Building professionalism

One of my objectives for the coming months is to hand off executive authority for running the in-market businesses to folks who have the experience and connections to do it well.  I have never run a sales force or a marketing campaign, and, while I’’;m sure that i could learn, the inevitable mistakes would cost time and confidence.  It’s better to focus on what I do best, bridging innovative product to clinical customers.

I’ve been fortunate to bring good operations people on-board, and I’m trying to support their working style.  We need to become a more professional company, and successful funding rounds finally give us the resources.  So, we’re implementing core offices, IT services with electronic calendars and shared addresses, improved purchasing systems, inbound marketing in web site upgrades, and employee contracts with pensions and share schemes.

It’s more to coordinate, so communication tools beyond emails and skype are being considered.  I traditionally work from paper notes, consolidated into to-do lists, and cocktail-napkin sketches of project plans.  They are idiosyncratic notes to myself, and there are calls to be more standard and transparent in making time and budget commitments, and more accountable for slippages .

I bristle a bit at the implied judgement of ‘overrun’ or ‘slippage’: we work hard and take good decisions.  The wise choice can be to invest in people, time, or tooling that ensures better outcomes.  I’m not going to pad schedules and budgets to give myself  cover,  But am learning how to talk positively about deviations while biting my lip over the language used.

One executive requests plans in the form of to-do lists, with dates and names next to each item.  I think it’s an awful way to communicate process and progress.  At a daily level, items are too numerous and dynamic to spend time updating, reporting, and defending.  At a monthly level, they amount to a disconnected wish list of idealized targets.  There are milestones, but they are few and fit within project narratives.

I prefer simple Gantt charts, laying a half-dozen streams of activity in parallel with dependencies defining the milestones.  If work stops when raw material runs out, then getting replenishment budgeted and shipped is a key event to monitor.  If submission of a regulatory file starts a clock to market introduction, it focuses people on bringing together the component tasks and parts.

Moving all of this from Excel into a formal tool like Project has been difficult. The structure falls apart as we move bits, and the output doesn’t fit neatly onto A4 paper.  Another executive has advocated a ‘Slippage chart’ showing deviations instead of plans: it proved counter-intuitive and folks have requested a simple project chart.

It’s all growing pains as we adopt professional standards and tools.   We’ll settle into methods that work for us.  A simple Gantt chart, clearly communicated in meetings and updates, with dependencies driving milestones and to-do lists, seems to work best at present.

Now if I could just make peace with my electronic calendar over my paper diary.

Political skills in the workplace

We’re successfully winding up the first period of fundraising for the business, taking the product closer to production and clinical trials.  It’s been an intense process, refining our story and clarifying plans, connecting with old friends and new leads, ultimately converting people’s interest into investment.

In one sense, it’s been project management: articulating a vision, assembling a coalition, motivating action.  Like any project, it has a goal, advances through stages, needs time and resources.  But instead of yielding a product, the process of closing a funding round assembles external relationships with influential third parties.  That makes it more of a diplomatic process than a management one (Guittard 2012).  So, I thought, success is achieved through soft skills rather than hard ones (Robles 2012):   projecting integrity, communicating well, demonstrating courtesy, responsibility, social skills, positive attitude, professionalism, flexibility. 

But this approach isn’t enough.  Closing the deal, securing investment, is a one-on-one process, selling an individual rather than recruiting an audience.

And that depends on hard political skills, not soft diplomatic ones.

I’ve been discussing the difference with colleagues: Diplomats build coalitions; politicians recruit followers.  Diplomats assemble support through intermediaries and councils; politicians make direct connections with individuals.  Diplomats build a framework of policy agreements; politicians cut deals. 

Tactically, it’s the  difference between West Wing and House of Cards.

Merrill and Reid (1981) described the necessary traits inn their work on Social Styles.  Their theory rests on two personality characteristics.  Do we ask (diplomacy) or tell (politics)?  Do we orient towards tasks (politics) or people (diplomat)?  These two axes produce four social types: diplomatic Amiables positioned across from political Drivers.

Ferris (2000, 2005) has more recently defined political skills as “the ability to effectively understand others at work, and to use such knowledge to influence others to act in ways that enhance one’s personal and/or organizational objectives”.  He has identified four key attributes of political competence:

1. Social Awareness – able to astutely observe others to understand their behaviors and motives.
2. Interpersonal Influence – able to influence and engage others using a compelling and charismatic interpersonal style.
3. Networking – able to build diverse relationship networks across and outside of the organization.
4. Sincerity –able to be forthright, open, honest, and genuine with others

Leslie (2012) later supplemented these qualities with two additional ones:

• Emotions – able to express feelings appropriately, aware of the timing and presentation of what they have to say.
• Management - able to communicate effectively with direct reports, teammates, and bosses: manages up as well as down.

