Peter Sorgenfrei

Live a happier and healthier life. I'll get you there in 3 months or less.

I work privately with founders when something has started to repeat or quietly erode, even though nothing has visibly broken yet.

By the time people reach out, conversations escalate more easily, conflicts don’t fully resolve, authority thins, or work begins to spill into personal life in ways that are hard to contain. What used to feel manageable starts depending on effort.

This is not coaching for growth, optimisation, or personal development. It’s not therapy.

The work focuses on stabilising these patterns before continuing as-is costs more than it should, professionally, personally, or both.

Engagements are private, time-bounded, and deliberately contained. We reassess once things begin to resolve cleanly again.

If you’re looking for ongoing support, performance work, or stress relief, this is probably not a fit.

If continuing as you are no longer feels neutral, this is usually the right moment to reach out.

I also send occasional writing under the name Intentional Leadership, quiet notes on pressure, responsibility, and decision-making. Sent infrequently.

Executive and Board Advisory

I work with Investors, Boards, and Leadership teams to develop people and grow companies

Being a startup founder explained in 12 seconds.

You start at the top.

You've got a plan. 

A strategy. 

A direction.

Then you spin around completely, and suddenly you're going downhill, facing the wrong way.

You can't see where you're going. 
You definitely can't see the finish line. 

Your investors are watching from the sidelines, trying to make sense of what just happened.

But you're still moving.

Still somehow staying on your feet.

And against all logic, you cross the finish line. 

Backwards. 
Confused. 
But you crossed it.

Six companies. 
Fifteen years. 
I've finished backwards more times than I'd like to admit.

The founders I coach? Same thing. 

The ones who make it aren't the ones who never spin out.

They're the ones who keep skiing when they can't see where they're going.

What's your "finished backwards" moment?

In 30 days, you can go from snappy and reactive to calm and clear, at work and at home | 60+ happy clients | 6x CEO/Founder | DM me: I can probably fix whatever it is you are dealing with.

CEO Coach | Board & Strategy Advisor | Chairman & NED - Helping ambitious CEOs, Founders and Entrepreneurs develop themselves, their people, and grow their companies.

Kevin McDonnell is a CEO Coach, Strategic Advisor and Chairman working with CEOs, founders, boards, and investors on leadership and execution that accelerate growth, scale and success.

Over a 30 year career, Kevin has built, scaled, and exited multiple Technology and Healthcare businesses across startup, growth, and global operating environments. 

His experience includes capturing 80 percent market share within 3.5 years, driving £60 million in revenue in 20 months, and taking a business into more than 10 international markets.

Kevin has led through and advised on four exits and has operated at enterprise scale inside a £5 billion organisation employing 75,000 people and serving 320 million users globally. 

He has chaired 11 boards and coached or advised more than 100 CEOs and founders.

His primary work is CEO coaching, with a focus on building the leadership capacity and operating infrastructure required for sustained growth. His work centres on scaling the CEO, leadership and the business.

Alongside his coaching work, Kevin supports a select number of companies as a Strategic Advisor, Chairman, or Non-Executive Director. In these roles, he focuses on aligning vision with delivery, strengthening board-level governance, and improving execution consistency.

HealthTech is Kevin McDonnell’s core domain. He also advises leaders outside the sector where complexity, regulation, and scale create similar leadership and organisational challenges. 

Across industries, his work reflects a consistent view. Growth constraints rarely originate in markets or technology. They originate in leadership systems and human decision-making.

Kevin also writes Defiltered, a newsletter on leadership, growth, and performance for CEOs and founders - defiltered.substack.com

Kevin McDonnell

Nobody quits a great boss.

They quit the manager who gave their idea to someone else in the Monday meeting.

They quit the one who said "I'll look into that" four times and never did.

They quit feeling invisible while watching someone louder get the credit.

The resignation letter usually says "new opportunities."

It was written six months ago. In their head.

The real decision - the one that actually ended the relationship - happened quietly. 

No drama. 

Just a slow accumulation of small things that eventually tipped the scales.

