Sanjeev Aggarwal, M.D., MBA, was just 12 years old when he knew he wanted to work in medicine. Both of his parents were doctors, so he saw firsthand how gratifying a career in medicine could be. But it wasn’t until his father needed emergency bypass surgery that he decided he wanted to be a heart surgeon. His father’s surgeon had taken the time to explain how the procedure worked—that he would stop the heart, operate on it and restart it—and Aggarwal’s mind was blown. The seeds were planted.
Fast forward to today, and Dr. Aggarwal now provides important clinical perspective on the development of surgical solutions and technologies at Johnson & Johnson MedTech. We sat down with the Heart Recovery Chief Medical Officer of Global Surgical Therapies to understand his journey—from performing life-saving surgeries in the operating room to partnering with the R&D team on innovative treatments at J&J MedTech.
What initially drew you to cardiovascular medicine?
SA: In school, I always gravitated toward the natural sciences, particularly biology. I was also completely fascinated with the heart, and learning more about it only deepened my interest. During my training while I did rotations in different surgical specialties like orthopedics, neurosurgery, and plastics, I just kept coming back to cardiac surgery. What most excited me about the cardiovascular system was that you could anatomically fix a pathology and almost immediately change the trajectory of the disease process. My father was an internist and would follow the progression of chronic diseases with medication and lifestyle changes over the course of many years. But with cardiac surgery, you could go in and replace the aorta, fix a leaky valve, remove a tumor, or bypass a blocked artery to treat and often definitively cure the disease. That the results and impact on a patient’s physiology and life are immediate was absolutely amazing and gratifying to me.
Why did you decide to pivot away from medicine and into medtech?
SA: When you first become a surgeon, you’re hyper-focused on mastering the technical aspects of different types of procedures and getting the best possible patient outcomes. Eventually—and with a lot of practice—you can comfortably and successfully handle any operation. At that point, you typically step into a leadership role in a healthcare system as a service line director, or as a chief of a department. That’s a big transition. When I became a chief, I was not only responsible for my outcomes, but also the work of nine other surgeons in addition to various clinical operations across multiple hospitals. I started to reflect on the kind of impact I wanted to have on patients and the healthcare system, and decided to go back to school and get an MBA, which transformed how I thought about solving healthcare problems.
While I knew I could continue to change thousands of lives if I kept operating, I wondered if I could leverage my knowledge and expertise in a different way that could impact even more lives—not only across the United States, but globally. Through my career, I was always evolving and adopting new technologies in the operating room. Some of the most common procedures that I performed after 20 years in practice didn’t exist when I was training. I started to think that it would be fascinating and fulfilling to be part of a team that develops those technologies, which have the power to fundamentally change the practice of medicine. That led me into the world of medtech. Even though my job would change, my mission did not: I’m still focused on bettering the lives of patients, just in a different way.
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Dr. Aggarwal performing a procedure
Was that a difficult decision to make?
SA: I had many sleepless nights where I contemplated this transition. As a physician, this kind of decision weighs heavily on you. There’s so much that goes into having a career in medicine. I remember thinking, You spent 14 years in postgraduate training to become a cardiac surgeon. What are you doing?
I was lucky because, throughout my career, I had developed close friendships with my surgical mentors, many of whom were leading innovators in the field and some of the most creative people I have ever met. I watched many of them pivot into medtech and develop medical devices, and that gave me the courage to take the leap. Left to my own devices, I could have talked myself out of it, but my mentors encouraged me to give it a shot. I realized that my motivation for going into medtech was the same motivation that led me to become a surgeon in first place, which was to help patients. Medtech offered me the opportunity to do this at a much larger scope and scale.
How has your surgical experience influenced your work in the medtech industry?
SA: The operating room is a unique environment because the surgeon is the captain of the ship. But everyone in the room is united around the shared goal of getting that patient through the procedure safely and bettering the patient’s quality of life. Everything in the OR revolves around the patient laying on the table. Working together to achieve that goal, which is bigger than any one individual, is an important concept that applies to medtech as well. It’s how I’ve informed my approach to leadership and how I navigate my day-to-day work at J&J MedTech. You don’t just serve a manager or a president—you serve a higher purpose, which is to transform and improve the life of a patient.
What’s been the biggest difference between working in medtech and medicine?
SA: As a surgeon, I had a high level of expertise in a specific domain. When I switched to medtech there was a lot that I needed to learn, so I had to approach things like I was starting from square one. In this industry, you certainly have knowledge of the medical side of things, but you need to understand how to lead cross-functional teams, navigate the global regulatory environment, manage research and development initiatives, learn about reimbursement and market access, understand manufacturing and how to scale the business, and identify unmet clinical needs. You need to approach the transition with humility and just be willing to learn. And I am the happiest when I am learning new things.
What’s been the biggest challenge?
SA: When you create a new, amazing technology that saves lives, it is, to me, a no-brainer to start using it. Changing behavior and norms in medicine, however, can be very hard. In medicine, and particularly in surgery, it can be challenging to change dogma: We take care of patients this way because that’s how we’ve always done it. While we have great data and clinical trials that support the use of a product, many physicians will be hesitant to adopt it. They often have understandable preferences for how they work and are loyal to the methods in which they were trained. It takes time to evolve how physicians treat diseases. You have to be diligent, persistent, and patient. That takes some getting used to.
Dr. Aggarwal at work with colleagues
Is there anything you miss about being a surgeon?
SA: The one-on-one interaction. As a surgeon, you get to know your patients and their families very well—I miss that, there’s no question about it. I also go to medical conferences that broadcast videos of operations. That makes me really miss the technical aspect of performing surgery.
But there are things I don’t miss, too, such as coping with a lack of resources and jumping through administrative hoops to provide good healthcare and do what is right for patients. Those are some difficult battles to fight.
My goal as a global chief medical officer is to advance science, innovation and our technologies to fundamentally change and improve how patients are cared for. Through it all, you have to keep your eye on the mission: to improve how the medical community thinks about and solves today’s biggest problems, and always keep our patients first in everything that we do.
Do you have any advice for people who want to hone their leadership skills and make their mark in medtech?
SA: First, learn how to lead by example. I would never ask someone to do something that I wouldn’t do myself. Second, be humble, and use the act of listening like it’s a martial art. If you’re formulating what you’re going to say next during a conversation, you’re not really listening. Seek to understand rather than seek to be understood. Be mindful and intentional about hearing and processing what other people are saying. There is always more to learn.
What are your goals for the future?
SA: My goal as a global chief medical officer is to advance science, innovation and our technologies to fundamentally change and improve how patients are cared for. You always need to be searching for better ways to practice medicine and care for the sick. That, in and of itself, presents challenges—you will have failures and setbacks and need to course-correct. You need to think on your feet and be persistent. And, through it all, you have to keep your eye on the mission: to improve how the medical community thinks about and solves today’s biggest problems, and always keep our patients first in everything that we do.