view.
We have the customer's process written down and we know how to pick him or her up. And then we have this chain reviewed by the customer. We want to find out what it takes to keep him or her in the funnel. And when he or she becomes unsure. We reflect on when we fail to take away that uncertainty. We've divided that into three colors, green=everything is clear, blue=customer is unsure, and red=dropout.
What would you like other growth architects to take away from your experience?
You tend to project wishful images onto your start-up. What it all might become. It's important not to do that. Because these wishful images are dreams that never come true. Instead of wishful thinking, one should clearly say: If I could only set three goals, which ones would I like to achieve?
In addition, you should be clear in advance what risk you are willing to take. And not naively, but honestly. The naked truth. Also, define clearly how much time you are willing or able to invest. It is important to be honest about this. And not build up a dream castle.
Myriam, that was fantastic. We thank you for the insightful conversation.
"Customers grow with us."
"We're bouncing back and forth like a ping-pong ball, gathering a lot of impulses."
"Thanks to Vendbridge, the haze was suddenly gone and the path was clear."