Top 5 things I have learned while building a start-up

By Inga Rose, Founder and CEO, Reference Medicine

In the very early stages of building Reference Medicine, it felt like everyone I spoke to had some kind of “tip” to share. Being a mother of two girls, it was very reminiscent of early parenthood - from opinions on how long to breastfeed, an insistence on sleep schedules, recommendations of this book to read, or that book to read, “don’t co-sleep”, “no blankets”, “ceiling fans are good”, “ceiling fans are bad”, to unsolicited promotions of the best gas remedies and diaper creams. All of the tips could be incredibly overwhelming and could also be just plain annoying (I am sure other parents reading this can agree), but when I stepped back and opened my perspective to all of the different possibilities of how I can treat my gassy baby, I was able to pick and choose “tips” to try and ultimately found a solution that worked for us. Upon reflection, I was able to navigate through those first months of motherhood, with some sleep and sanity, because of the plethora of wisdom and support that I had in my community. 

Today, entering the toddler years of Reference Medicine, I am realizing that our early days were shaped very similarly by embracing those around us, taking (and leaving) advice, asking for help, and also accepting help when offered. Throughout the journey, some advice sped up our progress, some helped us avoid unforeseen hazards, and some advice fell flat but helped us learn more about ourselves and the type of company we are building. In this experience, we learned our own lessons that we will carry on into our next stages of start-up building, and can also offer (in sometimes unsolicited fashions) to our communities. 

As I reflect back on our first year, five things stand out: 

It takes a village to raise a start-up

All of the advice - solicited and unsolicited, helpful and not helpful - was information that we could experiment with. When we have no idea what we are doing (yup, I just admitted that), the advice gives us a place to start. But maybe more impactful than the words of wisdom constantly being shared with us is our community’s energy, encouragement, and support. They are the catalyst that helps us move forward during some of the most challenging times. 

Much like parenthood, the team and I experience good days, bad days, and every kind of day in between. The community of wonderful people who network for us, act as sounding boards, pick up our kids from school, send notes of encouragement, celebrate with us over some drinks (and mope with us over others), give us the motivation, strength, and extra capacity to keep going. Building a start-up is more than a full-time job, and I think it would be nearly impossible to do it on your own. I have learned to embrace all of it - ask for help, lean on support, and act on the advice that makes sense for you and your business. Let your village in and keep them by your side.

There is no right path, and if you don't choose a path because you are worried it may not be the right one, you will never make progress

In our first year, there were a few times when progress stalled because we were uncertain about which path to take. We had multiple paths we could go down, and we dutifully listed out all of the pros, cons, and uncertainties associated with each one. It felt overwhelming to choose the “right” one from so many different options, so instead we made no decisions, and no progress. None of the pros or cons were tested. None of the uncertainties were resolved.

As a very tactical, accomplishment-driven individual, this drove me nuts! After some time spinning around a decision, we took a step back and realized that there actually was no right path (and we could always do a U-turn if needed). We simply just needed to pick a path, go down it, learn along the way, and evaluate the outcome. We were a car sitting stalled at an intersection; today we allow ourselves to explore the open roads and take in the views. We might not know exactly what is ahead, but we do know that we are making progress, which will get us closer and closer to our final destination. 

Consistent effort leads to significant results

You can always control your efforts, but you can’t always control when you get results. Especially in the early days of a start-up - as operations, sales, janitor, you name it - this lack of control over outcomes could really sink my spirits. Some days I would send a couple of emails and find someone who needed exactly what we had to offer, and some weeks I heard nothing at all. But what I’ve seen happen over time - day by day, email by email, Zoom by Zoom - is that our name started reaching the right people, and we’re becoming known as a company that is helpful and transparent, so that when the time is right, people think of us. 

So how do you keep at it when it’s a two-steps-forward, one-step-back kind of day (or week)? First, when things weren’t working at all, it gave me an opportunity to reflect on what my efforts looked like, tweak my strategy, and try again. Sometimes the work I had put in just hadn’t paid off yet. But it also gave me an opportunity to solicit, and receive, some great suggestions from ‘the village’ that helped hone my efforts. Second, we found that regular reflection on progress, celebrating all of the small wins, and mega-celebrating the big ones, have been critical for keeping our morale high. Our team of high achievers is guilty of finding ourselves focused more on the bad stuff than the good, so we’ve created very deliberate opportunities to remind ourselves (with the amazing help of our project manager extraordinaire) to gather as a team to reflect, learn, and appreciate how far we have come. This motivates us to dive straight into our current priorities and what results we are driving towards next. 

Throwing money at professionals does not just magically make things happen

A big financial lesson here. It is so tempting, and also highly recommended by some, to throw money at problems. I am here to say that in our experience, it didn’t always work.

When your problems are fundamental in nature - who are we, how do we want to represent ourselves, what do we stand for, how do we operate - there is no substitute for putting in the time. A start-up is a reflection of all of the people who are a part of it, and these foundational questions are answered by the sum total of their experiences, personalities, and energy. And the reality is that professionals who are helping you answer these difficult questions are doing it with you, not for you.

It's also tempting to use money to 'move faster', but if you haven't seen that the direction you are heading is validated by the market, then engaging with paid professionals is a good way to burn cash while heading the wrong way or running up against a wall. It might feel good because there is activity - like when you see high-quality work being done - but I can tell you that it won’t change your business trajectory.

With this lesson learned, we’re now more agile and willing to try (and fail!) to do things ourselves before we pay for help. Every attempt gives us more information about where our boundaries are for our collective talents, and what does and doesn’t work in our market. This approach lets us be more precise in the help we do solicit.

Remain open and curious, and never stop trusting your gut

This advice is nothing new, but I think it is a needed reminder to trust your gut. 

No one is strong in every aspect of a business. Some decisions will feel very easy, and some will feel pretty hard. For me, I thought that my feeling of confidence in some areas based on my previous experiences, whereas feelings of less confidence was due to uncertainty and lack of experience. I now realize that I was somewhat off in that perspective. 

I am generally curious about new ideas and want to make sure we have all of them on the table for integration into our visionary and tactical plans. No idea is off-limits, and the more ideas and brainstorming, the better the outcome. I believed that it was my own openness to varied perspectives and different ways to approach a task that affected my confidence gauge, thinking that I was feeling less confident with ideas that were untested or were simply “new” to me. However, I now realize I was only noticing this correlation when I felt a lack of confidence. When I expanded my reflection, I could see that there were plenty of uncharted territories where my confidence was high even though the ideas were new to me - and it turns out that the ideas that I had high confidence in correlated more frequently to successful outcomes for our business.

My confidence gauge wasn’t being influenced by “newness”, it was being influenced by my gut - and I wish I would have listened to it more in our first year. Sometimes we can’t explain why something doesn’t feel right. The lesson I learned here is that even if we can’t articulate it, we should never ignore this piece of ourselves. After all, our gut and intuition are our own personal protectors in this world - we need to let them do their jobs.