I’ve been reading Mark Leibovoch’s book, This Town, about the insiders game of social networking and influence building in Washington DC.  All of the political skills I’ve been discussing are on full display – it’s an illuminating study of the theory reduced to practiced art.  

In thinking about economic systems, I tend to focus on ecosystems as, (for example, Seven Days in the Art World). 

But, as my business matures and my role in it broadens, I can really see the relevance of having good political skills in addition to my more familiar diplomatic ones.  There is  real value in being able to navigate social networks as competently as technical ones for project management.e

It’s not difficult; its just different.

Rebranding the company

Stone Bridge Biomedical BV was founded in 2009 in Maastricht as a medical software developer for global markets.  I had some ideas for improving tools for remote patient monitoring, simplifying the task of aggregating, analyzing, and visualizing data from many patients.

My original business plan was to partner with a company making a sensing unit for cardiac problems, first aiding in fundraising and business development, then coming alongside to co-develop.

We pulled a $12 million deal together with a funding group, but it had too many conditions and took to long to complete, and so it died.  Fortunately, I had two other startup opportunities got funded in allied medical fields, so Stone Bridge became a hub to manage those ventures.

While the company has been successful and profitable, it drifted a bit, becoming a consultancy instead of a developer.  When Microsoft dumped the Stone Bridge web site last fall as they divested their small business unit, I used the website rewrite as a chance to redefine the business.

It’s hard to do.  What business am I in?  Who is my customer?  For what problems am I the best solution?  My web-site developer quickly grounded against the problem of writing content when I didn’t have a clear product or single vision. 

“Anything-for-a-buck, Inc” is not a business plan.

I was approached by a friend on Facebook, asking whether our businesses were looking for help with branding and messaging.   We’ve started a very fruitful collaboration that has enabled me to focus and direct my thinking about what I want to do and become, what messages the business has to project and to whom, what who values what I can bring.

• We build bridges from concept to commercialization.
• We understand the medical development process.
• We tailor teams to solve problems, from components to companies.
• We support European product development and market entry.
• We are ready to execute on innovative device ideas.

As I was thinking  about how to define and represent my business, I found a link to a wonderful video about Microsoft’s “re-imagining” of their own business and brand.  This is a conference presentation by two of the key people behind the effort and shows a perspective and thought process for understanding and marketing a business.

It’s all in the telling

One of our investors came by our offices recently, expecting the worst.  Communication had been sporadic and the company was definitely falling behind its milestones.  A planned fundraising was delayed; cash runway had been a concern for months.

Behind the scenes, though, really capable people had been beavering away on unexpected and difficult problems.  We had a few lucky breaks as experts came alongside with exactly the knowledge and connections that was needed.  A glimmer of a solution was starting to appear.

“So, I know the general outline – fill in some details for me?”

I’m proud of what’s been accomplished: we have a great story to tell. 

Anomalous results on a routine test last fall alerted us that something unexpected was happening in the base silicone….Two hypotheses explain the measurements…the first, although easier to try, led nowhere – we lost two months…the second was delayed by access to catalysts and resins – suppliers didn’t know us, didn’t trust us…At the same time, we found an alternative material with the properties we needed…We finally acquired the materials… We finally acquired the rights…We lost two quarters…We’re back on track…

Our investor pushed back.  “Plan A still sounds like something we’d invest in… Plan B is confusing, I’ll need to study it more...We’ll have questions…overall direction…timing…focus…”  Then it was done; he was off.

We had a great story to tell.  Why didn’t that come across?

That same day, a friend happened to have sent me a link to an blog post at the Harvard Business Review by Kate Minshew.  Titled “Every Entrepreneur’s Least Favorite Question”, it outlines the proper response to the query “How are things going?”  

Her advice is:

• Highlight two recent accomplishments,
• Talk about one problem you’re working on,
• Talk about what’s different than 3 or 6 months ago, and
• Ask for advice.

