Hire a diverse range of experience. Most startups hire many junior employees, however I’ve learned that it is important to hire a healthy mix of people who have strong experience as well as junior staff who is eager to jump in and bring their creativity.
Startups have such a glamorous reputation. Companies like Facebook, Instagram, Youtube, Uber, and Airbnb once started as scrappy startups with huge dreams and even bigger obstacles.
Yet we of course know that most startups don’t end up as success stories. What does a founder or a founding team need to know to create a highly successful startup?
In this series, called “Five Things You Need To Create A Highly Successful Startup” we are talking to experienced and successful founders and business leaders who can share stories from their experience about what it takes to create a highly successful startup.
I had the pleasure of interviewing Fred Turner, Chief Executive Officer and co-founder of Curative, a COVID-19 testing and healthcare company scaling a self-collected oral fluid swab for the detection of SARS-CoV-2. A British scientist from West Yorkshire, Turner attended the University of Oxford. Mr. Turner was named one of the top 100 practicing scientists in the UK by the Science Council 2013. Turner was also included in Forbes “30 Under 30” list and ranked first in the European Union Contest for Young Scientist.
Turner previously founded and led a 16z and YC-backed diagnostics (Dx) startup that built a CLIA lab for validating and launching a STD testing product in Menlo Park, California. This product was administered to over 10,000 patients in medical centers across 5 states. Other previous roles include Chief Executive Officer at Shield Bio, which was focused on solving the issue of antibiotic resistance related to cancer.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
Back in England when I was a teenager, I wanted to get into a microbiology lab, but no one in the UK would let me in at the age of 16. I decided that the only way to make it happen was if I built the equipment myself from scraps that I bought off eBay. So, I built a PCR machine, which is the backbone tool of most molecular biology, in my parents’ basement. A cattle farmer heard about my PCR machine and he mailed his cows’ blood samples that he wanted me to test with a check taped to it. Once the farmer received the test results, he referred all of his farmer friends to me and this was the start of TL Biolabs, my first diagnostics startup company.
I moved to the Bay Area after dropping out of Oxford University because I knew that I could learn and achieve more while exploring the questions and topics that fascinated me outside of the classroom. Prior to Curative, I started and pivoted two biotechnology companies in Silicon Valley. One was an a16z and YC-backed diagnostics (Dx) startup that built a CLIA lab for validating and launching a STD testing product. This product was administered to over 10,000 patients in medical centers across 5 states. I was also named one of the top 100 practicing scientists in the UK by the Science Council 2013.
What was the “Aha Moment” that led to the idea for your current company? Can you share that story with us?
The initial idea for Curative was between co-founders, Vlad, Isaac, and I, who all worked together at our previous startup, Shield Bio. We decided to develop a better model for integrating data from medical records that ensures an improved standard of care for sepsis patients. In March of 2020, we started setting up a clinical trial to test out a new idea, however the hospital we planned to work with suddenly rescheduled the call a month out, as a result of COVID-19. This indicated to us that COVID-19 was going to be a bigger deal than we were hearing about in the media. With our expertise in diagnostics, the team began exploring the pivot to COVID-19 testing. For many companies, pivoting isn’t easy — it requires decisiveness and tough decisions to leave behind a cause or a direction that teams felt committed to after pouring their energy into a particular direction. We got to work right away to determine how to launch a COVID-19 test. We imagined that we would only be adding capacity to COVID-19 testing for a few weeks before returning to our work on sepsis. However, we found that the vertical integration that we created for our testing product was a crucial differentiator to offering scalability of testing. In the early days of the pandemic there were several factors we worked to optimize around: the strained supply chain for testing materials (i.e. machines, plastic tube, reagents, etc.), personal protective equipment for healthcare workers, and an alternative to the unpleasant feeling of a nasopharyngeal sample. Our team created an orthogonal supply chain that did not compete with other major suppliers, allowing us to mitigate supply chain delays. In April 2020, we received FDA- EUA authorization for an oral-fluid sample collection which is observed and directed by a healthcare worker. The healthcare worker is able to observe and direct the patient to collect the oral fluid sample from a safe distance, providing both a pleasant sample collection experience and also reducing the amount of PPE needed for staff.
