Entrepreneurship 101: How to dream big—with your feet on the ground

Hertz Foundation Fellow Dr. Christopher Loose sold his first startup for $80 million. His advice is probably the kind you want to hear.

Chris Loose: As an entrepreneur, focus is critical, especially with a platform technology.
One often knows that you can go after many different product applications, but you ultimately get valued most importantly on the first application you bring forward, and as an entrepreneur you have limited time and limited resources, so you need to choose well and drive deep into clinical and regulatory validation for that first product.

Now, in order to make that often really painful decision about what to invest in and what to leave on the side—at least for a while—there are many aspects of a certain product you need to think through. Obviously market size plays a role. Technical fit to need plays a role.

As I’m looking at new ideas, I often try to follow some of the advice I once got from Bob Langer, who has been very prolific—he has started roughly 50 companies out of his lab, I think, at this point, and I have had the honor of starting two companies with him. Among the other kind of rules of the road he shares, is first: look for a platform company. If you're going to build a company make sure that if you’re successful in one area it can create value in a number of adjacent areas, because that really justifies bringing in the investment, building the whole infrastructure not just for one product but potentially for many.

But within that it's crucially important, and perhaps most important, to select an opportunity that has a very clearly defined first product opportunity that you have the ability to drive to a major value creation event, like a regulatory or a clinical approval.

As you’re building a business you ultimately get valued on that lead asset you’re carrying forward, so it’s important to have a platform but not to lose focus within that platform and make one crucial bet that ultimately can drive the early success of your company.

What really gets me excited is developing new therapies that can help patients. In order to do that you need to think through: who exactly is the patient you’re trying to help? What disease do they have, and what kind of clinical trial could you design that really proves that you’re giving a benefit to that class of patient?

When you do that you have to think through: What type of therapy is practical? How is it given? How frequently and by whom? And understanding that whole pathway from basic discovery to delivering an actual therapeutic requires a great variety of different skills you must bring together.
And early in our startups what we’ve done is first focused on some of the fundamental biology, but then defined: who are the experts along the way that we’re going to need to engage in order to advance all the way through the development, regulatory, and clinical process? And I can’t encourage young innovators enough to think about engaging project development experts and clinical experts early in the discovery process, because that really shapes what you’re trying to discover, and what you’re trying to create that can ultimately help the patient.

As I interact with a lot of young entrepreneurs who are thinking of starting companies, the most important piece of advice I like to give them, particularly on the technical side, is: find someone who has totally different skills from you, that you can trust and will challenge you. It can help you think through the many aspects it takes to build a business or create a new therapy.
For me this was when Bob Langer introduced me to David Lucchino, who in 2005 became my cofounder of my first startup.

And he took me out of the lab, dragged me into the hospital and really started meeting nurses and purchasers and doctors—who are people I never really interacted with at a deep level—so I could start to understand that if we’re to develop a new product, who are all the stakeholders this product would need to satisfy, and how can I understand all of their incentives, all of their constraints?

Because ultimately to get a new product to patients you need to understand the whole delivery system it must go through in order to bring that forward, and who must become champions. And the only way that was going to happen is by that early interaction and introduction to David, who brought a business and marketing and totally different background, but we challenge each other, we have mutual respect, and it has let us build now two businesses that have brought a number of exciting things into the clinic.

In order to enter this industry, particularly as an entrepreneur, as a first-timer, and I was straight out of grad school when I went into my first startup and I really had no experience developing products. The advice I would give is really to engage people who have gone through that product development experience very early on. They’ll have a lot of rules of the road, a lot of mistakes to avoid, and can really help make you successful even if you don’t have the deep domain experience yet. And it’s amazing how much young entrepreneurs who have a passion and enthusiasm and some really big ideas can engage and draw on people who have deep experience even before potentially they could afford them as consultants or employees.
I think, as entrepreneurs are dreaming big, you can share that energy, share that vision, get people involved and really bring in fantastic folks at a very early stage.

One lesson that was imparted to me early in my previous startup was to think very critically about all the testing and all the features that a medical device must go through to be successful. We were essentially creating a new technology to try to make medical devices safer: reducing clots or infection was ultimately our goal for devices that went into the body.
Now, we thought initially as technologists about the new feature we were creating and how powerful it was and how helpful it could be, but as we started to work with experienced product developers they made us realize that these devices were designed with a certain application in mind; they needed to perform certain functions first and foremost, and as we’re adding our new technology, as we’re making our advance, we couldn’t do any harm to the current standard of care as we’re adding new features onto an existing product.