The article is really an epiphany:  I had blown all four guidelines and, so, had failed to tell an understandable or compelling story.   What I wanted him to understand was that we had A, we were getting B, an that one or the other leads to the C that we promised: the team did a great job for the investors.  From my narrative, he likely understood that 1) we had problems, 2) the solution was hard, 3) we were casting about for a backup, and so 4) the original plan was toast.

Live and learn.

I think that this guidance also holds for expats, who face the inevitable question “How’s it going?” (or variants like “How do you like it here?”).

I’ve filed my visa renewal, after I found the new KvK offices up in Sittard.  With the nicer weather, I’ve take a couple of long cycles towards Spa.  Things are great:  I’ve passed the Dutch reading exam and am working to get the other three done in November.  I do have one question though: One of my creditors is a bit slow in paying, do you know who I might talk with who’s been through a similar situation?

Okay, I can’t write dialog…but I think it’s good to have talking pints in mind. I will for the next investor visit.

For more on storytelling, take a look at

Pixar’s 22 rules of storytelling, and

This American Life’s Ira Glass on YouTube

The thinking hats

I decided to take a break from the snow and the startups today and attend two seminars this week: an Innovation Masterclass at St. Johns Innovation Centre, and a CETC forum debating the Cambridge 2030 initiative.

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The Innovation workshop promised to offer creative problem solving techniques, help generate new ideas that will unlock new market opportunities, grow sales and improve bottom line performance.  We can all use a little more of that.

The event was sponsored by the new UK Department of Business Innovation and Skills, combining key government support services: UKTI (international trade), MAS (manufacturing advisory services), and GA (the growth accelerator).  GA turns out to be a coaching service, which means it’s self-consciously loud, superficially enthusiastic, and looking for paying clients.

The seminar used a decision methodology, the Six Hats, that force examination of problems from different angles.  They roughly parallel the Myers Briggs dimensions of personality and simulate bringing diverse opinions together.

We brainstormed Burger King: Who comes to the restaurant (teens, families, businessmen looking for WiFi), What do they want (predictable, clean, safe, convenient, cheap), How could it go wrong (kids get sick, manager hassles you, gang uses it as a clubhouse), How would you present it (clean the rest rooms, patrol the parking lot, train the staff).

The level of business-speak would make Lucy Kellaway sigh.  Do people talk about leveraging asset-based customer-centric skillsets because of training, peer pressure, aspirations, or simplicity?  Innovation is not exploiting invention to deliver transformative value, it’s simply creatively doing things better.  I innovate because it’s a kick, it’s fun, it gets appreciation, not because it builds sustainable barriers to competition while maximizing customer value.

In all, a wasted two hours of being hot-boxed like I was being sold a Turkish rug.  ‘better to spend your time browsing MindTools.

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The CETC seminar, in two-hour contrast, was thoughtful, informative, and even somewhat inspiring. The problem is “What should Cambridge Become?”, and a local group has been hosting public forum around ten key topics like transport, waste, housing, education, and culture.  Their two-year outputs had to be a single sheet of recommendations on A4 paper, and a single slide: jargon was completely absent.

It highlighted two things for me.

First, the limits of land use maps.  Cities are living things and the problems have to do with flows.  How do you move people, goods, water, information through a city; where do you connect (not direct) new businesses and  homes?

Second, the sprawling impact of decisions.  AstraZeneca is building a research facility and creating 10,000 new jobs.  Wonderful!  But that brings 30,000 new people, and their cars, wanting housing, sending children to schools.  Who provides for all of that; who pays for all of that?  And what does it do to the quality of life for everyone else?

A member of the County Council responded.  Most political discussion is us/them, takers/makers, news-bites that pass for reasoned debate.  In contrast, this bureaucrat had really spent a lot of time thinking about these questions, talking with government officials from nearby villages, and implementing solutions.

What do we do with green belts?  He wanted to convert a bit of fallow farmland into parks and homes.  I disagree, but I respect the discussion that balanced the viewpoints.  What about a congestion charge to limit traffic in the center and pay for expanded transport?  It wouldn’t work if all the money raised went to Whitehall.  What about ideas to link schools and businesses more tightly?  he knew what was being tried and what might work.

When he talks about the frustrations of raising local revenue and ideas, then losing it to national taxes and regulations, he voiced the same frustrations as any business owner.  I’d hope that government has lots of folks like this, and that we realize they have a constructive role in building and maintaining communities.

I navigate the Border Agency procedures, ride the Guided Bus, pay my Council Taxes, set up shop in the Incubator.  I’m glad to meet people taking the long view of how to make it all work together and better.

