Good Start Genetics is setting the pace for carrier screening. Based on proprietary gene-sequencing technology, Good Start Genetics’ pre-pregnancy test is more accurate and comprehensive, and is designed to replace other tests that only target a single genetic disorder and/or utilize a traditional genotyping approach. Thanks to Good Start Genetics, physicians will be able to help prospective parents make well-informed medical decisions prior to conception.
In this Q&A, Don talks about the role of mentors, the importance of a great team, and why technology is only part of the equation for life sciences companies.
Why did you choose to become an entrepreneur?
I grew up around a number of entrepreneurs in eastern North Carolina, including my dad. After college I had a number of entrepreneurial experiences, from working in a bank and helping people start businesses to becoming a sales rep in pharmaceuticals to running a facility in the commercial laboratory division of SmithKline Beecham (GlaxoSmithKline now).
In running that facility, I could really make an impact, as it was in serious financial trouble. In the course of running that particular business, I learned a lot about how to build a business. It was a great environment to learn in—it was a true turnaround and had the advantage of being a thousand miles from our headquarters so I could experiment without a lot of intrusion. It was the first time that I was running something that was truly mine. It was up to me and my team to make or break.
Next I worked at a consulting organization for sales and marketing strategies. It was very entrepreneurial—my job was to build a healthcare practice basically from scratch. Then I became the CEO of a startup called Exact Sciences, which I ran for seven years.
I found out after a while that I really like smaller companies where you can see a direct impact more quickly than you can in a large company, and it was the influence of a lot of people around me and just the thrill of seeing things happen quickly that drew me to entrepreneurial situations.
To what would you attribute your success?
I’ve always been able to tie the pieces together and connect the dots, and I’ve always been a hard worker. One of my mentors gave me some great advice early on in my career to not only analyze situations but have the courage to make recommendations to people who had much bigger jobs than I did. It stuck with me. I don’t think I’ve ever done any kind of analysis, even when I was somebody within an organization trying to move up, that didn’t include my recommendation on what we should do as a result of whatever the data said.
I also believe that if you hire the right people and treat them the right way, they’ll take care of whoever your customer is, and the numbers tend to work out pretty well in the end. People are the key ingredient in all this, and they’re not interchangeable. When you find really, really good people, you hang onto them, you try to develop them, and I think if you do that, they’ll grow and they’ll actually make you look good. So I have to give a lot of credit for my success to the people I’ve had the good fortune to either work for or work with along the way.
What’s the most important lesson you’ve learned as an entrepreneur?
Don’t take anything for granted. Nothing’s ever as good as it seems, and nothing’s ever as bad as it seems. One of things I’ve tried to do is stay pretty level-headed through all the ups and downs and make sure that the people around me don’t see me panic over any situation. In most cases, we’re going to get through it just fine.
And if it’s one specific thing, I always want to be in a position where I can control the sales channel, the primary go-to-markets channel. I think that in healthcare, particularly healthcare diagnostics, it’s not optimal if you’re not in control of your sales channel.
What’s your biggest business challenge right now?
We have three challenges ahead as we ramp product. We’re doing things that have not been done before in diagnostics, and we want to make sure that, number one, we have enough capacity; number two, we have enough customers to launch with; and number three, the insurance companies are paying us. We’re trying to make all of those things happen simultaneously, which turns out to be a pretty big deal.
A lot of people in healthcare fall in love with the technology and forget that there’s typically a third-party payer in healthcare. You have to make sure you’re going to get paid for the services that you’re rendering. We need to make sure we have enough capacity to run the test and to meet the turnaround time that physicians want, or we won’t have a chance to maintain that business.
Another challenge is building the right team. All those things I just said can be handled if you have the right team, and it’s definitely going to be a whole lot more challenging if you don’t. We’ve gone commercial much faster than a lot of healthcare companies traditionally do. Switching from more of a research organization to a commercial organization is a pretty big challenge because you don’t want to lose the scientific basis of the company and innovations that drove that. But you also have numbers you have to meet, so it keeps coming back to driving the volume, making sure we have the capacity to do it, then making sure we get paid for our services.
