Christina LaMontagne on Scaling Healthcare with Conviction

Scaling in healthcare is never just about growth—it’s about trust, discipline, and conviction. In this 31st episode of ScaleApp Podcasts, I sat down with Christina to unpack what it really takes to build and scale a healthcare business that works for patients, parents, providers, and payers alike.

Christina’s journey is grounded in first principles. Before chasing growth, her team doubled down on unit economics, playbooks, and proof points. As she puts it, you have to “understand exactly how your model works before you deploy your Series A capital to scale it.” That discipline shaped every expansion decision that followed.

Rather than spreading thin, Christina embraced a land-and-expand strategy. The focus was narrow and intentional: one condition, one state, executed exceptionally well. Only once the model was proven did the company raise capital to scale further. This approach reduced risk, built credibility, and created a repeatable engine for growth.

A central theme of the conversation is the flywheel of trust. Expansion wasn’t just geographic—it was relational. By delivering consistently for pediatricians, the company earned trust that translated into referrals, relevance, and long-term value for families. Growth, in this model, compounds not through marketing spend, but through reliability.

Christina also challenges conventional thinking around Total Addressable Market in healthcare. With nearly half of U.S. children enrolled in Medicaid, she argues that true scale is impossible without serving the full population. Big outcomes require inclusive models—anything less leaves both impact and opportunity on the table.

Underlying it all is founder conviction. Christina doesn’t frame success around exits, but around inevitability—the belief that a solution must exist and therefore will exist. That mindset deepens over time, turning ambition into responsibility.

Her advice to her younger self captures the spirit of the episode: the audacity to build a completely different life is a founder’s superpower. Healthcare, she reminds us, offers no shortage of meaningful problems—and a lifetime of opportunity for those willing to solve them.

🔑 Key Themes

1. Scaling with Unit Economics First
2. Land-and-Expand as a Risk-Reduction Strategy
3. Trust as a Growth Flywheel
4. Rethinking TAM in Healthcare
5. Founder Conviction Over Exit Thinking
6. Healthcare as a Career-Long Opportunity Space

From Immigrant Teen to Scale Up Pioneer: The Sahar Hashemi Story

What does it take to build one of the UK’s fastest-growing retail brands, lose it, rebuild yourself, and then reinvent entrepreneurship for an entire generation of women founders? In this episode, I sit down with Sahar Hashemi OBE, co-founder of Coffee Republic and Skinny Candy, and founder of the movement Buy Women Built.

Sahar’s journey is a masterclass in how entrepreneurial culture is born, how it dies, and how to protect it as you scale. She shares moving reflections on immigrating to the UK at age 12, how her parents instilled “evidence-based self-belief,” and why being a frustrated customer has always been her superpower.

From a single London coffee bar to 110 stores, Coffee Republic scaled at breakneck speed — only to lose its soul as “the grown-ups” took over. Sahar describes, with rare honesty, how bureaucracy can slowly extinguish customer focus, what she learned from watching her own company collapse eight years after she left, and why founders must fight to preserve agility, instinct, and scrappiness.

Key Themes
•Evidence-based self-belief: why childhood pushes create adult resilience.
•Scaling culture: how processes, titles, and silos quietly kill innovation.
•Founder relevance: the outdated belief that entrepreneurs have a “sell-by date.”
•Customer intimacy: the founder’s instinct as a strategic asset, not a liability.
•Women entrepreneurs: why empathy, resourcefulness, and personal problem-solving make women natural founders.
•Leaping before you feel ready: Sahar’s enduring motto for starting anything new.

Favorite Quotes
•“Self-belief is evidence-based — you build it by doing difficult things.”
•“A startup culture can quickly put on a corporate mask.”
•“Back then they thought passion was flaky — today every big company wants it.”
•“Women start businesses from personal need — and that’s where many great ideas come from.”
•“Leap and the net will appear.”

🎧 Listen to the full conversation: https://scaleapp.buzzsprout.com

Jorge Rodriguez, founder of Paciv, built a world‑class industrial automation and computer systems validation company from a small warehouse in Puerto Rico to a global player serving Eli Lilly, Johnson & Johnson, and other pharma giants. The son of Spanish immigrants who arrived on the island with nothing but work ethic and discipline, Jorge translated family lessons about integrity, paying suppliers first, and “keeping the machine running” into a business that became a trusted partner inside some of the most demanding plants in the world.

Paciv started as Jorge leaving a safe job at Johnson & Johnson with a single client contract and a laptop. Within months he was billing 80–90 hours a week, combining deep technical know‑how in control systems with an insider’s understanding of pharma’s regulatory pain points. The insight was simple but powerful: if you can deliver the same validated process in Puerto Rico, you can clone it in Indiana, Ireland, Singapore, or the UK—exactly what global quality and regulators expect.

Favorite Quotes

• “Don’t let go of something until you have something else secure. I quit Friday and started selling services Monday.”

• “Clients spoon‑fed me growth—‘we have a larger project, but you can’t do it alone… hire a few engineers and we’ll give it to you.’”

• “To drive customer intimacy, first you model it. I was 100% billable for the first 13 years.”

• “If you stop growing, you start dying.”

• “I was riding a Ferrari in second gear. If I could speak to my younger self, I’d say: take more risk and grow faster.”

Key Themes

• From Immigrant Household to Industrial Specialist
• Becoming an Entrepreneur from the Inside
• Customer Intimacy as Competitive Advantage
• Scale Globally Through Clients, Not Campaigns
• Radical Transparency and Trust
• Professionalizing the Business: From Mom‑and‑Pop to Scale‑Up