The GA could take a few lessons.

Finalizing my contact list

Well, it’s finally finished.

At Christmas, I resolved that I would get my contact list sorted out.  The problems started when I linked Plaxo to my Windows Live account; the two resonated off of one another and created over 3000 entries from the original 700.  I had to disconnect all of the social network syncs, the start with “A”, correcting, weeding, and merging all of the contacts in Windows Live.

I use LinkedIn as my business network, so I sent  invitations to everyone as I went along, hoping that if they kept their information up to date, then my address book would be too.  Auto-magically.

I estimated a one-month job: t took three.

But last night I finished , ending up with around 1000 unique contacts.   I exported the result, then moved the whole set over to Google Mail, where there are better tools for cleaning the list.  I auto-removed duplicates, then cautiously merged in data from Skype, Facebook (the F2G app works great), and Plaxo, watching for trouble.

But the seams held and the data blossomed into usable points conencting all across my social/business grid.

• LinkedIn claims to have found 325 more links than I did  and sent requests.  I hope that I didn’t end up spamming a lot of business associates.
• Goggle+ is starting to grow itself, the People tab has spontaneously populated on my Nexus.
• Outlook.com is tracking as well; Windows 8 should be improved.
• I’m still looking for how to get Skype synced into the flow.
• Then there’s Twitter…

It’s all pretty much how I hoped it would be.

The next task is to deal with the pile of business cards stacked on my desk.  I’ve looked at card scanners, but they cost 100’s of euros and I already have a scanner.  After a bit of searching and experimenting, I settled on the ABBYY Business Card Reader: it’s a 25 euro software app that takes a scanned image of up to 12 business cards and OCR's them to create vCard or CSV output.  It’s not perfect, but for the price it’s fast and pretty accurate.  I did 50 cards this evening and they slipped up into the contact list very easily.

With all of this coming to life, I’m finding that it simplifies other tasks.

Last night, I was reading an article about urban archaeologists on the Nexus.  I remembered a recent conversation with a friend who studied archaeology in college, but hadn’t been able to find a job in that field.  I hit Share, entered a few letters in his name, added a sentence to say ‘hi, and  it was off to him, in about a minute. 

Very cool.

The usual disclaimer: I select and purchase everything I use: nobody has asked me or compensated me to write about their products

Bases loaded, no outs.

The two things I was never good at in school were Chemistry and Languages  (okay, and Handwriting in elementary school). ‘Ironic that these hold center stage now.

But I do know baseball.

Our chemists tracked the ‘covering the coating’ problem down to an unexpected diffusion of silicone from the catheters.  This suggested a half dozen approaches to removing the material prior to applying the coating, and they ran everything in parallel. 

But, after two weeks, nothing seemed to work.

Their disappointment at the review call was really palpable: they sounded tired and discouraged, and didn’t immediately have an answer for what they might do next.  That sent shivers through the rest of the organization: I worry about a vicious spiral setting in where lack of confidence is more damaging than lack of progress.

October 11, 1995

The Seattle Mariners were in the American League playoffs against the Cleveland Indians in the Kingdome.  22-year old Rookie Bob Walcott started for the Mariners, who were desperately short of pitchers.  He immediately got into trouble, walking the first three batters and loading the bases.

Manager Lou Piniella headed to the mound after Wolcott threw his sixth successive ball.  They had a conversation, Piniella went back to the dugout, and Wolcott caught fire, retiring the side and eventually allowing only two runs in seven innings.  The Mariners went on to win 3-2.

I was there: I really wanted to know what  Piniella said that turned things around.

"I talked to him about hunting in Oregon," the manager related afterward. "I said, 'You can enjoy your winter in Medford'; he's from Medford. I said, 'Look, if it's 11-0, who cares. Just give us five or six innings. Have some fun and relax out here.' "

We had a good lunch, we talked about life, I let them tell their story.  We speculated more widely about what might be happening, and we brainstormed a few solutions.  My chemistry is at a metaphorical level, I’m afraid, but the purpose was to stimulate confidence and new approaches, not to suggest an answer.

At the end of the day it seemed to have restored their optimism an ideas: we all knew what we were doing next, how we were helping, and that we were backing their team.  I headed south with cautious optimism myself: hopefully to convey to the wider organization.

