What if the skill that built your product is the very thing holding your company back from scaling? We sit down with medtech founder and CEO Justin Ramsaran to unpack the real transition from hands-on builder to culture shaper, and why learning to let go—without losing touch—is the leadership unlock most of us avoid.Justin traces his path from biomedical engineering and FAA software to global product leadership and founding RGP and Health Mosaic. He shares how he delegated the parts he loved most—product and early sales—by installing clear SOPs, codifying tribal knowledge, and setting rhythms that keep him close to the signal while empowering specialists to execute. We dig into selecting and developing leaders by stress-testing for EQ and resilience: who cools the room when everything is on fire, who manages up when the founder is the spark, and how adversity quotient separates future VPs from strong ICs.Culture sits at the center. Justin explains how to keep teams flat and fast as headcount grows, using cross-functional squads and decisive ownership to avoid “meeting for a meeting.” When stakes are high, he flies the team together for focused, in-person sprints that compress alignment and decisions into days, not weeks. We also explore decision paralysis with big customers and how perspective shifts—mentors, outside conversations, and even solo sports like tennis—create the mental space to make clean calls. Looking ahead, Justin is building an entrepreneurial culture from the inside out: open office hours, hackathon-style experiments, and platforms like an internal podcast to turn curiosity into validated bets. The goal is a learning organization where ideas move quickly from hunch to test to shipment, and where leadership means an open door, clear standards, and real relationships that outlast any single project.If you’re a founder or operator wrestling with delegation, culture, and speed, this conversation will sharpen your playbook. Listen, subscribe, and leave a review with the one practice you’ll adopt this week—what’s your next step toward a flatter, faster team?

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