Was there somebody in your life who inspired or helped you to start your journey with your business? Can you share a story with us?
I was really inspired by the early SpaceX work. I remember having different YouTube videos up while I was working on engineering projects as a teenager and following closely the Reddit threads of the early days. The radical ambition of the project really captivated my attention. As an engineer, I was interested in the requirements needed to make SpaceX successful and as a business venture, SpaceX captured a vision of the future that looked so unlike the reality of the day.
What do you think makes your company stand out? Can you share a story?
The aspect that differentiates Curative from other diagnostics companies is also what enabled us to scale and succeed so quickly. Curative provides complete, end-to-end solutions for an increasing range of healthcare services including diagnostic testing, vaccinations, patient management software, and more. We have a comprehensive supply chain and logistics team layered with a custom software solution that helps us to forecast, distribute, and return test kits to the lab closest to the testing site. Our local partners include states, cities, local governments, businesses, and community organizations, and we work with them to deploy a testing and/or vaccination set up to fit the needs of the community. The Curative team provides a turnkey solution for communities to support expanded access to care via our drive-through, kiosk, and mobile unit environments.
Additionally, Curative pioneered the oral-fluid COVID-19 test in the United States — a non-invasive specimen collection alternative to nasopharyngeal or “brain swabs”. Curative’s COVID-19 PCR tests are a simple-to-use, self-administered and painless test. The test uses a unique oral-fluid swab collection method and are made from different materials, which helped us to avoid competing with overwhelmed supply chains that other testing companies were struggling with.
We developed a major logistics operation to process tests quickly from across the country, and built a custom suite of in-house software to efficiently and clearly communicate results to thousands of patients within 24–48 hours of testing. Our software continues to support the scheduling of over 20 million COVID test appointments across 15,000 test collection sites.
Upon realizing the limitations of retrieving a test from a physical doctor’s office, we developed Next Generation Testing: walk-up kiosks, drive-throughs, vans and mobile trailers. Our mobile units travel to hard-to-reach, often disadvantaged and low-income populations to provide easily accessible and convenient solutions. In everything that we do, we’re looking for ways to make large and small improvements on existing systems, from the way we source materials, the customized software that we have built to run every part of the healthcare delivery, and the teams that we have hired across the country to support the patient experience and ensure that we provide a seamless end-to-end service.
How have you used your success to bring goodness to the world?
When we pivoted our company to join the fight against COVID, we worked toward the goal of putting ourselves out of business with the end of COVID-19. The approach was unorthodox and gave our team an incredible sense of mission. Unfortunately, the pandemic continues and accordingly, we have outperformed all expectations.
I am really proud of the work that the Curative team has done since we started. To date, we have administered over 21 million COVID-19 tests, 2 million vaccine doses, partnered with hundreds of community organizations to increase accessibility to care, and employed nearly 7,000 people. In an effort to increase accessibility to COVID testing and vaccines, we have developed a range of adaptable, community-level programs that utilize our pop-up sites, vans and mobile kiosks. A recent success was our partnership with the Friendship Foundation and Disability Voices United. Together, we built a mock vaccine clinic to reduce anxiety and prepare people with developmental disabilities to receive their COVID vaccine. Since Curative began with a team of only 9 in February of 2020, we have continued to make strides in building a healthier tomorrow, together.
