As co-founder of Nimble Works (and most recently Vital Works), Barbara Pantuso provides strategic, creative, and operational insights for clients including Philips, Exact Sciences, Takeda, and Robert Wood Johnson Foundation. She thrives on solving problems and thinking about what's next for technology and culture. With 20+ years of bootstrapping small startups and leading large interdisciplinary corporate engagements, Barbara knows how to think big while still executing on time and on budget. A lateral thinker who has worked across many industries, she’s led client engagements with Apple, General Motors, Novartis, Eli Lilly, Planned Parenthood, AARP, Comcast, and many more.

Barbara has grown two digital agencies from seed to thriving, multi-million dollar businesses. She’s also held senior leadership positions at Frog Design, Huge, and SYPartners – firms that have given her the experience and know-how to build her own successful agency.

Q: Barbara, you’ve been in a constant state of reinvention for much of your career, starting as a pastry chef in Italy and then running a prominent restaurant in San Francisco. How did your early years in the food and hospitality industry prepare you for entrepreneurship?

If you’ve watched the show The Bear, or really any restaurant show, you’ve seen the complexity and unpredictability of running a restaurant. A water main breaks and floods the kitchen. The POS system goes down mid-service and you have to switch to manual order tickets. You have a long line of hungry customers and 50% of your staff called out sick because they are hungover from Halloween the night before. All true stories that I dealt with at the age of 25 as a general manager. I’m not going to say that I handled each situation perfectly, but I made it through them. More importantly, I learned to give up on the idea that I have full control. As an entrepreneur, that lesson is essential. You just can’t predict everything. Things will go wrong. Curve balls will get thrown. Learning to respond to and roll with unpredictability builds the resilience you need to be an entrepreneur.

The restaurant business also provided a great training ground in other important ways. First, as a general manager, I was exposed to the many facets of running a business. Supply chain, production, customer service, human resources, finance, front-of-house, back-of-house, all of it gave me a micro-view of the macro-world of business.

Second, the restaurant business is an example of rapid prototyping. The business cycle runs its course each day. You start with raw materials, prepare them, serve them, transact and get feedback every day. Having your customer right in front of you, reacting to what you produce is invaluable. The rapid business cycle and immediate feedback teaches you where to focus and how to get better.

Q: You each had different career trajectories, with Lisa following a creative/copywriting path in higher education and healthcare, and Barbara being more of a serial entrepreneur. How did your paths intersect to create Nimble Works? 

Nimble Works was not our first professional intersection. Many years ago, we worked together at a healthcare agency where Lisa was a director of copy and I was the head of the digital division. We collaborated on a few projects and realized how perfectly we complemented each other and how well we worked together. It planted a seed, perhaps subconsciously, that we should start our own company one day.‍

Q: When you co-founded Nimble Works in 2014, the idea that you could run a successful agency with a fully remote team seemed ludicrous. You were clearly ahead of the curve. What led you to pioneer this new way of working?

It started, like many business ideas, with a personal need. We were both burned out from the typical agency life of long hours, draining commutes, and wasted time in the office. We had a hunch that we could be more productive working from home. So we set out to prove our hypothesis: that great work can happen anywhere, anytime, outside the confines of a traditional office.

In our early years, clients and team members wondered if we could be creative, collaborative, and productive without being in person. But as we proved ourselves again and again with a growing team, our approach started to catch on. The benefits to the team (better quality of life) and to the clients (more nimbleness, lower costs) made us realize that we were onto something - a new and better way of working.

Q: What are the challenges that come with being business partners and sisters?

The challenges are often the shadow side to the advantages of working with your sister. You know each other so well, and there is a built-in comfort and ease. But that can lead to assumptions and taking each other for granted. We might assume we know what the other person is thinking. Or we are sometimes so direct with each other that it’s harsher than we intend. We have to take care not to fall into shorthand that short circuits good intentions.

Q: The Nimble Works model has proven so successful that in 2023, you launched a sister agency called Vital Works to serve competitive accounts including GE Healthcare, Clario, and Somnomed. What is your secret sauce that differentiates you from other agencies in this space?

Any agency is only as good as its people. Our secret sauce is our wonderful teams and their expertise in healthcare and health tech. Over the past 10 years, we’ve carved out a niche of expertise that few agencies have. We have both clinical and technical depth. For example, our team not only understands the clinical science of cancer, we also understand how precision diagnostics, algorithms, and care pathways work to treat cancer. We have a systems view of healthcare that allows us to see how and where our clients solutions fit, and more importantly, why they are essential to the people who need them.

Q: You lead two of the only female-founded marketing firms specializing in health technology. What does change look like and how are you fostering those values within Nimble Works and Vital Works?

First and foremost, change looks like putting more women in agency leadership and ownership. Not just for equity, but for sheer competence. Some of the most dynamic and powerful leaders we’ve both encountered in our career have been women. Yet many of those women were faced with difficult choices trying to navigate a patriarchal world, to balance motherhood with career, or just questioning values and asking “is it worth it?”. We believe that change also requires rethinking our culture and economic values. Growth at all costs has dire consequences, as we are seeing at the climate level, societal level, and personal level. We agree with what Cindy Gallop said, “Our industry will be saved by women founding and owning agencies—that create the industry we all want to live and work in.”

Q: What advice would you give to women aspiring to start their own business?

It’s tough to answer this universally. It depends so much on timing and context. Each person’s situation is different, and it’s really important to understand those differences. For some people who can take bigger risks, whether that’s because they have a financial cushion, fewer people depending on their income, or myriad other advantages, we might say, “Quit your day job and go all in. Force yourself out of your comfort zone and swing for the fences!”. For others, we might say “Keep your day job and find a side hustle that starts small. Be opportunistic and you’ll know when it’s the right time to put both feet in”.

For all women who have an entrepreneurial bug, you don’t know until you try. And try at least once. You and the world will be better for you doing so.

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