Okay, there was a jerk on the Doncaster – Stevenage train who had spread out across my reserved seat and table, who loudly declared that reserved seats were rubbish, and who forced me to squeeze in elsewhere in the train.  It was really irritating.

But I’m just not going to let the jerks ruin my day.

Especially when there’s a playoff at stake.

Entrepreneurial adolescence

I am so ready for revenue.

My businesses are still in development, dependent on investment from angels and syndicates.  I am very grateful for their support and work flat out, every day, to make the plan succeed and to be one of the minority parts of their portfolio that return cash to them.  But every investment round is finite, every plan has limited runway, and all too quickly we have to be pitching for another round.

So our in-house talk increasingly turn towards what our company looks when its in-the-market, how it would be self-sustaining, and how life might change.  There have been four major themes to the advice I get, four scenarios for possible futures. I think that there are two underlying dimensions in play: what the business sells and how the business grows.

Product Sales: When I pitch the businesses, we always talk about Big Markets with Generous Margins.  With 5% penetration, 10% growth, the business becomes profitable in months, pays back it’s investment within a year,becomes fully self-sustaining soon after.

But the reality is that building manufacturing and distribution channels is expensive; renting them costs half the revenue.  Scaling up to product launch requires hiring people, building inventory, and tackling the know-like-trust barriers.  Substantial time and investment, ten times the development budget, is needed for market entry.

This requires new risks, different skills, and larger investors.  Business that I know who have succeeded in this model are family-owned, decades old, and have achieved eight-figure yearly sales: Cadwell Labs, Mortara, MediPlus, Garrett Tech, MIPM.  It’s a long-term commitment to organic growth of a Mittestand.

Platform Sales: The first product is based on unique technologies that can be leveraged into other applications, opening new markets.  Revenues are re-invested in development, creating variations and extensions, demonstrating feasibility, and introducing new products and services.

Jeff Jarvis has written insightfully about the nature of platform businesses, recognizing that a platform is defined by its users, especially users who create content.  The business isn’t about how you spawn new products, it’s about how you recruit and encourage others to create new products. It’s about how you use networks to build the applications base to critical mass, not the product revenues.

This requires thinking about process more than product.  How do we make the technology accessible; how do we support and promote entrepreneurs who build from our technology?  How do we ensure transparency without losing control, reliability while taking risks?  What are we selling if we are not the ones creating content?  It’s a successful model used by Dow, BASF, AkzoNobel: the business can scale very quickly if it catches fire with developers (holds for materials as well as for software developers) on relatively small investments.

Portfolio Sales: We acquire related technologies or product lines, giving us new revenue sources for existing customers.  Rather than leverage technology we leverage brand and channels, forming a confederation of products and services that build from their proximity to one another, a synergistic growth model.

DuoFertility, another Cambridge medical startup, became Wired’s Startup of the Week; numerous friends mailed me the link.  CEO Shamus Husheer, a friend of mine along the entrepreneurship journey, presses the value of Focus: “you can't be a "portfolio entrepreneur" in the same way that you can be a "portfolio investor". Nobody has the bandwidth to perfectly execute just one good idea, let alone several at once.”

I’m not sure that I agree.  Nobody can spend every hour of every day executing the single track of a single plan.  There are only so many times that a subcontractor needs a call or a developer delivers an update.  You should be thinking broad and long about allied opportunities, and negotiating access to people, products, technologies that grow the business.  It should make the management smarter, the business more resilient, and the long-term risks smaller.  Surmodics and Teleflex are always looking outward for the next great ideas, while still maintaining focus on delivering value to core customers.

Business Sales: Ultimately, we all hope to be acquired or to be able to license our technology and products to  big players who can do the heavy lifting of manufacture and distribution.  Configure the business to mimic their processes, build a portfolio of evidence for them: make your business as easy as possible to slipstream into theirs, so that they can deliver product to market within a year at $10m+ in sales.

This is the dream: sell the business for $30m while you still retain a significant share, then retire to mentoring and philanthropy.  A very few achieve it; it has a knock-on effect of making everyone else think they can do it.  Investors want exits: entrepreneurs see comparables.  Cameron Health presented to my Cambridge class about their $1.3bn exit to Boston Scientific: BEST LECTURE EVER enthused the emails sent back from the students.

That dream lives on. Half of our time is spent on packaging and business development, canvassing industry leaders as potential partners, comparing our processes with theirs, debating what evidence meets which “Log-2” threshold that would attract attention.  It distorts the business, perhaps in a good way: it does force focus on milestones and value creation, licensing and partnerships, that lead to running a business rather than a project.