You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
Likely, this would not be considered a positive trait to most people, but I’m not particularly patient. When I hear a timeline, I like to press into what factors determine the length of time and how we can make things move quickly and iterate to improve processes. This stems from a ‘first principles’ approach and that way of thinking and solving problems is always at the forefront of my mind when trying to attack a problem. It’s easy to become task loaded and bogged down as a startup when there is so much to build, but with ‘first principles’ thinking, you can focus on the essentials and work to optimize later. For example, when we started COVID-19 testing, we needed a laboratory information system (LIS) to process samples and send results to patients — an essential part of every diagnostics company. Building a LIS from scratch takes time, so we initially used an off-the-shelf LIS so we could start resulting samples immediately. Quickly, we realized that we needed a custom solution to handle the volume of tests we processed every day. Bit by bit we worked to build sections of our own LIS until one day we switched from the off-the-shelf LIS to our own Curative software solution. Perfect should never be the enemy of the good.
Secondly, my desire to seek out new information comes from my curiosity. Because of this, I have grown a strong ability to digest large quantities of information and synthesize it quickly. One of the best parts of this period in time is how much access to information we have — the number of sources is actually endless. I’ve honed the ability to landscape a topic through research, apply learnings, and share with others in a competent and compelling way. With each new company I’ve started, I spend a lot of time reading formal and informal publications on the subject and with that, try to boil down and synthesize the major takeaways.
Lastly, I feel that my compassion for others has been an integral part of my work in the healthcare industry. I put patients and our team first, and their wellbeing is at the center of everything we do at Curative. I think that my bold ambition is actually routed in my desire to make a transformational difference in healthcare because I want to see people thrive.
Often leaders are asked to share the best advice they received. But let’s reverse the question. Can you share a story about advice you’ve received that you now wish you never followed?
I’ve often received recommendations or advice that urge me to “conform” to the status quo, but for me, venturing off the traditional path has proven to be the right choice. While I think many people benefit from and should attend college, I didn’t find university helpful. Instead, I found I could learn much more outside of the classroom and at a faster rate by working on projects that were interesting to me and most importantly, had impact for others.
Can you tell us a story about the hard times that you faced when you first started your journey?
In the early days of the pandemic we anticipated supply chain issues, so we purposefully developed an orthogonal process that doesn’t rely on the same supplies all the other test companies use. This has allowed us to keep our supplies stocked, and thus continue the rapid delivery of testing and results. While many labs were facing shortages in the supply chain, we approached every element to ensure that we had stability in our process and provide results to patients quickly — within 48 hours.
Where did you get the drive to continue even though things were so hard? What strategies or techniques did you use to help overcome those challenges?
Our driving mission since the beginning of Curative was to help end the pandemic. As a healthcare company in the middle of a pandemic, many people across the country relied on our services. Knowing that our work has been contributing to such an important effort is what gives our team the drive to continue, even in the times of adversity. Our ability to pivot and adapt is what has enabled Curative to overcome the many challenges that we continue to face during this unprecedented time.
The journey of an entrepreneur is never easy, and is filled with challenges, failures, setbacks, as well as joys, thrills and celebrations. Can you share a few ideas or stories from your experience about how to successfully ride the emotional highs & lows of being a founder?
A difficult time for me was at the end of 2019 when my former company went from having Series B term sheets to falling apart in a few weeks. The team had done amazing work, we had a plan for the future and it was a pretty spectacular failure. After about a week and a half of decompressing, I started Curative. I didn’t have anything else to do with my time, so I had to keep trying and pushing on the next idea.
An emotional high at Curative was at an All Hands meeting early into Curative’s COVID-19 testing work where I stood atop a cherry picker in the receiving section of our San Dimas lab. It was a truly gratifying moment where I, along with a number of our early leaders, gave speeches to the team that was working around the clock in the lab. Since then, we’ve grown tremendously, but it was this early moment of acknowledging our success as a company and internalizing how much of an impact we could have on the pandemic response that sticks out to me above many other moments in Curative’s tenure.
Let’s imagine that a young founder comes to you and asks your advice about whether venture capital or bootstrapping is best for them? What would you advise them? Can you kindly share a few things a founder should look at to determine if fundraising or bootstrapping is the right choice?
