How to set up and run a company board

If you’re a healthtech or biotech founder, the thought of setting up a board might feel daunting. I’ve had many conversations with founders who suddenly find themselves navigating this new responsibility after raising investment or find themselves nervously putting together board slides once per quarter. But here’s the thing—done right, a well-structured board can become one of the most powerful tools in your company’s growth.

I had the pleasure of chatting with Claus Torp Jenson on The Healthtech Podcast—someone who’s sat in boardrooms across the healthcare industry—and he shared some incredible insights that are too valuable to keep to myself. Claus’ experience spans leadership roles at Memorial Sloan Kettering, Teladoc Health, and CVS Health, where he’s helped steer transformation at scale. You can check out his LinkedIn profile here (the full episode isn’t out yet but I’ve just finished chatting to him and had to get this out as an academy entry! I’ll link to it once the episode comes out). 

So, let’s break it down. What are the practical steps to setting up and running an effective board for your healthtech or biotech startup?

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1. Governance vs. Stewardship: What’s the Purpose of Your Board?

First off, understand this key distinction—boards can either lean toward governance or stewardship. Here’s what I mean:

• Governance-focused boards: These tend to focus on oversight and compliance—are you managing risks correctly? Is the company financially on track? This might sound necessary (and at the latest stages it will be), but early on, this level of oversight can really stifle you and your speed of innovation.
• Stewardship-focused boards: This is what most early-stage healthtech and biotech companies need. A stewardship board isn’t there to micromanage or nitpick financials—they’re there to support, mentor, and guide you as you navigate the complexities of scaling a company.

The key here is alignment. During your funding rounds, have very open conversations with potential investors about their expectations for board involvement. Are they focused on governance, or are they more interested in helping you think long-term and strategically? You’ll want to ensure they’re on the same page as you, so your board becomes a strategic partner, not an irritating compliance machine.

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2. Hire an Independent Board Chair—Seriously

One of the smartest pieces of advice Claus shared with me is this: get an independent board chair as soon as you’re serious about being in the market. Trust me, this can completely change the dynamic of your boardroom. Here’s why:

• Objectivity: An independent chair acts as a neutral party, balancing the interests of the founders, the investors, and the company. It helps prevent any conflicts of interest from clouding key decisions.
• Maturity: A strong chair will bring maturity to your board structure, helping you and your leadership team stay focused on strategy and big-picture issues rather than getting bogged down in day-to-day operations.

The right chair will even help manage the board itself, ensuring everyone stays in their lane and board meetings are productive, rather than turning into investor-driven micromanagement sessions. This hire is worth the investment. And honestly, you might not have the right connections to find this person, so it’s often a good idea to get professional help in recruiting them. Yes, that does mean a recruiter and there are healthtech and biotech specialist recruiters. DM me on Linkedin if you want a recommendation.

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3. Who’s on Your Board? Make Sure They Add Real Value

You’ve probably been told to get “big names” or well-connected industry experts on your board. But here's the reality: you want complementary skills. Ask yourself—what areas are you weaker in, and who can fill those gaps?

• Complement your skills: If your background is in scientific research, for instance, you’ll want board members with commercialisation, regulatory, or operational experience.
• Strategic mentors: Look for people who’ve scaled companies in highly regulated industries. This is crucial in healthtech and biotech, where regulations and market access challenges can make or break you.
• Diverse backgrounds: It’s easy to focus on commercial or clinical experience, but don’t forget about other perspectives. Board members with expertise in technology, regulatory affairs, or even payer relations can offer insights you may not have.

One critical thing to avoid is loading up your board with people who just agree with everything you say. You need members who challenge you constructively—people who aren’t afraid to ask tough questions, but still respect your leadership. That kind of dynamic pushes you to grow.

Also remember that the board isn’t there to cover your weaknesses at a management level - that’s what your exec team is there for day-to-day. This is about network, strategy and vision. See below.

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4. Keep Clear Boundaries Between Management and the Board

Once your board is up and running, it’s crucial to establish clear roles. This is where I see a lot of founders struggle—especially if their investors sit on the board.

• Management = execution: Your role, and that of your leadership team, is to run the company. You’re there to execute strategy and drive operations day-to-day.
• Board = oversight and advice: The board’s role is to provide oversight, yes, but more importantly, to advise on the long-term vision and strategy. They’re not there to run the company.

Make sure everyone knows where these boundaries lie. Nothing kills momentum faster than a board that meddles too much in operations.

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5. Tap Into Your Board’s Network

Your board members are likely well-connected in the healthtech and biotech sectors, and they can be incredibly valuable if you use them wisely. Leverage their networks for:

• Hiring talent: Whether it’s your first commercial leader or a regulatory expert, they can help you find top talent.
• Partnerships: Your board can introduce you to potential partners or customers.
• Market validation: They might even offer insight into market trends or product development that can give you a leg up on competitors.

This is especially important in healthtech, where the landscape is constantly evolving. Having experienced mentors to bounce ideas off can give you a competitive advantage.

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6. Regular Communication and Meeting Cadence

Running effective board meetings is an art. I’ve seen founders who dread these meetings, but they don’t have to be a burden. The trick is clear communication and structured meetings:

• Pre-meeting updates: Send detailed updates ahead of time so board members can come prepared. Include financials, KPIs, and progress on strategic goals.
• Structured agendas: Keep meetings focused on strategic topics—things like clinical trial milestones, regulatory updates, or commercialisation strategy. Don’t waste time on operational minutiae.
• Follow-up: Assign action items at the end of each meeting and follow up on them to show the board that their input leads to tangible outcomes. Remember, the board is there to help you.

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7. Manage Investor Expectations

Once you’ve taken on investment, your investors will want to stay updated on how their money is being spent and the company’s progress. Regular communication outside of board meetings can keep them in the loop and prevent friction. That said, it’s important to maintain control over your vision. Just because someone invested in your company doesn’t mean they should dictate its direction.

So there you have it—practical, no-nonsense advice on setting up and running your board. The goal is to build a board that acts as a strategic partner in your journey, not a bottleneck or compliance headache. Keep the focus on long-term vision, get the right people in the room, and remember, at the end of the day, it’s about helping you grow your company the right way.