I am still sorting this all through: Office Days and Travel Days give me lots of opportunities to thrash this through with my business team.  There are also good blogs, like Scott Brinker’s and Andreessen Horowitz, that develop similar themes in slightly different contexts.

I am so ready for revenues, for the change in the nature of the developing business, for the next act.  I must be reaching entrepreneurial adolescence.   It’s a lovely fantasy to think that we’ll all be sitting on the beach in St. Maartens this time next year, but realistically, we need an in-market strategy.  I’m portfolio-oriented by nature: reliance on a single technology, product, customer, or investor makes businesses brittle and increases risks.  But broader strategies require more time and energy to execute, dissipate focus, and worry investors.

“It’s 10% science,” my former research director always advised.   And if it was easy, the beaches would be littered with retired entrepreneurs.

Midweek themes and proverbs

The part of ourselves that we regard as most exceptional is also our basis for feeling most aggrieved.

We are distinct persons, each with a unique identity.  We define identity and through those parts which are distinct from others, including both intrinsic qualities like gender, age, ethnic and geographic origin, and acquired qualities like skills, affiliations, and appearance.  We value ourselves for those qualities which we think are exceptional: we suffer when those same qualities aren’t respected by others.  Several times this week, I’ve seen people launch into rambling defense of how their group isn’t treated fairly by institutions or society: I think the basis is rooted in identity.

I can always tell people who are seriously studying a language because they have a text and a dictionary close at hand.  I’m currently carrying my Prisma and a book of essays; I smiled at finding a kindred spirit doing the same on the Tube today.  

In mixed groups comprised of people from both native and host countries, expats will feel greater affinity for their hosts.

I attended a business meeting this week with both American and Dutch participants.  Opinions were freely exchanged on the tradeoffs of doing business with the Chinese,.  I felt both less concerned about the issue and more uncomfortable with the dogmatic US position on the topic.

On one level, I know that conservative perceptions of China arise from provincialism,differing economic and political philosophies, and accusations of unfair trade practices.  There’s probably reaction to Obama’s “Asia Pivot” thrown in as well.  But it made me uncomfortable, I thought about how it looked to our hosts (who tweaked him whenever they had the chance by pointing out how his computer and clothes likely came from China).

On a deeper level, I was taking sides with host participants over my native participants, just the opposite of what might be expected.  On reflection, I suspect that as a result of trying hard to understand and integrate into host society, I develop an affinity for their (rather than a simple tolerance) for their point of view in mixed settings.

There is an alternative view that holds that expatriates are escaping their identity by leaving their native country, and would  naturally feel less affinity with their visiting countrymen as a result.

I visited the GSK Bioscience Catalyst research facility this week, and took in all the slogans lining the road from the main gate to the conference center.  I understand the concepts, pioneered by Henry Chesbrough, that if you put a critical mass of diverse talents around a problem, creative solutions emerge from their interactions.  But does it work?

As a research director, I’ve come to believe in the power of grand challenges and insightful individuals.

I found it was most effective to pose a problem without specifying a means for solving it.  Resources (data and tools) and motivation (competitive (a performance “shoot-out”), passionate, or monetary) generally kick-started individuals.  Someone would break through with a really novel and effective idea, which would catalyze others.  Now the collaborative group begins to really achieve something from shared excitement.

But simple co-location, interaction, and brainstorming is not enough.  I wonder how the slogans are working out at GSK?

Executive and national leadership

What is the role  of a leader in government: is it different than the role of  business leader?

I’ve thought about this a lot over the past months, thinking about this picture of Angela Merkel and Nicholas Sarkozy last summer during the euro negotiations.  On one viewing, they look like any two business executives leaving  meeting for a nice dinner together. Yet they represent Germany and France:  Countries and Peoples, History and Culture.

As executive leaders, they set policies and administrate agendas.  They advance their own national interests, provide for the welfare of their citizens, and negotiate to their advantage with peers and supplicants.

But they are also embodiments of their countries on the global stage.  They represent their culture and industry, defend their language and economy, speak for their citizens and commit their resources and support.  Kings and Popes take on these tasks where parliament and monarchy share power, but these leaders take on both roles.

As do business leaders.

How many activities are familiar in this montage?

We carry out the same scope of executive functions, on a smaller scale, and we answer to quasi-legislative and judicial authority through governments, shareholders, trade groups and Boards.  We share nice dinners with our peers.