And that even applies in therapeutics, thinking about not in any way falling short of the standard of care in some aspects as you’re trying to improve another aspect is very important, and experienced product developers can really help you understand that process.
In order to drive new innovative medicines to the clinic, a critical aspect of this is developing a strong intellectual property position because of the great resources required to advanced a medicine. It can be hundreds of millions of dollars to advance from concept through trials, and even billions of dollars before ultimate launch of a product. In order to justify those kinds of investments one needs to be able to have a product that one can protect for a period of time on the market.

The benefits of the patent system are—essentially it’s a trade. For a period of time you’re granted that right to be able to have exclusive access to sell a certain medicine, but in trade for that essentially you have to disclose to the world, “Here is exactly how we did it,” and it can let the world start thinking pretty quickly about: how can they do better? And at the end of the day whole fields of science advance, new medicines move forward, and as things become generic, medicines continue to reach a broader and broader patient population.

Hertz Foundation Fellow Dr. Christopher Loose sold his first startup for $80 million in 2012, and co-founded his second startup, Frequency Therapeutics Inc., in 2015, which is developing methods to restore hearing loss, with greater applications in human regenerative medicine. Even if you aren't in the field of medicine, innovators of any kind looking to found their first startup will benefit from his experience and advice on mentorship, building a balanced team, consulting experts, and how to develop the right first product—one that the rest of your career might be valued on. The Hertz Foundation mission is to provide unique financial and fellowship support to the nation's most remarkable PhD students in the hard sciences. Hertz Fellowships are among the most prestigious in the world, and the foundation has invested over $200 million in Hertz Fellows since 1963 (present value) and supported over 1,100 brilliant and creative young scientists, who have gone on to become Nobel laureates, high-ranking military personnel, astronauts, inventors, Silicon Valley leaders, and tenured university professors. For more information, visit hertzfoundation.org.

Are we really addicted to technology?

Fear that new technologies are addictive isn't a modern phenomenon.

Credit: Rodion Kutsaev via Unsplash
Technology & Innovation

This article was originally published on our sister site, Freethink, which has partnered with the Build for Tomorrow podcast to go inside new episodes each month. Subscribe here to learn more about the crazy, curious things from history that shaped us, and how we can shape the future.

In many ways, technology has made our lives better. Through smartphones, apps, and social media platforms we can now work more efficiently and connect in ways that would have been unimaginable just decades ago.

But as we've grown to rely on technology for a lot of our professional and personal needs, most of us are asking tough questions about the role technology plays in our own lives. Are we becoming too dependent on technology to the point that it's actually harming us?

In the latest episode of Build for Tomorrow, host and Entrepreneur Editor-in-Chief Jason Feifer takes on the thorny question: is technology addictive?

Popularizing medical language

What makes something addictive rather than just engaging? It's a meaningful distinction because if technology is addictive, the next question could be: are the creators of popular digital technologies, like smartphones and social media apps, intentionally creating things that are addictive? If so, should they be held responsible?

To answer those questions, we've first got to agree on a definition of "addiction." As it turns out, that's not quite as easy as it sounds.

If we don't have a good definition of what we're talking about, then we can't properly help people.

LIAM SATCHELL UNIVERSITY OF WINCHESTER

"Over the past few decades, a lot of effort has gone into destigmatizing conversations about mental health, which of course is a very good thing," Feifer explains. It also means that medical language has entered into our vernacular —we're now more comfortable using clinical words outside of a specific diagnosis.

"We've all got that one friend who says, 'Oh, I'm a little bit OCD' or that friend who says, 'Oh, this is my big PTSD moment,'" Liam Satchell, a lecturer in psychology at the University of Winchester and guest on the podcast, says. He's concerned about how the word "addiction" gets tossed around by people with no background in mental health. An increased concern surrounding "tech addiction" isn't actually being driven by concern among psychiatric professionals, he says.

"These sorts of concerns about things like internet use or social media use haven't come from the psychiatric community as much," Satchell says. "They've come from people who are interested in technology first."

The casual use of medical language can lead to confusion about what is actually a mental health concern. We need a reliable standard for recognizing, discussing, and ultimately treating psychological conditions.

"If we don't have a good definition of what we're talking about, then we can't properly help people," Satchell says. That's why, according to Satchell, the psychiatric definition of addiction being based around experiencing distress or significant family, social, or occupational disruption needs to be included in any definition of addiction we may use.

Too much reading causes... heat rashes?

But as Feifer points out in his podcast, both popularizing medical language and the fear that new technologies are addictive aren't totally modern phenomena.

Take, for instance, the concept of "reading mania."

