What a Ph.D. Engineer Learns When He Walks Into Private Equity

An Interview with Mike Magliochetti

I’ve known Mike Magliochetti for years. He’s the kind of person who makes you think harder in a conversation than you expected to when you sat down. So, when he told me he had written and published a book, Dancing Between the Toes of Elephants, about his transition from medtech CEO to private equity (PE) Operating Partner, I wasn’t surprised. What surprised me was how useful it turned out to be given that I wasn’t someone specifically looking to decode private equity.

Mike’s book evolved based on the steep learning curve he encountered upon entering PE full-time.  He became fascinated by the nuanced language, idioms, and very real circumstances encountered when interacting with PE and venture capital (VC) professionals, investment bankers, and limited partner fund investors; and by the decisions made, and human dynamics behind this. To help acclimate, Mike began keeping a journal of these expressions, documenting their meanings and the impactful stories behind them as part of his own learning process. Over time, that journal evolved into a book with an intent to be educational and entertaining. Dancing Between the Toes of Elephants is Mike’s account of stepping into a world whose language he didn’t speak and a “club” whose rules weren’t written down.

I have found the book resonated deeply with me and very easy to digest, as it is a collection of over 200 short, accessible stories designed for executives running PE- or VC-backed companies, entrepreneurs raising capital, etc.  I really enjoyed Mike’s candid, experience-driven view of how investment relationships function in practice, and speaking with Mike further about this, I came to understand his objective of providing a real bridge between executive management and PE investment deal teams on the value creation journey.  

The book’s title came from a moment Mike still talks about. Early in his time at Riverside Partners, he was part of a deal team conducting diligence on a small, founder-owned company in the tech-enabled healthcare services space. The company operated in a segment dominated by a handful of large players and had a strategy built around riding alongside them with an adjacent service. As Mike dug in, he realized those billion-dollar competitors already had similar technology and were planning to roll it out as part of a broader, bundled offering. To him, it became clear that the smaller company lacked real, durable differentiation and could easily get squeezed out.

When Mike raised his concerns, one of his colleagues grew a bit frustrated, looked at him, and said: “There’s a business here dancing between the toes of elephants.”  Mike immediately knew that line was going into his journal.  He still voted against the deal.

Over the years, Mike has been involved in investments that truly could “dance between the toes of elephants”; businesses with the differentiation and positioning to coexist alongside much larger competitors. In this case, though, he believed that once the elephants decided to take market share, they would do so at any cost. Mike voted no, and Riverside ultimately walked away. But the phrase stuck and eventually became the title of the book.

That image will resonate with anyone in the mid-market medtech space. The companies we work with at Suntra operate in exactly that terrain: smaller than the industry giants but building real innovation and differentiation in their shadow. What we’ve found, and what Mike captures well, is that size is not the liability it looks like from the outside. Companies that are nimble enough to respond, focused enough to care, and capable enough to move the needle on a product roadmap can do things the elephants simply won’t. That’s the space where the best medtech innovation actually happens.

Mike’s background is worth understanding. He earned a Ph.D. in chemical engineering, followed by an MBA while in the early years of his career, spent more than 20 years as a CEO across multiple healthcare subsectors, took companies through successful exits, and then made a full pivot into investing as an Operating Partner at Riverside Partners. That’s not a straight line. It’s a series of deliberate reinventions, each one requiring him to build credibility from scratch in an unfamiliar room.

What makes the book useful for a medtech audience isn’t the PE lingo, though there’s plenty of that. It’s what his outsider experience reveals about leadership, pattern recognition, and the discipline of adding tangible value when you’re no longer the CEO in the room. Mike writes about medical device launches, reimbursement battles, FDA timelines, and what it actually feels like shifting from player to coach.  He doesn’t hold back, unafraid to share the gritty reality.

There’s a chapter on ‘Skate to Where the Puck is Going’ that covers how savvy investors identified the shift to minimally invasive surgery in the early 1990s and backed it before the market moved. Mike lived that era as an operator, running companies trying to get those devices cleared, reimbursed, and adopted. Seeing it again through an investor’s lens gave him a different appreciation for how pattern recognition gets built over time and what it costs to miss it.

For the leaders we work with at Suntra, those navigating program risk, regulatory timelines, reimbursement challenges, resource constraints, partnerships, and investor dynamics, Mike’s perspective on what good judgment looks like under pressure is well worth your time.  He doesn’t dress it up as “strategy.” He calls it what it really is: curiosity, preparation, and the willingness to ask the question everyone else is too proud or too hesitant to raise.

The book is available now on Amazon and Barnes & Noble. If you work in medtech, lead a team, or are trying to make sense of how PE and VC partners think about your business, it belongs on your shelf.

And if you want to check out a recent interview with Mike and medtech influencer, Joe Mullings at One60Studios, the link to the entire interview can be found here.