# Your marketing is busy. Your pipeline is not. Fractional CMO and GTM advisor for health tech and regulated B2B. I am Peter Cullinan. I work with Seed to Series B founders in health tech and regulated B2B software, where long cycles, security review, and multi-stakeholder buying committees stall pipeline that looks healthy on paper. I build the system that turns marketing activity into pipeline you can forecast. [Book a strategy session](https://scheduler.zoom.us/peter-cullinan-goto-marketing/go-to-marketing) [peter@go-marketing.ai](mailto:peter@go-marketing.ai) 20+ years building GTM and revenue functions in healthcare IT and regulated B2B software. GTM OS Certified Partner. ## Proof **$100M+** — Annual pipeline for three consecutive years, from a revenue marketing and operations function I built from scratch at a PE-backed revenue cycle management company. **$6.5M** — Company-record pipeline and $2M closed-won at a Series A healthcare technology company, from the first formal marketing organization it ever had. **$200M+** — Pipeline supported at a healthcare technology company, plus $200M+ in e-commerce revenue at a healthcare and life sciences business. ## Nine GTM failure patterns I see in regulated markets These are the failure patterns I look for first. The symptom is common to every B2B company. What it costs you, and how you unwind it, is specific to selling into health systems, payers, and compliance-heavy buyers. ### Business is relying on heroic sales players and not plays One rep knows how to navigate a health system. Their deals close. Nobody can explain what they do differently, so the number depends on whether that person stays. ### Sales, Marketing, and Customer Success are out of sync The AE says the lead was unqualified. Marketing says nobody worked it. Meanwhile the evaluation has a clinical champion, a CISO, and a CFO in it, and no one owns the committee. ### You can't predict and forecast revenue for the next two quarters Deals slip on security review, BAA redlines, and budget cycles you do not control. Until your stages are defined by those gates, the forecast is a feeling. ### Heavy discounting and feature wars are eroding your value prop The buyer cannot tell what you replace, so you get priced against a point solution. Then the pilot gets negotiated down before it has proven anything. ### Your customers love you, but can't quantify their ROI at renewal time Clinical teams are happy. The CFO cannot find the savings in their own P&L, so the renewal becomes a flat-fee conversation instead of an expansion. ### You can't prioritize or say no to new initiatives Every prospect asks for one more integration or one more module. The roadmap turns into a list of one-off commitments and the motion never becomes repeatable. ### Your churn is killing your business Logos renew but usage sits inside one department. A champion leaves, the enterprise-wide expansion never happens, and net revenue retention stays under 100%. ### You are THE last to enter a deal cycle By the time security review and procurement surface, the incumbent has already shaped the requirements document. You are bidding against a spec written for someone else. ### Your point of view is not differentiated with your product You describe yourself in the same category language as six competitors. The shortlist gets built on who is easiest to explain to a board, not who is best. If three or more of these are true at once, the constraint is not in any single function. It is in the connections between them. [See how I find it](#diagnostic) ## How I work Peter Cullinan, Fractional CMO and GTM advisor I have spent 20+ years building marketing and revenue functions in healthcare IT and regulated B2B software. I built one from nothing at a Series A health tech company and scaled another inside a PE-backed business running $100M+ in annual pipeline for three straight years. Here is what I find almost every time. The functions are not weak. The connections between them are. Marketing runs campaigns, Sales runs deals, Product runs roadmap, and nobody owns the line from effort to revenue. Adding headcount to that does not fix it. It makes it more expensive. So I start with a diagnosis instead of a campaign. Where the constraint actually sits. What the conversion data means once the ICP is settled, because averaged across the wrong audience it means nothing. Which three things are worth doing in the next 90 days. Then I build it with you, not for you. I work inside the business, next to Sales, Product, and RevOps. When the engagement ends, the operating model and the decision logic stay with your team. Diagram: four functions, Marketing, Sales, Product and Customer Success, arranged in a cycle. Each connection between them is broken - lead quality gets relitigated between Marketing and Sales, the roadmap fills with one-off commitments between Sales and Product, usage stays inside one department between Product and Customer Success, and no ROI story exists at renewal between Customer Success and Marketing. Nobody owns the line from effort to revenue. Adding headcount to this does not fix it. It makes it more expensive. ## Who this is for Health tech, digital health, and health IT from Seed through Series B. Regulated B2B software including cybersecurity, fintech, and compliance-heavy SaaS. PE-backed companies under a growth mandate. - The product is strong and the market is real, but added spend is not producing enough qualified pipeline. - The board wants a scale plan and what exists today is a list of tactics. - Marketing has never had experienced leadership, or it had a leader and no operating model. - Leadership is willing to change how marketing is resourced and measured. ## Start with a diagnosis, not a campaign Most growth problems do not begin with a lack of activity. They begin with an unclear diagnosis, and every month spent executing against the wrong constraint is a month of spend you cannot get back. The diagnostic builds a shared view of the commercial problem, pressure-tests the current motion, and names the few priorities that matter over the next 90 days. It ends with a plan your leadership team can actually decide against. You can start it yourself right now. The GTM assessment takes about ten minutes, scores your business across the areas below, and returns a written readout of where the constraint sits. No call required, and the results are yours whether or not we ever speak. [Take the 10-minute assessment](https://themovebook.com/?assessments=move&ptoken=petercullinan#assessment) ### What we resolve - ICP and segment focus - Positioning and message - Demand and pipeline architecture - Sales and Marketing ownership - Metrics, reporting, and operating cadence - The capabilities required