But, particularly in our dual role as Founders, we represent the business.  Our companies exist because we believe in the product and market, because we could recruit people and money to the cause, and because we could organize and execute on the project.  So we become very much the ceremonial and practical embodiment of the company.

Should successful business leaders emulate the dual roles of national leaders?  There are business leaders that do: Jobs at Apple, Welch at GE, defined the business as themselves, themselves by their business.

It’s a role and responsibility that I don’t think about as much as national leaders like Sarkozy, even though it’s an important part of my job. 

I don’t often think of myself as the embodiment of my business, as  Merkel thinks of herself as German, but I’d be a better actor and agent if I did.

I’ve attended curses where we learn from politicians how to speak, relate, negotiate, and motivate.  At a deeper level, I’m watching how they govern, in roles that both administer and represent their organizations and institutions.

An interlude

This maxim takes first place among all causes of success: Pursue one great decisive aim with force and determination.

-- Clausewitz, Principles

• Find reality and face it squarely.
• Stay on offense; never be completely passive.
• Inventory what’s known, what’s still good and the assets available.
• Set small achievable milestones.
• Keep your friends close and your debts paid.
• Arrange events to your advantage.
• Take new ground where the old can’t be defended.
• As circumstances are favorable, modify your plans.
• Give everyone a stake in success, both tasks and rewards.
• Avoid mistakes; challenge assumptions.
• Focus resources onto the top priorities; eliminate the unnecessary extravagance.
• Be clear, delegate, then depart; don’t overbear.
• Stay inwardly, outwardly confident.
• Decide the criteria for success in advance, and know when to quit.
• And, in times of economic uncertainty, never ever fuck with another man's livelihood.

Practice the virtues of wisdom, sincerity, benevolence, courage, integrity, and strictness. Not least on yourself. 

-- after Sun Tsu, Art of War

Leadership and *thinking*

My Cambridge thesis explored how companies could profit from failed R&D: what was the optimal timing and structure for creating corporate spinouts.  My academic advisor, Peter Hiscocks, told me that to solve the problem, I needed to spend at least half my time *thinking* (drawn out and emphasized, as Cambridge does).   Go down to the river, sit on the banks, shut the computer and books, and just breath the problem.

Most leaders spend far too little time deeply contemplating their business vision and purpose, but when they do, they are doing the very creative work that makes their companies form, grow, innovate, and transform.  -- Chilcote 2002

My startup is deep into the hard phase of commercializing it’s first product.  We have our challenges: we’ll get through them.  But the process requires *thinking*, which paradoxically raises organizational doubts along with operational insights.  Is *thinking* incompatible with leadership?

An example:  We will create a coating that reduces the rate of hospital acquired infections. In execution, we make left-right choices constantly and every decision has long-term consequences.  Is colonization or infection, by e.Coli or p.Mirabilis, more important?  Alternatives are backed by data, 90% decrement in the number of live bacterial on the surface after 3 days, but every element of data is open to interpretation.  Are the experimental conditions controlled, measurement technique relevant, investigator reliable?

And, all too quickly, decisions that need to be made crisply, cleanly, correctly, seem mired in uncertainty.

Leadership is about choosing, organizing, and executing.   But deciding is about *thinking*.  This week, solving this problem, the two feel incompatible.

Thinking takes time.  If there’s an issue on the table, I’d like an hour or two to focus on understanding it, enumerating alternatives, weighing evidence, and getting comfortable with the choice.

Thinking  involves discussion.  I want to closet with people who know a lot about the subject and swat interpretation and hypotheses back and forth.  Inductive solutions come from open debate, having ideas enter from different viewpoint and experiences.

Thinking is critical.  I want to challenge the data and idea so that the outcomes are robust.  Constructive skepticism and alternative hypotheses pick out the unknowns and weaknesses that need to be resolved.

But leading by these principles leads to delays and confusion.  The next step is on hold while we collect data.  Experiments, especially in medicine and biology, carry risks.  How will we react if the difference is less than expected?  Criticism spawns fear, uncertainty, and doubt.  What do we know if we don’t even know that?

All businesses have to live with uncertainty; successful ones  translate myriad options to specific actions without becoming doubtful and lost.  The best leaders achieve this by building confident and effective organizations that can coolly execute through stress and ambiguity. 

Leaders and their organizations have to be able to think critically about their choices and strategies.  But how to transition successfully out of the process?

