Thera-No-Nos: Startup Lessons from Theranos

mike gellman
Mike Gellman
Apr 17, 2019

If you read Bad Blood, listened to The Dropout, or watched The Inventor, you know a thing or two about Theranos, the Fyre Festival of digital health startups, and its non-blinking CEO and founder, Elizabeth Holmes. While they didn’t disrupt the entire healthcare industry with their magical blood box, they did provide us with a whole lot of info on how not to run a technology startup.

For those of you who’d rather not crash and burn in flames of failure, infamy, and indictments, here’s my list of lessons learned from the Theranos debacle:

  • If you’re going to “fake it till you make it,” be pretty sure you’re eventually going to make it.
  • Not everyone can rock a black turtleneck. Not everyone can be Steve Jobs.
  • Listen to smart people and be willing to change course based on what they tell you.
  • Make sure your advisors are going to add value in the required realm of expertise.
  • Don’t believe your own hype. Don’t drink your own Kool Aid.
  • Don’t be so secretive. Bring others along on your journey and build an ecosystem. Partnerships might just be the key to achieving the unachievable.
  • Don’t be afraid of competition. It makes you better and advances the cause.
  • Blink! Take a minute to think about what’s working and what’s not.
  • Be stingy with your cash. The more runway you have, the more time you have to reach your goal.
  • It’s not all or nothing. Settle for singles or doubles initially. The homeruns will come later.
  • Make your employees your allies, not your critics.
  • Breed the opposite of schadenfreude. Make the world want to see you succeed.
  • If it doesn’t seem possible, it might not be.
  • Be honest early!
  • When you fail, admit it and take responsibility. People will sympathize and help you move on, rather than vilify you.
  • If you dance like Elizabeth Holmes, don’t let it be filmed.

Building a revolutionary product from scratch is extremely difficult. For a while, Ms. Holmes made it look easy, just like Bernie Madoff made investing look easy and just like the Enron folks (including Elizabeth’s father) made energy trading look easy. If you really want to change the world, put in the time and the effort, take your lumps, and be prepared for a brutal journey that’s anything but easy.


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