I would always advise founders to avoid fundraising if possible. Fundraising is a powerful and sometimes necessary tool that must be used. However, I’ve seen it happen too often that investors may not be as aligned as you think they are with your goals, mission, and vision. I don’t think there is anything glamorous about either route despite the hype and buzz around “bootstrapping” and “fundraising” and it all comes down to the particular situation of your company and what you need to be successful. Some companies, you just can’t bootstrap, it’s not possible, but don’t fundraise just for the glory of it. There are too many companies that get a lot of press for their successful fundraising, but when it comes down to delivering a product, there isn’t much being delivered. Founders tend to optimize for the amount funded as opposed to the services delivered.
Here is the main question of our interview. Many startups are not successful, and some are very successful. From your experience or perspective, what are the main factors that distinguish successful startups from unsuccessful ones? What are your “Five Things You Need To Create A Highly Successful Startup”? If you can, please share a story or an example for each.
- The most successful startups I’ve seen are able to put aside the “would like to haves” or “nice to haves” of their businesses and really focus on the core fundamentals of what they need to get done today. This takes deep focus and dedication to hammering away at the problem day in and day out without being distracted
- There are times when the company really needs to pivot and knowing when to pivot is a difficult, but important skill to have.
- Especially as your company grows, it is important to overcommunicate and establish processes for communication. This will allow your teams to be informed as the business quickly changes and know who to go to with any questions.
- Trust and empower your teams. When you are able to do this successfully, each member of the team feels personally connected and driven by your mission.
- Hire a diverse range of experience. Most startups hire many junior employees, however I’ve learned that it is important to hire a healthy mix of people who have strong experience as well as junior staff who is eager to jump in and bring their creativity.
What are the most common mistakes you have seen CEOs & founders make when they start a business? What can be done to avoid those errors?
- Getting too in the weeds on the technical parts of the business. I really have to keep myself from doing this because on the one hand, sometimes it’s actually useful for me to go and learn about the particulars of a problem because I make better decisions when I’m more informed. At the same time though, you get too embedded in the weeds and it becomes difficult to pull away.
- Hiring employees who are too junior. You always want a healthy mix of people who know the ropes and people who can jump in to learn and bring new ideas.
- Not making enough structure at the right time, or rather, not making the appropriate amount of structure at a given time. At the beginning stretch of new projects, it’s very useful to have a limber structure that allows for open discussion, but at some point, everyone needs to start executing. It’s a hard thing to judge when to bring in more structure and requires active effort to create this structure.
Startup founders often work extremely long hours and it’s easy to burn the candle at both ends. What would you recommend to founders about how to best take care of their physical and mental wellness when starting a company?
Curative was not like most startups. The urgency of our work was palpable and we were working around the clock to try to add capacity during the most frightening and uncertain time of the pandemic in the U.S. I really deferred care for myself both mentally and physically because there simply wasn’t another way. I don’t recommend this for extended periods of time, but sometimes you have to fully commit, particularly as we are a healthcare company and people depend on our services. I’m taking better care of myself now, as is our team, but in the early days, there wasn’t a way to have a wellness routine. I don’t think we would have been as successful in delivering testing and vaccines to so many people if we put ourselves first. Again, I don’t recommend this for extended periods of time, but the sacrifices made were well worth it to help millions of people.
We are blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch, and why? He or she might just see this if we tag them.
Craig Venter was the leader of the private Human Genome Project. I love that Craig’s private business venture was able to beat out the public sector accomplishments in the Human Genome Project. I would want to ask him about what drove him to sequence the human genome, and what he sees in the future of biological research.
How can our readers further follow your work online?
Readers can like Curative on Facebook (https://www.facebook.com/CurativeInc) and follow us on Twitter @Curative and Instagram @curativeinc. My personal Twitter is @FredTurnerBio.
This was very inspiring. Thank you so much for the time you spent with this. We wish you continued success and good health!