Yesterday on Twitter I not only saw, but got challenged to respond to Mark Cuban’s 12 Rules for Startups, which ran in 2012 in his column in Entrepreneur and got re-circulated yesterday.
I have to say I agree with pretty much all of his rules as it applies to all startups, regardless of industry, with a few minor edits. I still think some things should be private, such as certain employee matters (rule 7). Sometimes it’s very helpful to hire a PR firm (rule 12), though you have to be far enough along to make it worthwhile; I’d probably change that rule to Never Hire a PR Firm Unless You Have Real Results to Discuss.
I particularly love his rule 4 (Sales Cure All). So true. When startups struggle and decide the first to be laid off should be the salespeople, they are likely on the path to certain doom. Undoubtedly they hired salespeople because the other management couldn’t sell. And that has likely not changed.  My favorite relevant cartoon on the matter is this one the the right.
But then Jess DaMassa put out a challenge on Twitter and called me out specifically, saying she would like to see the healthcare version of the list. The result, Jess, is I woke up with the rules pouring out of my head, so here I am with much less fancy graphics but the specific appendix A that needs to be added to Mark Cuban’s already pretty great list.
I didn’t even have my coffee yet, so maybe I’ve missed some – feel free to suggest them in the comments below.
ps- thanks to Shannon Hooper at ReviveHealth for generously making my graphics look far better than I could on my own!
Rules one and two say it all in healthcare!
Lisa:
Nicely done, as usual. Here’s another possibility:
Thinking about companies built on loopholes and regulatory niches (e.g. ER groups/out-of-network surprise bills; drug treatment centers/unnecessary lab testing):
“If your business model relies on no one figuring out how you’re actually making money, try again.”
Good point Mark! I like to call that “the fleeting business model” or the “hey, look over there” business model. Lisa
Lisa, love Mark’s 12. Difficult as it has been, like better your 12th.
Thanks
Great list, Lisa! Fortunately (or unfortunately) there are no shortages of real problems to solve in healthcare but it’s a complex environment and success is multi-factorial as your list illustrates. Thanks for always having a point of view.
Thanks Sharon! L
Lisa – Thank you so much for Number 8!!!
In healthcare, like banking, there is no “go fast and break things”… the stakes are too high.
Thanks! Also my favorite, actually. L
I particularly like Rule #8 about MVPs and People.
It’s so interesting – that is the one that caused the most controversy. Most people liked it but some thought it was naive (as in “you have to test things, obviously.” My response to that is “duh,” but don’t launch a beta that’s got the potential to hurt people because you are rushing to market – slow down, make sure your product has appropriate validation and sensitivity and specificity and for God’s sake, don’t strategize how to avoid the FDA – they could make the difference in your product being adopted because it’s proven safe. Safe is good, efficacious and beneficial (clinically and financially) is essential, and human guinea pigs are not ok. L
Great list Lisa! I suggest another one:
Healthcare professionals are extremely busy and overworked. If using your product adds 2 steps to their workflow, you’d better be saving them another 10 steps somewhere else. Otherwise you will get no adoption.
Hi Kian, alas I agree with you. I say “alas” because it’s hard to remake the system if we have to be incremental about it, keeping flawed workflows in place, but if your real point is, don’t add work without taking more than that extra work away, I totally agree! Lisa
Wow, you came up with #6 before coffee – impressive! So true, as some think wealthy patients will self-pay and that finding those patients is easy with data and DTC efforts. Sadly, money is spent only to find later there is no sustainable biz model there.
Thanks for writing.
Jennifer, indeed, I have observed it too many times (thankfully from a distance). Lisa
Love this list and would have to agree with Mark, above. I think people often assume that a complex (read: unfocused) business model can compensate for the straightforward foundation you laid out (it can’t) and/or that appealing in small ways to many stakeholders will create mega value for everyone down the line (it won’t).
Also appreciating that you broke rule #13 in this post 🙂
Thanks Lora 🙂
Lisa – I enjoy your posts, but found this list truly fabulous! Rules 4, 10 and 13 resonate with me, particularly 13. Planning and fundraising MUST account for the extremely long sales cycle within healthcare. Pots and pots of coffee (coupled with cash!) needed.
Thanks Minerva! I’ll take mine with heavy cream…L
And for those who plan on bringing a product to market: It’s never too early to include design for manufacturing and quality controls!
Agreed Jenny! L
Rule #3, in fact the first four words alone, maybe ought to be Rule #1. It’s the difference between being in medical device and tech and why so many of us love what we’re doing despite the challenges.
I like the entire list though, and #13 is a great way to end it.
Thanks Steve! L