What advice would you give other entrepreneurs of the life sciences or diagnostic space?
It’s critical to understand reimbursement. It’s an odd system when the person who’s ordering the service—in this case, a physician—isn’t the person who’s paying for the service. Every payer does something a little different. Every plan within that payer is maybe a little different.
Many of the larger U.S.-based companies are self-insured employers, so they really drive the plan that the insurance company maintains for them. What you sell in many cases may be fantastic and may do a lot of public good, but you may not be paid unless what you are offering is within proper practice guidelines. All those things turn out to be important, and after a while, they’re as important as the novelty of your technology.
Finally, find employees who complement each other. I’ve really tried to go out of my way to make sure that in each department we have really great performers who look at problems in different ways. The idea is that together we can see more than we would if we were just trying to look at something from one individual’s point of view.
How do you operate at Good Start Genetics? How do you motivate your team? What’s the culture like?
The nature of a startup company attracts people who can generate great ideas. What we’ve tried to do is encourage the sharing of those ideas. We have people at all experience levels, including some who have not had a lot of commercial experience. So we try to supplement their functional knowledge or subject matter knowledge with the business concerns I talked about earlier: How do you get paid? How do you align with guidelines in the proper medical society? How do you market your product?
We try to be very open and transparent. That becomes more of a challenge as we grow, but I try to meet with our employees as often as I can, just to see how they’re doing and so they know that I care. I care about what they’re doing, and I care about them.
We try to stress mentorship. I’ve been fortunate in my business career to have four or five people who had a profound impact on me. Their only request was that I pass it on, and so when we bring somebody new into our company, I offer to personally mentor them, and I take it very seriously. I think it can make a difference if the senior leadership within a company really cares about the employees and their careers.
What’s your long-term vision for genetic testing and next-generation sequencing?
To our reproductive endocrinologist clients, we’re offering what we think is the best carrier testing available because we sequence for most of these tests. We’re thinking about what else we can bring to physicians, and what else we can bring more broadly to reproductive medicine and women’s health.
Next-generation sequencing has applications across almost all medicine, and one of the things that we’re trying to figure out is whether there are other things that we can do with this platform that are as efficient as what we’re doing now. And by efficient I mean we’re focused on a large market dominated by a limited number of customers.
It takes a lot of money and a lot of time to go to market, so we’re looking for other applications where we can have a focused market like we have now, where we can control the go-to-market strategy and the sales force, which would be fantastic use of our next-generation sequencing platform. We think our scientific group here is superb and they’re doing things that we don’t think anybody else is doing.
What should startups look for in VCs beyond just the financing? What core services are most important for startups? What do startups tend not to think about?
For me, it starts with the board member from the venture firm, and I think we are lucky that we have Gary Kurtzman as a board member and Wei Zhang as an observer from Safeguard. Both have been fantastic. They ask challenging questions and are always thinking about how to help us grow and think strategically about where we should go. They recommended that we talk to different people who may be able to help us either in our current market or new markets, which is much appreciated.
In addition, Safeguard has offered us marketing and PR services as well as resources to help us evaluate vendors to help us with our billing operations. There are a number of things that can be brought to bear with the added support, which is so helpful for small startup companies, where you just never have enough resources.
It’s important to take advantage of a VC’s resources versus resenting the intrusion that might come from the financing. I think it’s also helpful when your vision of the future and that of the VC are lined up as far as timing. In our case, I think we have the advantage of having investors who understand that healthcare is not something that happens overnight.
What’s your go-to news source?
I read the New York Times and the Wall Street Journal. I just find them more complete as far as the stories they bring, the things they cover, and their insights. They come at issues in different ways, and are well thought out compared to what you see in some other publications. I enjoy getting the perspective of both of these different news sources.
What’s your must-have app?
For me, it’s my email. I end up finding that you never can be away, so the email is the most important thing. But I’m also a University of North Carolina athletic fan, so I follow Tarheel Times to keep up with all of my sports teams. The email is number one for business, and Tarheel Times is number one for another important part of my life.
For more information about Good Start Genetics, please visit the company’s website (www.goodstartgenetics.com).