MedCity Influencers, Startups

What corporate culture characteristics make or break startups?

As someone who invests in small companies where the culture is really, really important to outcome, it is something I think about almost all of the time when I perform diligence on companies and sit on their boards.

I am fortunate I get to moderate a lot of interesting panel discussions.  They are usually about healthcare or investing and occasionally about gender issues.  But recently I got to participate in a different discussion and it was quite enlightening.

BIOCOM and Slone Partners co-hosted an event called Culture as Cornerstone: Bay Area Perspective – Activating Senior Executives To Build Thriving Cultural Environments.”  The focus was on workplace culture – what defines it, what builds it, what ruins it.

The program wasn’t life sciences-focused per se, though the participants all were. They included:

Boy George was not involved though he is the first thing I think of when I hear the word “culture,” at least since it was released in my formative college years.

But culture is a great topic and one that doesn’t get discussed enough.  As someone who invests in small companies where culture is really, really important to outcome, it is something I think about almost all of the time when I perform diligence on companies and sit on their boards, just not always as consciously as I probably should.

A company’s culture can make or break it.  If the culture is toxic, no good comes out of it – and I have seen this first hand.  If the culture is thriving, people beat a path to your workforce and growth follows; luckily I have seen this too.  Since culture is the sum total of people, it is an extension of the thought that the most important part of a company’s success is the team, which nearly every investor would agree is true.  Those that don’t agree are simply wrong.  What can I tell you?

So while I don’t generally hang out among the HR executives that live and breathe this stuff, I was interested to hear the conversation, which I got to do as panel moderator.

I confess I always thought of corporate culture as the “personality” of the place, the panel totally disagreed with me, so I shunned them.  No seriously, this is how they defined it:

  • A company’s culture is defined by how it makes decisions;
  • A company’s culture is defined by what gets rewarded vs. punished;
  • A company’s culture is defined by the behaviors that are passed down that guide how it progresses over time.

These clearly aren’t the same as “personality,” but they are related.  Or at least that’s what I’m telling myself to justify being wrong.  I was particularly struck by the first definition and have thought about it a lot since then.  I think that is definitely a key part of what defines culture – necessary but not sufficient.  Decisions can be made in a lot of ways but if people feel generally empowered to make decisions or trust in leadership to make good decisions with or without much input, it can go well.  When people are just taking orders, not so much (although maybe there are military exceptions, who knows?).  But I have been in workplaces and at junior work levels where decision-making was highly concentrated and the culture still healthy and I have seen companies where decision-making was widely disseminated among the team and was a disaster – the empowered masses were just not making good decisions out of a lack of knowledge and experience.

This whole thing led to a discussion about the distinction between culture (which was defined as behavioral per above) and climate, which is more the “fun” or more superficial aspects of a workplace, like beer and artisanal coffee or the ubiquity of those damn fleece vests that have become the dress code of Silicon Valley (see best Instagram account ever, courtesy of Scott Lenet).  And while we are dwelling in semantics, I appreciated Eric’s definition of his own company’s culture as irreverent and alcoholic – I’m assuming those are more climate than culture, right Eric?

We also had a fulsome discussion about whether culture is set by the leader at the top or emerges from the great unwashed (or as HR would probably call it, the employee base).  Personally, I think that culture is largely set at the top – maybe not just the CEO, but the top one to three people who lead the company generally set a tone that others follow.  Yet, my fellow panelists did and didn’t agree with me on this one.  There was emphatic agreement that small companies, particularly founder-led ones, have a top-down culture and that is essential to their early success.

But we also discussed how culture can be set by the “middle”, aka the agitators, who shake things up and create their own organizations with their own cultures, which together contribute to the sum total of an organization’s culture.  We discussed how large companies can have different cultures in different departments and especially in different buildings and among geographies.  One of the panelists talked about how important it is for management to spend time in each and every building, regardless of locale, in order to spread the corporate culture more evenly, which of course proves my top-down theory applies also at big companies. But it’s so true, actually.

