Learn
Below are resources we have found to be especially helpful as we’ve worked to understand the world in which we live and work a little better.
Resources
How to identify real problems. How to think about uncertainty. How entrepreneurs actually bring solutions to the marketplace. How to weather the storms along the way.
Articles
John Ioannidis, PLoS One
This article lays out the framework for understanding why so much of the peer-reviewed literature is “fake news” – interesting findings that, upon re-examination, cannot be reproduced by other investigators. Sloppy statistics, a broken peer-review process, rigid promotion and tenure criteria all create perverse incentives that make it harder and harder to interpret the scientific literature that serves as the foundation for innovation. Ioannidis’ work was also featured in the Economist article entitled Publish and Be Wrong.
Victor Volovici, Nature Medicine
This manuscript points out some of the important errors commonly seen in healthcare research that utilizes machine learning and artificial intelligence, including overfitting, inadequate sample size, biased training data. A must read in the everything-AI era.
FDA, Health Canada, MHRA
Jointly published by the FDA as well as its counterparts in Canada and the United Kingdom, these 2021 guidelines offer ten best practices to ensure that ML/AI are being used appropriately (and, importantly, these guidelines have been referenced by the FDA during the regulatory approval process).
Gregory Marcus, Nature Reviews Cardiology
Worth reading for Figure 1 alone, entitled “Inversion of the conventional workflow of scientific discovery.” Succinctly describes how the traditional paradigm of Idea -> Research -> Dissemination -> Adoption has been completely flipped in some markets (e.g. wearables), where products are developed, marketed and sold, and then data are collected and research is performed to determine if there is medical utility or not.
Melanie Senior, Nature Biotechnology
Nicely describes the “life cycle” of money in the startup space. In particular, when IPOs are active, the rewards can be re-invested into startups. When IPOs stall, there’s less money available to re-invest into new business ideas. Analogous to the carbon cycle.
Brandon Freiburg, Proceedings of the National Academy of Sciences
Analysis of over 10,000 founder-startup dyads, analyzing the impact of five personality traits on the entrepreneurial success. Interestingly, while “conscientiousness” was significantly correlated with the amount of funding raised, it also significantly decreased the probability of a successful exit (IPO or acquisition). (see also Talking to Strangers below)
Books
Ryan Holiday
An accessible introduction to Stoicism, which launches the reader into a two thousand year journey back in time with this opening statement – “The chief task in life is simply this: to identify and separate matters so that I can say clearly to myself which are externals not under my control, and which have to do with the choices I actually control. Where then do I look for good and evil? Not to uncontrollable externals, but within myself to the choices that are my own…” -Epictetus, Discourses, 2.5.4-5. This mindset, trying to understand what levers you can pull, and which you can’t, is fundamental to successful participation in any activity that involves uncertainty and decisions about how you use your time (investing, living your life, whatever).
Nassim Taleb
Humans evolved to be pattern generators, and this was a survival mechanism. If your dad and your uncle were killed by lions, next time you saw a lion you would run! If you didn’t, you would not pass on your DNA. But an experiment with two data points (n = 2) is hardly “scientifically valid.” We are hard-wired to jump to conclusions, to see things that aren’t there, and this has implications ranging from religion to investing and everything in between. For some specific examples of apophenia (“magical thinking”) in the scientific literature, see Apophenia and anesthesia: how we sometimes change our practice prematurely, which was written by two Hoplites!
Michael Lewis
A fascinating treatise on the value of 1. being a contrarian and 2. using data to guide decision-making. Also mandatory reading for anyone assembling a team to accomplish a task (the main point being that teams are not merely the sum of their individual parts, but a more complex entity that has everything to do with how they interact and fit with one another).
Ryan Holiday
65% of venture capital investments yield a negative return (at least according to data from Correlation Ventures, reported by mergersandacquisitions.com). This is very different from healthcare more broadly, where a failure rate even in the double digits might be seen as unacceptable. For those who were valedictorian of their high school and graduated from medical or business school with honors, entering an industry in which most of the companies you back will lose you money can be tough. This book will get you in the right headspace to stomach these repeated failures, and will hammer home the reality is that choosing to do hard things can be incredibly rewarding.
David Epstein
The intellectual counterweight to the 10,000 hours / Battle Hymn of the Tiger Mother myth that if you obsess over one thing, you will become really good at it. The reality is that the super-specialization ethos is a drag on progress and in some cases (e.g. NASA), has been incredibly dangerous, even lethal. Yes, you can find individuals who achieved greatness in their field following thousands of hours of narrow-minded pursuit of excellence, but these individuals are rare and exist largely in what are called “forgiving” domains. In the real world, the artists (Van Gogh), athletes (Federer), and scientists (Feynman) who truly advance their specialties typically have deep interests in a variety of seemingly unrelated disciplines. Yet when they approach their work, they are able to leverage this broader background to identify relationships and patterns that other more “focused” individuals would have missed. In other words… Be Curious.
Malcolm Gladwell
Humans are pack animals and evolved with an innate tendency to trust each other. Without this, cooperation and societal formation would have been impossible. This sense of trust can easily be exploited, and this book presents a series of examples in which “getting to know” or “laying eyes on” someone else can lead to misplaced trust and harm (e.g. in espionage, court systems, investing). For instance, judges who make bail decisions after meeting defendants are significantly worse at predicting the probability of re-offense than an unbiased algorithm. Calls into question what we are really doing when we evaluate people (see also Freiburg’s paper in PNAS above).
Annie Duke
Over a two decade career, Annie Duke won over $4 MM playing poker. Unlike chess, in which there is no element of chance and there is always a single, correct decision, random chance plays a prominent role in the outcome of a hand, Which is a lot like life. How then are we to know whether we are making good decisions? One way is to avoid “resulting” – labeling a decision as good or bad because of the results. A good decision can still yield a bad result (thanks to chance), and vice versa. Duke offers a reasonable mental framework for learning how to make progressively better decisions despite the influence of uncertainty.
Brad Feld and Jason Mendelson
An absolute gift to anyone wanting to learn more about venture capital, from two men who have been in this space for decades (as part of Foundry Group). Concise, brutally honest, irreverent, and peppered with insight from entrepreneurs, this book is useful to both people seeking to raise money and those who seek to deploy capital.
Podcasts
Keith Figlioli, LRV Health
Deep insight into how healthcare venture capitalists think, brought to you by Keith Figlioli of Boston-based LRV Health, who interviews the biggest names in healthcare. Hilights include episode 31 on rural health innovation (and focuses on the amazing work done at Ballad Health) and the three part series (episodes 34-36) called “The Retailers Are Coming,” which focuses on CVS, Walgreens, and Walmart.
Stephen Krupa, Silos Group
The OG digital health podcast, with over 164 episodes and counting, brought to you by Healthcare VC (and CEO of HealthEdge) Stephen Krupa.
Mike Pesca
Former Advisory Board members bring you daily updates in healthcare, every weekday, in 10 minutes or less.
Malcolm Gladwell
No, it’s not medical, but continuing the theme of Be Curious, and that acquisition of new knowledge in one domain may allow you to think creatively about another domain, and for sheer entertainment value, this is well worth your time. The four-part series on Curtis LeMay is particularly masterful.
