Product Strategy vs. Product Management: The Critical Distinction Every Founder Must Understand
- Kristina Furlan
- Aug 15
- 6 min read
When smart founders misdiagnose their product leadership needs, and how to get it right
A LinkedIn message landed in my inbox: "I've been looking for unicorns — someone with the intersection of healthcare product and engineering experience. We need help."
The founder was a clinician and researcher who had built something remarkable. Two decades of evidence-based research at a major academic institution. Multiple clinical trials proving their approach could dramatically reduce treatment time. A significant grant to scale their training platform with AI.
But despite all that clinical validation, they were struggling to translate their breakthrough research into commercial success. The founder was convinced she knew exactly what they needed: execution. A product manager who could handle the day-to-day work of building features, managing sprints, and coordinating with their engineering team.
"We have a 50% product person," she explained during our first call. "We just need more hands. More hours."
It seemed straightforward. The founder had done her homework, researched the market, and identified a clear gap in execution capacity. She even had a budget range in mind and a job description ready.
But as we dug deeper into her actual challenges, something more complex emerged.
The Diagnostic Moment
A few minutes into our conversation, I asked what seemed like a simple question: "Do you feel confident in your strategic pillars, how they map to your business objectives, and how that translates into a granular roadmap?"
Her pause said it all. Roadmaps changed every time they got a new grant. Market segments weren’t prioritized. Clinical validation hadn’t yet been translated into commercial positioning.
She didn’t just have an execution gap. She had a strategy problem disguised as a management problem.
Here's what I was hearing beneath the surface: They had incredible clinical validation but hadn't aligned their clinical value proposition with their economic value proposition and go-to-market approach. They were spread across multiple market segments without clear prioritization. They had grants driving product decisions rather than strategic frameworks.
This is the difference between product strategy and product management — and why conflating them can be costly.
Strategy vs. Management: The Critical Distinction
Product management is about execution. It's the daily work of translating requirements into features, managing backlogs, running sprints, coordinating with engineering teams, and ensuring products get built efficiently.
Product strategy is about direction. It's the higher-level work of deciding what to build, for whom, and why. It's aligning product decisions with business objectives, choosing between competing opportunities, and creating frameworks that guide execution.
Most founders intuitively understand this distinction in other areas of their business. They wouldn't confuse bookkeeping with financial strategy, or hiring with organizational design. But when it comes to product, the lines often blur.
Here's why this confusion is particularly common in health tech:
Regulatory complexity creates false urgency around execution. When you're navigating FDA approvals or HIPAA compliance, it feels like the main challenge is getting things built correctly. But building the wrong things the right way won't get you anywhere.
Clinical validation can mask commercial strategy gaps. Proving your solution works in trials doesn't automatically translate to product-market fit. The path from "clinically effective" to "commercially viable" requires strategic thinking about positioning, pricing, and market entry.
Technical complexity demands immediate attention. Integration with EHRs, clinical workflows, and provider systems creates daily fires that need putting out. It's easy to mistake urgent execution needs for fundamental strategic challenges.
The Real Cost of Getting This Wrong
When founders misdiagnose whether they need strategy or management (or both), three expensive things happen:
You hire the wrong level of person. If you need strategic guidance but hire for execution, you get someone who can build what you tell them but can't help you figure out what you should be building. If you need execution but hire strategically, you pay senior rates for work that could be done more cost-effectively.
You solve symptoms instead of root causes. Adding execution capacity won't fix strategic confusion. You'll just build more features faster without clear direction. Adding strategic oversight won't solve execution gaps. You'll have great frameworks but poor follow-through.
You delay the real solution. Every month spent with misaligned product leadership is time not spent building momentum toward actual product-market fit. In competitive markets, this delay can be existential.