By establishing balance: divergent discussion and fact-finding followed by consolidation and consensus.  It’s the poldermodel once again: not ending meetings with closure,  but closing the process with agreement and engagement.

There are two elements to this consolidation:

Leaders have to renew their understanding of the purpose and integrity of the project in the face of new information or changed circumstances.  How do the issues resolve personally in a way that is real and honest, consistent and compelling?

Leaders transfer engagement, ownership and accountability across the team.  They communicate purpose and confidence, clear in both direction and attitude.

In our case, two weeks work have cleared some uncertainty.  We understand the problem, the gaps, what we do and don’t know.  The experiments are clear: follow-on scenarios in the event of success or failure seem straightforward.   The open discussion and delay has sapped confidence, but I think that has to be accepted as side-effect of honest *thinking*.   But it can’t linger: as with finally leaving the river to write the thesis, it’s time to bring everyone together around a course of action, understanding of risks, and delegation of roles.

The future will belong to companies whose senior leaders remain calm, carefully assess their options, and nurture the flexibility, awareness, and resiliency needed to deal with whatever the world throws at them.  -- Bryan 2008

The value of clinical trials

What is supposed to be an objective scientific process designed to assess whether product work, whether they are better than products already on the market and whether their side effects are a price worth paying for any benefits they might convey s routinely being corrupted.  Companies bury clinical trials which show bad results and publish only those that show a benefit.  Trials are often run on small numbers of unrepresentative patients, and the statistical analyses are massaged to give as rosy a picture as possible. Entire clinical trials are run not as trials at all, but as under-the-counter advertising campaigns. That is a scandal.

Economist, reviewing Ben Goldacre’s new book.

This was my jumping-point for a talk on Clinical Trials Strategy that I gave to an industry audience at Medtec Ireland this week.

My first point was a straightforward solution: Clinical trials must inform and conform.  To inform, trials must be designed to answer a significant question honestly, with the possibility of a negative result.  To conform, trials must be executed using hypothesis-driven scientific methods, following rules to assure patient safety and privacy.

My second point was strategic: Recognize that clinical trial results serve many other audiences.  Publication in peer reviewed literature is obvious.  But regulators, payers, professional clinical associations, industry risk / usability standards,  and investors also have particular needs for information and evidence.  If the planning process doesn’t take account of them, then trials may need to be repeated.  As our Business Development director reminds me, 10% more investment broadening a trial's data collection strategy returns 30x savings later when the right information is available as needed.

I’m in Washington DC now for the Anesthesiology Society of America meeting. We’re presenting five abstracts (here’s one) describing the results of clinical studies that demonstrate safety and baseline characteristics of a new surgical monitoring device in normal subjects. 

The first two day’s experiences has really driven home both points.

These are High Science presentations: hypothesis-driven, rigorous methodology, direct comparison to the  commercial gold standard, formal registration, peer-reviewed publication.  These studies establish facts and promote open discussion, first through formal presentation and then through hours of informal walk-by discussions with clinicians. Our next set of results, accepted for December, will move to clinical experiences describing efficacy and usability.

But more broadly, the presentations also connected with multiple audiences.  We brought a prototype of the monitoring device that illustrated the likely instantiation of the idea.  Doctor who understood the need and the evidence could comment directly on the product.   They told friends; friends talked but it on the trade floor.  Industry rep’s dropped through to inquire and to  fret.  We were featured in n article in the ASA Daily News (p.3).

We hoped for a few hours of comment by our medical advisory group.  We got very full 12-hour days of intense discussion by a diverse audience of people from academics, clinical practice, and industry.  The prototype got a month of shakeout in days.

To be honest, the momentum built so fast that I got a bit worried.  Was it being oversold?  Could we meet expectations for performance and delivery time?  Was awareness building too quickly among competitors?  Were we losing control of the process?

There’s no question of the value that connecting with customers through clinical trials  has brought to the process of developing the product and the business.   Context, credibility, awareness, and access have all accelerated; optimism and enthusiasm have infused the founding team.  It’s driving late night discussions over nibbled tapas and glowing tablets about planning and funding.  It’s exciting.

Are we losing sight of the simple maxims that I advocated in Ireland just days before?  I think it’s really fortunate that I presented on these issues immediately before the conference: so far I think we’re wholly on the side of the angels and headed in directions that will both inform and conform. 

In directions that should, ultimately, benefit patients and the business.