to scale ## Three ways to work together Which one you start with depends on whether the problem is already clear. If it is not, we find that out first. ### Hands-on build **When you know what needs building** I stand up the work and run it. Demand generation, pipeline reporting, revenue operations, messaging, MarTech, and the team cadence required to keep the motion running after I leave. ### Leadership alignment and a 90-day plan **When the constraint is broad or contested** We produce a shared diagnosis and a decision framework for the CEO, CRO, and commercial leaders. Useful when the real blocker is that nobody agrees on what the blocker is. ### Focused deep-dive **When you agree on the problem** One area, solved. ICP and segmentation, positioning, demand architecture, pipeline quality, customer expansion, pricing and packaging, or revenue operations. ## What changes The goal is not more marketing activity. It is a go-to-market model your team can run and improve without me in the room. - Everyone has a different definition of a qualified lead → One definition of ICP, qualified pipeline, and commercial priorities - Lead quality gets relitigated in every pipeline review → Clear ownership between Sales, Marketing, and Revenue Operations - Campaigns run, and nobody can trace them to closed revenue → A demand and pipeline model tied to revenue outcomes - Board reporting is assembled by hand the week before → Reporting that supports investment and forecast decisions - Tradeoffs get made in the hallway, or not at all → An operating cadence for reviewing performance and making calls - The knowledge leaves when the consultant does → Decision logic and capability that stay with your internal team ## How an engagement actually runs **Cybersecurity, credential and access control** The engagement started where most do, with a diagnosis rather than a campaign. Voice-of-customer research first, to establish how buyers actually describe the problem. Then a website and messaging assessment against what the research surfaced. Pricing strategy and partner-platform evaluation followed, because the route to market and the packaging had to resolve before demand programs were worth building. The sequence matters more than any single deliverable. Instrumenting a funnel before the ICP and the message are settled produces conversion data averaged across the wrong audience. It produces clean-looking numbers and unreliable decisions. Diagram: engagement sequence, voice of customer research, then message and website, then pricing and packaging, then partner route, and only then demand programs. Most engagements start at demand programs instead - that is how you get conversion data averaged across the wrong audience. ## Questions founders ask ### What is a fractional CMO? A fractional CMO is a senior marketing executive who leads your go-to-market function part time, for a fraction of the cost of a full-time hire. In my work that means owning strategy, building the operating model, and working alongside Sales, Product, and RevOps at health tech and regulated B2B software companies from Seed through Series B. ### What does a fractional CMO cost? A fraction of a full-time executive's total compensation, scaled to hours per week and scope. Pricing depends on whether the work is strategic guidance, hands-on execution, or both. Book a strategy session and I will scope a quote against your stage and goals. ### What is the difference between a fractional CMO and a marketing consultant? A consultant delivers recommendations and leaves execution to your team. I sit inside the business, own the marketing function, build the operating model, and execute alongside Sales, Product, and RevOps. The deliverable is a working engine, not a deck. ### What is the difference between a fractional CMO and a marketing agency? An agency executes a defined scope of campaign or channel work. A fractional CMO owns the question of what the work should be: where the constraint sits, who the ICP is, and how marketing connects to pipeline and revenue. Many companies need that decision made before an agency's output is worth buying. ### What does a fractional CMO do at a health tech company? The work starts with a diagnosis, then moves to building. That can include ICP and segmentation, positioning and messaging, demand generation, pipeline reporting, revenue operations, MarTech, and the team cadence that keeps the motion running. In health tech it is all designed around long sales cycles, security review, and multi-stakeholder buying committees. ### What is a GTM diagnostic? A GTM diagnostic is a structured review that finds where the commercial constraint actually sits before you spend on execution. It builds a shared view of the problem, pressure-tests the current motion, and names the few priorities that matter over the next 90 days. The 10-minute GTM assessment is a way to start it yourself, with no call required. ### What industries do you work with? Health tech, digital health, and health IT, plus regulated B2B software including cybersecurity, fintech, and compliance-heavy SaaS. Seed through Series B and into PE-backed businesses. The focus is deliberate. Regulated markets share the same buying mechanics, long cycles, security review, and committees, so I can pattern-match against problems I have already solved instead of learning your market on your budget. ### How long does a typical engagement run? Anywhere from a focused audit measured in weeks to ongoing fractional leadership measured in months. Scope depends on whether you need a readiness review, a 90-day plan, or hands-on execution and team building. ### When should we hire fractional instead of a full-time marketing leader? When you need senior go-to-market leadership but are not ready for a full-time executive hire, or when the bottleneck is unclear and needs a diagnosis before you commit to a permanent structure. It is also common when a founder wants someone who has already built the function elsewhere. ## Start with a clear diagnosis Thirty minutes, no pitch. Tell me what is happening in your pipeline and I will tell you what I think is actually causing it, whether or not that turns into work for me. [Book a strategy session](https://scheduler.zoom.us/peter-cullinan-goto-marketing/go-to-marketing) [peter@go-marketing.ai](mailto:peter@go-marketing.ai) ## Read before you decide **The Growth Signal** Practical GTM operating insights for health tech and regulated B2B software leaders. Every week I write about what breaks go-to-market in health tech and regulated B2B software, and what to do about it. Short, specific, and drawn from work I am actually doing. [Subscribe on Substack](https://gotomarketing.substack.com/subscribe) Weekly. Unsubscribe anytime.