And here's what makes it expensive: by the time you notice, you've already lost them. They're just still showing up.

I wrote about this for Defiltered. Not the perks-and-ping-pong version of retention. The actual version - what loyalty costs to build, how fast it erodes, and what leaders consistently miss until it's too late.

CEO Coach & Chairman | Author of ‘Decisive by Design’ (soon) | Helping HealthTech CEOs unlock potential, growth and scale | 100+ CEOs coached.

Your best people don’t leave loudly. They leave slowly - and usually, you gave them every reason to. There’s a particular kind of resignation letter t

Open article: Nobody Quits a Great Boss. So Why Are Your Best People Leaving? by Kevin McDonnell • 5 min read

Nobody Quits a Great Boss. So Why Are Your Best People Leaving?

You can build a HealthTech product with a small team.

But scaling it will break you if you treat it like SaaS.

There is a massive difference between shipping software and changing clinical behaviour. 

One is product delivery. The other is system change.

Here is the “Pilot Ceiling” most HealthTech CEOs hit:

A pilot proves value. It does not prove adoption:
Clinicians tolerate experiments. They resist permanent workload.

One Trust win does not equal repeatability:
Every new site resets trust, risk, integration, and procurement.

Integration beats innovation in every buying meeting:
A 10/10 model still loses to a 7/10 tool that fits the workflow.

The hidden cost of “we’ll figure it out after go-live”?

Operational debt:
Workarounds become your default delivery model.

Credibility leakage:
Each rough rollout reduces belief in the next one.

Founder bottleneck:
You become the translator between product, clinical, IG, and procurement.

Scaling is not more deals. Scaling is less reinvention per deal.

What blocks HealthTech scale more often?

→ Workflow friction
→ Integration and data access
→ Procurement timelines
→ Clinical risk and governance

If your pipeline is growing but delivery feels harder every month, you’re not scaling.

You’re accumulating debt.

In healthcare, the status quo has 100% market share. 

Here’s how to actually steal it.

Your biggest competitor in HealthTech isn't who you think it is. It's not:

 - the startup that just raised £20M.

- the legacy vendor with enterprise contracts.

- the HCP who says: "We've always done it this way."

- the HCP who doesn't have 30 seconds to learn your interface.

- the HCP who knows that change = risk.

In HealthTech, you're not just fighting other companies.

You're fighting inertia.

And inertia has a 100% market share.

Here's why the status quo is unbeatable if you fight it the wrong way:

The status quo has zero onboarding friction - Your product might be 10x better. But "better" requires learning, training, and workflow changes. The old way? Everyone already knows it.

The status quo has zero blame - If a patient outcome is bad using the current system, it's unfortunate. If it happens after adopting your tool? You're liable. Risk-averse institutions will choose "unfortunate" over "liable" every time.

The status quo doesn't need a business case - You need ROI projections, clinical studies, and board approvals. The status quo just... continues. Doing nothing is the only decision that requires zero justification.

The status quo is exhausting to fight - Most HealthTech founders burn out trying to convince people to change. They mistake "this is better" for "this is worth the disruption." It's not the same thing.

So how do you actually win against inertia?

Make adoption feel like less change, not more - The best HealthTech products don't ask clinicians to change their workflow. They embed into it. If your product requires new habits, you've already lost.

Make the status quo more painful than switching - Don't sell features. Sell relief from a problem so acute that doing nothing hurts more than trying something new. If providers aren't in pain, they won't move.

Find the people who hate the status quo - Every hospital has clinicians who are fed up. Burned out. Desperate for a better way. They're your champions. Ignore the early majority - they'll never move first.

Your product isn't just competing in a market.

It's competing with the path of least resistance.

And until you design for that reality, you'll keep wondering why "the best product" isn't winning.

Why being a great founder makes being a CEO so difficult.

In the early days, your value was tied to your output. 

You were the "Chief Everything Officer." 

You wrote the decks, closed the deals, and knew every line of code.