The Framework: Diagnosing What You Actually Need
Here's how to determine whether your product challenges are strategic or executional:
You Need Product Management When:
You have clear strategic direction but poor execution
Your team knows what to build but struggles with how and when
You're missing basic product development processes (sprint planning, backlog management, stakeholder communication)
Your engineering team has capacity but lacks organized product requirements
Decisions get made but don't translate into shipped features
You Need Product Strategy When:
You're building features but you’re not sure they're the right ones
Multiple stakeholders have different opinions about priorities
You're spread across too many markets or use cases
Your product roadmap changes frequently based on external pressures
You have good execution but unclear business impact
You Need Both When:
You're experiencing both sets of symptoms simultaneously
You're at an inflection point (new funding, market expansion, regulatory changes)
Your team has grown beyond the founder's ability to provide both strategic direction and execution oversight
You're juggling multiple products or significant platform evolution
The Creative Solution: Right-Sizing Your Investment
Back to the founder's situation. Once we identified that she needed both strategic guidance and execution support, we had a choice. I could have proposed a comprehensive engagement where I handled everything — strategy, execution oversight, team management — at my senior-level rate.
But that wasn't a smart business decision for her company, and it’s not what I recommended.
Instead, I proposed a team approach: I would provide strategic guidance at 5 hours per week, while we found a junior product manager to handle execution at 15-20 hours per week. This gave the founder both capabilities with a better cost structure.
The junior PM could focus on:
Sprint management and engineering coordination
User research and feedback documentation
Provider workflow optimization
Translating clinical algorithms into technical requirements
While I focused on:
Aligning clinical and economic value propositions
Go-to-market strategy and positioning
Commercial prioritization frameworks
Maximizing their accelerator grant opportunity
This approach addressed the founder's initial need (product execution) while solving the strategic gap we uncovered together. More importantly, it was designed around what her business actually needed, not around maximizing my engagement.
Why This Matters Beyond One Engagement
This story illustrates something important about how fractional product leadership should work. The goal isn't to maximize the size of the engagement — it's to find the right tool for the job.
Sometimes that tool is pure strategy. Sometimes it's execution support. Often, it's a creative combination that gets you both capabilities efficiently.
But you can't make that determination without rigorous diagnosis. And you can't do rigorous diagnosis without someone who understands the difference between strategy and management challenges — and has the founder empathy to recommend what's actually best for your business.
The best fractional leaders act as problem-solvers first, service providers second. They help you figure out what you actually need, then structure solutions around your business constraints and objectives.
Getting the Diagnosis Right
If you're wrestling with product leadership decisions, start with honest assessment:
What specific problems are you trying to solve? Get granular. "We need product help" isn't specific enough. "Our engineering team has capacity but we can't prioritize features effectively" or "We have clear priorities but poor follow-through" gives you more to work with.
What capabilities exist internally? Maybe your head of engineering is already handling some product management work. Maybe you're providing strategic direction but need execution support. Build on existing strengths rather than replacing them.
What does success look like in 6-12 months? If success requires fundamentally different strategic positioning, you need strategy help. If it requires better execution of known priorities, you need management support.
What's your learning curve budget? Strategy work often requires domain expertise that's expensive to build internally. Execution work can often be learned on the job by smart generalists.
The companies that get this distinction right move faster because they're investing in the right capabilities at the right level. They avoid expensive mishires and get to product-market fit more efficiently.
The companies that get it wrong spend months or years building excellent execution around poor strategy, or developing beautiful frameworks with no follow-through.
Your Path Forward
Product strategy and product management are both critical capabilities, but they serve different purposes and require different expertise. Understanding which one you need — or how to combine them effectively — can be the difference between breakthrough growth and expensive spinning.
The key is honest diagnosis before solution design. What are you actually trying to solve? What capabilities would best serve your business at this stage? How can you structure the most efficient path to both strategic clarity and execution excellence?
Ready to explore creative solutions? Schedule a strategic conversation where we can discuss your specific challenges and explore the most efficient way to address them — whether that's strategy, execution, or a combination approach.
I'm Kristina Furlan, a fractional CPO specializing in health tech product strategy. Having co-founded and scaled a health tech company, I understand the challenges of balancing strategic vision with execution realities. I help health tech companies navigate complex product decisions by first diagnosing what they actually need, then structuring creative solutions that optimize for business success.
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