Fractional CTO · regulated healthtech
I build engineering teams that hold.
Through the audit, the fundraise, the migration, and the week your best engineer wobbles.
Currently Head of Software for a medical-device company. I take on a small number of clients alongside it, on purpose.
- 8+ years leading engineering
- Medical-device / safety-critical
- Async from France, US & UK overlap
The bind
Most startups run engineering flat out. It works, for about three days.
- 01
The trade you were sold
Push for speed and the audit gets scary. Slow down for compliance and the runway burns. Lean harder on the team and your strongest engineer starts returning recruiter calls. Founders get told this trade is the price of building in health. It has a simpler name: running the org at its maximum all the time, and calling it “velocity.”
- 02
The system that holds up
Margins are what let a team absorb an audit date, a migration, a bad week, without dropping the roadmap. Set up properly, one system produces the speed and the audit evidence together, and people stay, because working there got better. That system is what I build.
Offers
Four ways in. Every one starts with a conversation.
Which one fits depends on your stage and what's at stake. Every one begins the same way: a conversation, no pitch.
Diagnostic
The truth about where you stand, and what to fix first.
Founders who sense something is off: velocity drifting down, a team gone quiet, an audit on the horizon.
02Fractional CTO
A team that ships faster, and an audit that stops being a crisis.
Funded healthtech scaling fast or under regulatory pressure, without a senior technical leader in the building.
03Thinking partner
A second brain for the calls you can't take to the board or the team.
Founders and technical leaders who are the most senior engineer in the room, with no peer to pressure-test the hard calls.
04Advising
Managers who run 1-1s that change something, and a team you can finally read.
Engineering leaders who need the managers under them to actually lead, not just pass information up.
How I work
The hard part was always the people.
I started in backend and infrastructure. The deeper I went, the more the problems I cared about turned out to be human ones. These are the things I watch, and the way I hold the job.
- 01
Margins, not maximum
A team with margins absorbs an audit, a migration, a bad week. One at maximum drops the roadmap.
- 02
Bad news should travel fast
The health of a team is how quickly a problem reaches the person who can fix it.
- 03
Someone owns every decision
If nobody can name who owns the thing they're blocked on, that's the bug.
- 04
Mistakes get studied, not hidden
A team that flinches from errors repeats them. One that studies them gets better.
- 05
Listening is most of the job
One question, then silence. The truth arrives around minute fifteen, never the first sentence.
- 06
The honest thing over the polished thing
I'd rather tell you what's actually going on than the tidy version.
The record
I've done the job, not read about it.
Three companies in regulated, safety-critical work. The through-line: teams that shipped under real pressure, and stayed.
- 2024–present
Okeiro
Head of Software
Medical-device company building software for organ-transplant care. The team grew roughly 5x on my watch, through regulatory audits, and the people stayed.
- 2021–2024
Dreem
Engineering Manager
Grew into leading the team, then took it through the company’s acquisition and a cloud platform migration on a deadline the next funding round depended on.
- 2018–2021
Conity
CTO
Joined at the earliest stage. Took ownership of the codebase, built the cloud architecture from scratch, and shipped the products the business built its name on.
- since 2014
Earlier
Backend · Web · Data
Custom business software, e-commerce, real-time data. The technical base I lead from.
References from founders and engineers available on request. The full history lives on LinkedIn.
What to expect
No black box. Here's the shape of it.
No mystery and no lock-in. Here's what the first hour, the first days, and the first year tend to look like.
After 1 hour
A straight read on your biggest engineering risk, and whether I'm even the right person.
After 2 days
A ranked plan, in plain language, that someone could act on tomorrow, with or without me.
After 6 months
Audits feel routine, velocity is up and you can see why, and the team you were worried about is still here.
After 1 year
The last unplanned thing, a departure or a pivot, got absorbed instead of becoming a crisis.
Questions
What founders ask first.
"We're regulated, so we're slow." True?
The most common sentence in first calls, said like weather. In the teams I've been inside, false: the rules were rarely the slow part. Fear was. A scared engineer sits on a bug for another week; a scared team brings you a tidy solution and keeps the messy problem, which was the part you needed. Build the documentation into how the work flows and the audit becomes a snapshot of an ordinary week. Fix the fear and the speed shows up on its own.
How does working remotely from France with a US team work?
A few hours of real overlap each week for what needs faces; everything else in writing, decisions logged where your team can find them. My morning happens before yours, so your engineers often start the day already unblocked. I've worked fully remote for years.
Do you only work with medtech?
Regulated healthtech is home turf and where I'm most useful. The core work travels well: scaling cleanly, keeping a team healthy, shipping under real constraints. If you're in an adjacent serious or regulated field, get in touch anyway.
What size of company is this for?
Funded startups and scale-ups, mostly seed to Series B. The unifying trait is scaling pain or regulatory pressure, usually both.
Is fractional just a fancy word for part-time consultant?
The hours are partial. The involvement isn't. I know your people by name, I'm in the decisions, and I carry responsibility for outcomes. What you skip is the full-time package and the long executive search.
Can we start small?
Yes, and many founders should. That's what the diagnostic is for: two days, a written plan, and then you decide what happens next.
How fast can you start?
Usually within a couple of weeks. I keep the client list short on purpose, so the start date depends on who's already on it.
What does it cost?
Scoped on a call, once I understand your stage and what's at stake. I'd rather give you a real number for your situation than a menu that fits nobody.
Let's talk
Get in touch.
I read every message myself. Tell me what's actually going on. The messy version is fine. If I'm not the right person, I'll say so and point you to who is.– Richard
Got it. I read every message myself, so you'll hear back from me directly. If anything looks stuck, write me at hello@r-ichard.com.