The questions people actually ask.

What does a fractional CRO for a healthcare company actually do?

A fractional CRO builds the commercial function a company doesn't have yet, rather than carrying a quota inside one that already works.

In practice that means defining who you sell to, what you say, how the process runs, what the CRM tracks, how sales hands off to operations, and what the compensation plan actually rewards — then hiring and coaching the people who take it over.

Unbound's version explicitly excludes carrying a bag. That is written into the scope of work, not just implied.

What's the difference between a fractional CRO and a sales consultant?

A consultant usually delivers a recommendation. A fractional CRO delivers working infrastructure and a team trained to run it.

The practical test: at the end of a consulting engagement you have a document. At the end of a fractional engagement you have a defined ideal customer profile, a documented sales process, a configured CRM, a compensation plan, hiring profiles, and someone on staff who can run all of it after the advisor leaves.

What causes growth to stall even when the product is strong?

Usually a constraint somewhere other than the sales team — which is why adding salespeople so often fails to fix it.

The common ones: a value proposition customers cannot repeat back to you; the wrong buyer, or the right buyer without budget authority; pricing that doesn't match how the buyer actually purchases; leaders who agree on the goal but not on who decides; a sales process that exists in one person's head; no handoff from sales into operations, so delivery contradicts what was sold.

A strong product is not the same as a scalable business. The work is identifying which constraint is actually binding before spending money scaling around it.

When should a company bring in fractional commercial leadership instead of hiring a full-time executive?

When the commercial system needs to be built, and a full-time hire would be asked to invent it while also carrying a number.

A senior commercial hire is a significant, slow commitment — search, compensation, equity, ramp — and it goes wrong most often when the person walks into a role with no defined targeting, no process and no infrastructure to run. A fractional engagement builds that foundation against a defined scope and leaves the documented system behind either way.

The clearest signal: if you are about to hire your first salesperson, build the system first. Hiring into a vacuum is the expensive way to find out what doesn't work.

What is commercial due diligence, and how is it different from financial diligence?

Financial diligence asks whether the numbers are real. Commercial due diligence asks whether they will keep happening.

It examines a target's commercial function, pipeline quality, sales process maturity and the credibility of its growth assumptions. The central question is whether revenue comes from a repeatable system or from a founder with good relationships — those look identical on a spreadsheet and behave completely differently after close.

It is a commercial assessment. It is not a legal, accounting or financial audit, and it does not replace one.

What is Foundation First?

Foundation First is Unbound's methodology: ten commercial domains assessed and built across five phases, numbered Phase 0 through Phase 4 — survey the site, pour the foundation, frame the house, bring in the crew, make the house run.

Phase 1 begins with the customer's problem rather than the product: what expensive problem the buyer actually has, what they do about it today, who decides, and what evidence would convince them. A value proposition that cannot survive those four questions is the constraint, whatever the pipeline says.

The premise is that commercial gaps are scale-invariant. The same six or seven things are missing at a small startup and at a $600M enterprise, so the same sequence works at both ends.

How much does an engagement cost?

Every engagement is priced as a fixed fee against a defined scope, quoted before any work begins. No hourly billing and no open-ended retainers.

Fees depend on scope, duration and access required, and they are set out in the statement of work alongside deliverables, milestones and exit criteria, so there is no invoice you did not expect.

Specific numbers come in the first conversation, not off a web page.

Do you take equity instead of fees?

No. Cash engagements only, no exceptions.

Performance upside is available as separately negotiated cash milestone fees where lawful and appropriate — for example tied to defined commercial milestones.

Equity-for-services arrangements misalign incentives at exactly the moment a company needs honest advice.

What does Growth Leadership Alignment assess?

The operating system behind growth — not personalities.

Growth stalls when product, clinical, operations, finance and commercial leaders are solving different problems, making conflicting promises, or waiting on decisions nobody owns. The engagement examines priorities, decision rights, ownership, escalation paths, conflicting incentives and operating cadence, then maps where the friction actually sits.

Depending on the option chosen, it delivers a decision-rights and ownership map, cross-functional friction findings, and either prioritized recommendations or a facilitated leadership working session with a 30/60/90-day roadmap.

It is explicitly not psychometric or personality testing, executive therapy, an employment investigation, legal or HR advice, or mediation. Stakeholder interviews and the limits of their confidentiality are defined in the statement of work before anyone is interviewed.

How do you prevent scope creep?

By writing the boundary down before the work starts, and by not moving it quietly.

Every engagement has a written scope of work covering responsibilities, deliverables, milestones, decision authority, fees, and the criteria for exit or transition. Work outside that scope requires a written change order — it does not get absorbed because it came up on a Tuesday.

The same discipline applies to the longer engagements. Fractional leadership defines its mandate, weekly capacity, decision rights and handover plan up front, and explicitly excludes quota ownership and prospecting. Duties do not expand automatically.

Who hires Unbound?

Founders, CEOs, investors and boards — in roughly equal measure.

Founders and CEOs typically come when growth has missed plan and the reason isn't obvious, or when they are about to spend significantly on commercial hiring and want to know the foundation is there first. Investors and boards typically come before a decision: assessing commercialization risk in a target, or working out whether a portfolio company's problem is the product or the go-to-market.

The common thread is a healthcare company facing a commercial growth or scale constraint, at whatever stage that happens. There are four conditions for any engagement: an executive sponsor with real authority who has agreed to act on the findings, an acknowledged commercial gap, a cash budget, and real access to customers, data and the team.