I have worked in many places that have more than one floor where you can feel the difference the minute the elevator door opens.  Similarly, the difference in one company from country to country reflects not just the corporate culture, but the societal one.  I won’t list all the stereotypes (fleece vests, kombucha on tap) for every country (yes, that was just Palo Alto), but you can imagine the difference from here and Switzerland or here and Japan.  People are just the sum total of their experiences and where they hail from is one of them.  That’s why everyone can tell in a moment that I’m from New Jersey (exit 9).

The super fun part of the discussion was dishing about companies that are famous for great or awful cultures.  It took less than half a second for Theranos and Uber to come up.  Guess which category they were in?  As for the winners, Netflix was widely considered the best because of its commitment to transparency and rewarding great performance (and punishing poor performance). Other revered cultures dwell at Zappos (a democratic decision-making structure), Wegmans (for their real commitment to health as a mission – if Jane is reading this, you are nodding your head right now), and Patagonia, also for its commitment to the environment.  Interestingly, there was a unanimous view that biotech companies have “nicer” cultures than tech companies because they are mission-driven.  Personally, I’m going to go with “it depends” on that one (Martin Shkreli anyone?).

We covered so much (including gender, race, open floorplans vs. offices, even the role of plants) that this will be a book if I try to cover it all, so I’ll end with the advice the panel gave about how to learn about a company’s culture when you are interviewing there.  Here are the questions HR says you should ask:

  • How are decisions made?
  • What would you most like to change in the company’s culture and why? What are you doing to change it and who is doing that?
  • What kind of people are successful here and who flames out and why?

You should also ask questions that elicit what you want to find in the culture when you go somewhere, like “What kind of beer and kombucha are on tap?” Oh wait, that’s climate.  But you get the drift.

And last but not least, one panelist said something I feel to be particularly insightful for those of you building companies and hoping to inculcate a strong and positive culture, “Culture is spread through storytelling.”  So true.  Stories are essential to every culture and mission.  I’ve written about this before and telling a great story is one of the most important things that any leader needs in their arsenal.

Thanks to Slone Partners and BIOCOM for this really interesting discussion and to my fellow panelists – it was great fun.

Photo: Getty Images

Lisa Suennen has spent nearly 30 years as an entrepreneur, venture investor and advisor in the healthcare industry. She currently serves as Senior Managing Director at GE Ventures, leading the firm’s healthcare venture fund. Lisa is also co-founder of CSweetener, a not-for-profit company focused on matching women in and nearing the healthcare C-Suite with mentors who have been there and wish to give back. She is a member of the faculty at the UC Berkeley Haas School of
Business, where for 10 years she has taught classes on venture capital and the changing healthcare economy.
Prior to joining GE Ventures, Lisa operated Venture Valkyrie Consulting for 3 years, advising large corporations around corporate venture capital, new business creation and digital health strategy. Prior to that she spent 15 years as a Partner at Psilos Group, a successful healthcare-focused venture capital firm. Lisa is currently a Board Member of Evidation Health, Health Reveal, Gravie, the Dignity Health Foundation, and Heart To Heart International. She is also on the Advisory Boards of the California Health Care Foundation Innovation Fund, the
American Heart Association Innovation Think Tank, global digital health organization HealthXL and NASA’s Translational Research Institute.  Lisa is a Fellow of the inaugural class of the Aspen Institute’s
Health Innovators Fellowship and a member of the Aspen Global Leadership Network. Through her Venture Valkyrie media company, Lisa writes a widely read blog on healthcare and healthcare investing at http://venturevalkyrie.com . She published her
first book in 2013: Tech Tonics, Can Passionate Entrepreneurs Heal Healthcare with Technology, coauthored with Dr. David Shaywitz. Together they also host a popular podcast, also called Tech Tonics, focused on the people and passion at the intersection
of technology and health.
Lisa an M.A. in political science, a B.A. in political science and a B.A. in mass communications, all from the University of California, Berkeley.

This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.