Healthcare, education, publishing. They don’t usually top startup pitch decks, unless you’re already knee-deep in the industry. But maybe they should.
Behind the buzzier sectors, these are the places where friction piles up. Costs creep higher. Systems slow down. And the people doing the work are left patching problems no one’s solving. That’s also where the biggest opportunities tend to hide, in plain sight.
Today, we’re taking a closer look at two industries HubSpot flagged in its recent Industries Ripe for Disruption report: medical devices and academic publishing.
What do they have in common? Centralized control, rising costs, and enough cracks to make room for something better.
Medical Devices: When Repairs Become Roadblocks
Canadians know long wait times. It’s one of the most talked-about issues in our healthcare system. What rarely gets mentioned is how often those delays come down to something as simple (and as frustrating) as a broken machine.
Not catastrophic failure. Not a multi-million-dollar replacement. Often, it’s routine maintenance or a basic fix that shouldn’t cause a ripple in the system. And yet it does.
A growing market with shrinking control
Canada’s medical device market is on track to hit $13.65 billion this year and nearly $17 billion by 2029. With so much growth, you’d expect access to repairs would be getting easier, but that hasn’t been the case.
Instead, as hospitals invest in more equipment, original equipment manufacturers (OEMs) like Medtronic, Siemens, and Abbott have only tightened their grip on what happens after the sale. How? By locking hospitals into service contracts that cost up to 30% of the machine’s original price annually. But those contracts aren’t just about maintenance, they’re about control. Manuals are off-limits, software is password-protected, and replacement parts are only available through them—on their schedule, and at their price.
Even when hospitals have qualified technicians in-house, they can’t touch the machines they work with every day. So the equipment sits or gets replaced. Not because it’s failed, but because repair has been made so restrictive, expensive, or slow that replacement feels like the only option.
And while that’s happening? Patients wait.
To make matters worse, the U.S. is considering a 25% tariff on Canadian medical exports. Since most Canadian-made devices are sold to U.S. buyers, any drop in demand would hit manufacturers hard. And when manufacturers take a hit, hospitals in Canada feel it too. Through higher prices, reduced supply, and longer waits for equipment and parts.
Where startups can move the needle
Hospitals aren’t short on talent. What they need is tech that works around the roadblocks, without creating new ones.
Here’s where that could start:
- Predictive maintenance tools: The best repair is the one you never need. AI that tracks equipment performance and flags unusual wear before a breakdown would give hospitals a chance to act early, schedule service on their terms, and avoid costly downtime.
- Smarter parts procurement: Hospitals don’t need another gatekeeper. They need direct access to parts, clear pricing, and reliable information, especially for legacy equipment manufacturers no longer support. A tool that makes it easier to source and order could save both time and money.
Canadian spotlight: Dynacare
Dynacare didn’t overhaul diagnostics; they simply made the system work better. By expanding local labs, tightening turnaround times, and investing in digital logistics, they’ve helped take pressure off hospitals without adding complexity or cost.
Founder takeaway: Fixing systemic gaps isn’t always about building something new. Sometimes it’s about making what’s already there work better for the people who need it.
Academic Publishing: Locked Up and Ready for Disruption
Most Canadians assume publicly funded research is free to access. After all, taxpayers help fund the work; shouldn’t you be able to read it? Technically, you can. But unless you have a university login, it’ll cost you $40 or more per article.
That’s the model a handful of publishers (like Elsevier and Wiley) have built a $26.5 billion global industry on, with around $9.5 billion coming from journal subscriptions alone.
Here’s how it works. Researchers write the papers. Their peers review them. Then, publishers lock the work behind paywalls and charge subscription fees to the same institutions that funded the research in the first place.
And despite years of pressure for open access, not much has changed. If anything, big publishers have gained more power by buying up smaller ones and widening the gap.
Who gets shut out:
- Researchers at underfunded institutions who can’t access key journals.
- Early-career scientists stuck in a “publish or perish” loop.
- Taxpayers who fund the work but can’t read the results.
- Clinicians and patients looking for the latest evidence-based treatments.
- Scientists in developing countries blocked by cost and access.
The case for small-scale disruption
Academic publishing isn’t broken because no one’s tried to fix it. It’s broken because most fixes have either been too small to matter or too big to stick.
Here’s where startups have a real shot:
- AI research tools: Platforms that help researchers sort through open-access databases and preprint servers. Even better if they highlight patterns or summarize key findings.
- Better peer review workflows: Transparent, trackable, and efficient systems that improve the process instead of making it more complicated.
- New ways to publish: Most research doesn’t belong in a 10,000-word PDF. Give scientists a way to share code, data, videos, and visuals all in one place.
We’re already seeing cracks in the old model and signs that smaller, targeted solutions can make a difference:
- Canadian Science Publishing is pushing diamond open access by removing both paywalls and author fees.
- The Gates Foundation plans to stop funding author-side processing charges by 2025, pressuring publishers to rethink their business model.
- The UKSG is calling attention to the need for more not-for-profit options driven by academic communities themselves, not just commercial publishers.
Founder takeaway: Some systems aren’t built to change on their own, and that’s exactly where better ideas have a chance to stick.
Where Disruption Is Overdue and Opportunity Is Wide Open
These aren’t broken systems waiting for a big idea. Both medical devices and academic publishing are working exactly as designed, for the few who control them. Power stays concentrated at the top. Access is restricted. And the people doing the work (whether it’s technicians, researchers, or practitioners) are often left without the tools they need to do it well.
That’s why these industries deserve more attention from founders. Sure, they don’t have the hype of AI startups or the instant traction of consumer apps. But the barriers are real, the stakes are high, and the cracks are easy to spot if you’re close (or frustrated) enough to notice.
For founders ready to take on a less obvious path, these are the kinds of opportunities worth chasing. If that’s where you’re headed, TBDC is here to help. Whether you’re testing an idea, validating a market, or looking for support to grow, we back founders building smarter systems in industries that need it most.
