By Dennis Sponer, Consultant, SRX Advisors
March 2025 – Fractional leadership is reshaping how healthcare companies approach executive hiring. In an economic climate where financial prudence is critical, engaging high-caliber executives on a fractional basis ensures businesses maintain strategic leadership without excessive costs. Depressed valuations, stalled fundings, and increasing market competition define today’s corporate environment for healthcare companies.
Enterprises of all sizes in healthcare must navigate these challenges while managing costs and ensuring access to strategic leadership. Fractional leadership offers a win-win solution: businesses can engage experienced executives part-time or project-based, gaining high-level expertise without the financial burden of full-time executive salaries, bonuses, and benefits; and experienced, seasoned executives can offer their expertise to companies of all sizes on a part-time basis, filling up as much or little of their weeks as they like.
Commercial fluctuations require businesses to remain agile and adapt quickly to shifting market conditions. Fractional executives often work across multiple market segments and companies, bringing diverse insights and innovative strategies that can be implemented quickly.[i] Their exposure to multiple businesses provides a valuable perspective, ensuring companies stay ahead of industry trends while avoiding common pitfalls.
While interim leadership has existed for decades, fractional executives differ by offering hands-on executive and professional engagement on a more flexible and cost-effective basis. This model is particularly effective for roles such as Chief Financial Officer (CFO), Chief Technology Officer (CTO), General Counsel, and other senior leadership positions where strategic oversight is crucial. Neglecting these functions can lead to operational inefficiencies, regulatory exposure, and missed opportunities for growth. Financial oversight, technology strategy, and regulatory compliance are no longer optional; they are necessary for survival and scalability. Failing to engage experienced executives in key areas is not just a cost-saving measure—it can be a critical mistake that hampers business success.
Hiring a fractional executive provides access to the same or a higher level of expertise as a seasoned full-time leader but at a fraction of the cost. A company can engage the executive while only paying for the work that is needed.[ii] This model ensures businesses remain agile and competitive without overextending financial resources.
Startups and growing companies, and even sometimes firms undergoing restructuring, often cannot afford a competitive compensation package for every leadership role. For example, a growing company may not have the budget for a full-time CHRO, CFO, CTO, and General Counsel. These functions may not yet even require a five-day-a-week effort. But trying to cover these functions without top-tier talent can cause regrets and possibly impede capital-efficient growth.[iii]
For example, without legal oversight, CEOs may have to manage legal matters themselves, a risky proposition that also takes them away from core business functions. They may also attempt to fill the gap either by hiring junior attorneys, who may not have the requisite experience and who may require significant oversight, or by using outside attorneys who do not come cheap. Both solutions can lack the strategic insight needed for long-term legal planning.
Legal missteps can be disastrous for growing companies. Contract disputes, compliance failures, and employment law violations can result in unnecessary legal fees and reputational damage.[iv] A fractional General Counsel offers a middle ground, ensuring access to affordable top-tier legal expertisewhile also fostering a proactive approach to legal strategy rather than reactive crisis management.
Securing investment for growing healthcare firms is a critical milestone, yet the complexities surrounding fundraising and the sheer amount of expertise needed can be overwhelming. Presenting to investors, cap table management, quality of earnings, term sheet negotiations, and financial and compliance audits require expert oversight by someone who has “been there and done that.” Fractional CFOs can help structure deals efficiently while ensuring regulatory compliance.[v]
Navigating labor laws and HR compliance is time-consuming and complex. Startups and midsized companies are at risk of wrongful termination disputes, wage compliance issues, and even workplace harassment claims. Many also may need competenta M&A due diligence. A fractional HR expert can address these needs while avoiding landmines.[vi]
Many healthcare companies require niche expertise in regulatory compliance. However, these needs do not always justify a full-time hire. A fractional executive, such as a Chief Compliance Officer (CCO), can provide targeted expertise that is aligned with specific business objectives and ensures adherence to industry regulations, avoiding costly fines, legal battles, and reputational damage.
All healthcare companies must optimize their IT infrastructure, cybersecurity policies, and product development pipelines. For example, a SaaS company looking to scale may require cloud architecture, security, and software development expertise but not be able to justify the salary of a full-time CTO.[vii] A fractional CTO can step in and provide strategic guidance while the internal team executes daily operations.
Using fractional executives allows businesses to allocate resources toward growth, product development, or market expansion rather than executive overhead. It also enables the company to optimize decision-making, mitigate risk, and drive long-term growth. This model is a strategic advantage in today’s healthcare landscape. As fractional leadership continues to gain traction, companies that embrace this flexible, high-impact approach will be better positioned for sustained success.
About the Author
Dennis Sponer serves as Fractional General Counsel to several healthcare companies through his consultancy, SRX Advisors. Dennis is licensed as an attorney in California and Nevada and is a senior advisor to Connected Capital, a London-based UK FCA-regulated advisory firm. He is a thought leader in the legal, health-tech, biotech, pharmaceutical, and startup worlds.
Prior to founding his consultancy, Sponer co-founded ScripNet, a uniquely designed Pharmacy Benefit Management (PBM) company. After serving as in-house counsel for one of Las Vegas’s largest healthcare conglomerates, Dennis devised ScripNet as a payor-based technological solution to the pharmaceutical payment and remittance challenge. Dennis sold ScripNet to Optum Healthcare Solutions in 2012. His latest venture, HSARx, was a consumer-facing pharmacy benefit manager focused on the owners of health savings accounts. He sold HSARx to SwiftScript in October of 2023.
Dennis obtained his Juris Doctorate from Brigham Young University and his Master of Laws in Taxation (L.L.M.) from the University of San Diego. Dennis earned his MBA through TRIUM, the program jointly administered by New York University’s Stern School of Business, the London School of Economics, and HEC Paris.
Dennis can be reached at dsponer@srxadvisors.com
[i] Jannery, B. (2024, November 18). The Strategic Advantage of Hiring Fractional Executives. Fast Company. https://www.fastcompany.com/91227367/the-strategic-advantage-of-hiring-fractional-executives-empowering-ceos-to-lead
[ii] Liu, D., & Nguyen, H. (2024, September 10). Fractional Executives: a force multiplier for startups and a potential career path. Perspectives. https://debliu.substack.com/p/fractional-executives-a-force-multiplier
[iii] Cravey, C. (2024, November 21). Accelerating Business Growth With Fractional Leaders. Fast Company. https://www.fastcompany.com/91227899/accelerating-business-growth-with-fractional-leaders-a-game-changer-for-startups-and-middle-market-companies
[iv] Tish.Law. (2025, March 10). The Cost of Non-Compliance: How Regulatory Violations can lead to business litigation. https://tish.law/2025/03/10/the-cost-of-non-compliance-how-regulatory-violations-can-lead-to-business-litigation/
[v] The role of fractional general counsel in scaling startups. (n.d.). https://www.dhweberman.com/post/the-role-of-fractional-general-counsel-in-scaling-startups
[vi] Exude Human Capital. (2024, December 5). Understanding Fractional HR & Fractional HR services. https://exudehc.com/blog/fractional-hr/
[vii] Salary.com. (n.d.). Chief Technology Officer salary, hourly rate (March, 2025) in the United States | Salary.com. https://www.salary.com/research/salary/benchmark/chief-technology-officer-salary