That "hustle" is exactly why your company can start to slow down. 

It’s was your superpower.

But as you scale, the physics of leadership change.

Suddenly, the very traits that built the company - speed, hands-on problem solving, and being the "answer person" -  can become the things that limit its next phase of growth.

This isn't a failure; it’s an evolution.

When I sit down with leaders navigating scale or a major corporate transition, we don't talk about "fixing" things. 

We talk about the shift from being the Lead Actor to being the Director.

Here are three subtle shifts that help high-performers reclaim their time and impact:

1. From "Giving Answers" to "Building Context"

In the beginning, you provide the solution. Now, your job is to provide the "Why" and the "Guardrails" so your team can find the solution themselves. It feels slower at first, but it’s the only way to build a self-sustaining machine.

2. The 80% Rule for Excellence

High-performers hate "good enough." But if a team member can do a task at 80% of your quality without your input, that is a 100% win for the organization. It frees you up to focus on the 20% of the business that only you can touch.

3. Creating a "Third Space"

You spend all day being "on" for your board, your employees, and your customers. Every leader needs a space where they can be "off" - where they can pressure-test ideas, admit uncertainty, and think out loud without it becoming "company policy."

Leadership at this level isn't about working harder; it’s about thinking more clearly.

The most effective CEOs I know aren't the ones doing the most.

They are the ones who have created the most space for their teams to shine.

HealthTech PMF is seven permissions, sequentially.

Miss one, and you stall.

A pilot “wins”.
Clinicians like it.
Outcomes look good.
Everyone breathes out.

Then the deal disappears into a void of polite silence.

No rejection email.
No hard “no”.
Just delay. deferral. committees. “next quarter.”

That is not a weak value proposition.

That is permission not transferring across the system.

So here’s the framework that stops teams blaming the wrong thing.

The Seven Permissions (in the order they kill momentum)

1) Clinical permission
“Is this acceptable practice?”
If it threatens identity or guidelines, you get soft sabotage: agreement in meetings, avoidance in reality.

2) Workflow permission
“Who absorbs the extra steps at 07:12?”
Seconds per patient are not trivial. They compound into resentment.

3) Data permission (IG)
“What exactly moves, where, why, and for how long?”
If answers are fuzzy, trust evaporates.

4) Security permission
“Can we defend choosing this after an incident?”
Teams don’t buy ‘secure’. They buy ‘defensible’.

5) Procurement permission
“Can we buy this without creating trouble?”
Frameworks, thresholds, incumbents, and the quiet rule: adding a new vendor creates work for everyone.

6) Budget permission
“Whose cost centre funds it, this year?”
If there’s no clear budget line, there’s no decision. Only hope.

7) Liability permission
“Who owns the edge cases when it goes wrong?”
Edge cases are guaranteed. Ownership is not.

Most HealthTech teams try to solve Permission 6 with better messaging.

Or Permission 7 with more clinical evidence.

It rarely works.

HealthTech buying is not persuasion.

It is risk migration.

How teams stop stalling

1) Create a Permission Ledger before building more.
One page. Seven permissions.
For each: the owner, the fear, the proof required, the cycle time.
If the owner is unnamed, the work is imaginary.

2) Run a deployment pre-mortem, not a product retro.
Ask: “Assume this fails in 90 days. What killed it?”
Teams will surface the real killers: access, logins, exceptions, training load, incident response, change control, and handoffs between departments.

3) Design for the worst Tuesday, not the best pilot.
Pilots happen with goodwill and attention. Tuesdays happen with shortages, backlog, and fatigue.
Build for Tuesday and adoption stops being fragile.

4) Make ‘yes’ safe for every function.
Not just clinicians.
IG needs clarity. Security needs defensibility. Ops needs ownership. Finance needs a budget story. Procurement needs a clean pathway.

The most scalable HealthTech products are not the most loved.

They are the most permittable by the whole system.

If momentum is stuck, don’t ask, “Do they like it?”

Ask, “Which permission are we failing to earn, and which team is silently protecting itself?”

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