There is a part of R&D leadership that does not get nearly enough attention in leadership conversations, and yet it quietly determines whether your entire operation stays compliant, competitive, and solvent. It is sustaining engineering.
I have had the privilege of leading sustaining teams across very different cultures. In Ireland, trust was built over late nights at the pub. In Costa Rica, it happened over dinners that went well past midnight with some of the most talented engineers I have ever worked alongside. In both cases, the lesson was the same: my job was to form a bridge between corporate and local leadership, and the bridge was built entirely on trust. Sustaining engineering, done well, runs on exactly the same principle.
Up until now in this series, we have talked about choosing new programs, building high-performing teams, and getting projects to deliver on time. What gets discussed far less, and what may ultimately matter more, is how you manage the engineers whose job is to keep existing products moving. These are the people manufacturing calls first when the supply chain breaks down. They are the ones who untangle a CAPA that has been sitting open too long, or who figure out a workaround when a critical component goes on allocation. They do not get celebrated at company all-hands. But when they are not there, you feel it immediately.
What sustaining engineers actually do
Sustaining engineering teams operate within a change control framework. The goal is not to create new requirements but to maintain product output while keeping everything saleable and compliant. The work typically falls into five categories:
Younger engineers often start their careers in sustaining roles, and that is genuinely valuable. Sustaining work teaches design controls in a very practical way. The risk is that it can also become a comfortable place to stay, which over time erodes the team’s capacity for true innovation and requirements-based development.
The balance problem
If your portfolio is aging and your sustaining team has grown large, that is a signal worth paying attention to. Every dollar spent maintaining existing products is a dollar not invested in what comes next. That balance between sustaining existing products and funding future growth is also a critical part of R&D portfolio management.
The business side of this equation requires some difficult conversations. Obsoleting products reduces the sustaining burden significantly, but your sales team will push back. Your operations group will be relieved. Getting both aligned requires deliberate cross-functional work and clear strategic rationale. It is not fast, but it is necessary.
Once you have a baseline on what the team is actually doing and whether they are working efficiently, you can make informed decisions about staffing, investment, and priorities. That includes understanding which engineering capabilities your organization needs to own permanently and where specialized or episodic support makes more sense. Use whatever cloud-based tools work for your environment to categorize and prioritize the work. Then set a deadline and act on what you find. The analysis is only useful if it leads somewhere.
The investment reality
Across the medtech industry, total R&D spend typically falls between five and ten percent of revenue. Companies at the lower end of that range, around five to six percent, tend to have large portfolios and are primarily running sustaining programs to protect market position. That strategy can work for a period of time, but it carries a structural risk: without meaningful investment in new product development, IP erodes, competitors find entry points, and pricing pressure follows.
The most growth-oriented companies in this industry invest closer to ten percent, with a meaningful share of that going toward new product development and clinical programs that change the competitive story two to five years out. If you are not sure where your company sits, that is worth knowing.
The bottom line
Sustaining engineering is not glamorous work. But it is the connective tissue between your installed base and your operational margin, and it deserves the same strategic attention you give to new product development.
Organize the team deliberately. Incentivize them. Build the trust that creates discretionary effort. And then protect them, because they will save you from the fire you do not yet see coming.
Next: what happens when the auditor shows up unannounced, and why your sustaining engineering team is either your greatest asset or your biggest liability at that moment.
Terri Kapur is a seasoned R&D executive with more than 20 years of experience driving innovation in the medical device industry. She has led global, multidisciplinary teams across the full product lifecycle, from early research through development, commercialization, and post-market support.