In the 18th Century, an author named J. G. Heinzmann claimed that people who read too many novels could experience something called "reading mania." This condition, Heinzmann explained, could cause many symptoms, including: "weakening of the eyes, heat rashes, gout, arthritis, hemorrhoids, asthma, apoplexy, pulmonary disease, indigestion, blocking of the bowels, nervous disorder, migraines, epilepsy, hypochondria, and melancholy."

"That is all very specific! But really, even the term 'reading mania' is medical," Feifer says.

"Manic episodes are not a joke, folks. But this didn't stop people a century later from applying the same term to wristwatches."

Indeed, an 1889 piece in the Newcastle Weekly Courant declared: "The watch mania, as it is called, is certainly excessive; indeed it becomes rabid."

Similar concerns have echoed throughout history about the radio, telephone, TV, and video games.

"It may sound comical in our modern context, but back then, when those new technologies were the latest distraction, they were probably really engaging. People spent too much time doing them," Feifer says. "And what can we say about that now, having seen it play out over and over and over again? We can say it's common. It's a common behavior. Doesn't mean it's the healthiest one. It's just not a medical problem."

Few today would argue that novels are in-and-of-themselves addictive — regardless of how voraciously you may have consumed your last favorite novel. So, what happened? Were these things ever addictive — and if not, what was happening in these moments of concern?

People are complicated, our relationship with new technology is complicated, and addiction is complicated — and our efforts to simplify very complex things, and make generalizations across broad portions of the population, can lead to real harm.

JASON FEIFER HOST OF BUILD FOR TOMORROW

There's a risk of pathologizing normal behavior, says Joel Billieux, professor of clinical psychology and psychological assessment at the University of Lausanne in Switzerland, and guest on the podcast. He's on a mission to understand how we can suss out what is truly addictive behavior versus what is normal behavior that we're calling addictive.

For Billieux and other professionals, this isn't just a rhetorical game. He uses the example of gaming addiction, which has come under increased scrutiny over the past half-decade. The language used around the subject of gaming addiction will determine how behaviors of potential patients are analyzed — and ultimately what treatment is recommended.

"For a lot of people you can realize that the gaming is actually a coping (mechanism for) social anxiety or trauma or depression," says Billieux.

"Those cases, of course, you will not necessarily target gaming per se. You will target what caused depression. And then as a result, If you succeed, gaming will diminish."

In some instances, a person might legitimately be addicted to gaming or technology, and require the corresponding treatment — but that treatment might be the wrong answer for another person.

"None of this is to discount that for some people, technology is a factor in a mental health problem," says Feifer.

"I am also not discounting that individual people can use technology such as smartphones or social media to a degree where it has a genuine negative impact on their lives. But the point here to understand is that people are complicated, our relationship with new technology is complicated, and addiction is complicated — and our efforts to simplify very complex things, and make generalizations across broad portions of the population, can lead to real harm."

Behavioral addiction is a notoriously complex thing for professionals to diagnose — even more so since the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the book professionals use to classify mental disorders, introduced a new idea about addiction in 2013.

"The DSM-5 grouped substance addiction with gambling addiction — this is the first time that substance addiction was directly categorized with any kind of behavioral addiction," Feifer says.

"And then, the DSM-5 went a tiny bit further — and proposed that other potentially addictive behaviors require further study."

This might not sound like that big of a deal to laypeople, but its effect was massive in medicine.

"Researchers started launching studies — not to see if a behavior like social media use can be addictive, but rather, to start with the assumption that social media use is addictive, and then to see how many people have the addiction," says Feifer.

Learned helplessness

The assumption that a lot of us are addicted to technology may itself be harming us by undermining our autonomy and belief that we have agency to create change in our own lives. That's what Nir Eyal, author of the books Hooked and Indistractable, calls 'learned helplessness.'

"The price of living in a world with so many good things in it is that sometimes we have to learn these new skills, these new behaviors to moderate our use," Eyal says. "One surefire way to not do anything is to believe you are powerless. That's what learned helplessness is all about."

So if it's not an addiction that most of us are experiencing when we check our phones 90 times a day or are wondering about what our followers are saying on Twitter — then what is it?

"A choice, a willful choice, and perhaps some people would not agree or would criticize your choices. But I think we cannot consider that as something that is pathological in the clinical sense," says Billieux.

Of course, for some people technology can be addictive.

"If something is genuinely interfering with your social or occupational life, and you have no ability to control it, then please seek help," says Feifer.

But for the vast majority of people, thinking about our use of technology as a choice — albeit not always a healthy one — can be the first step to overcoming unwanted habits.

For more, be sure to check out the Build for Tomorrow episode here.

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Credit: World Values Survey, public domain.
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