That's a long list, of course. And the longest lists are created by inexperienced founders. But there is wisdom in learning from the failures of others - another example of looking before you leap.

     There's a great Harvard Business Review article from 2013 that continues to instruct today. We see time and again how its lessons coincide with the failings we encounter in advising our own early-stage clients. The authors spoke with 120 founders, more than half of whom had previous start-up experience. In the HBR article, they examine the mistakes they cited most frequently, explore the objections they faced when they began making sales calls, and present an alternative sales model uniquely suited to a start-up's circumstances.

     My favorite lesson, which we routinely emphasize in our own practice, is this:

     Theranos redux. I first wrote about the mystery that is Theranos in October 2013. It's a mystery no more.

     Theranos has developed a process for IVD assays that require very small volumes of blood yet demonstrate performance comparable to existing lab-based assays. Now we learn that their actual business model is to manage independent, new neighborhood labs that run these tests quickly and cheaply, presumably cheaply enough that consumers will be willing to pay for them out of pocket.

     Now I'm compelled to respond to a recent opinion piece in the Wall Street Journal authored by Elizabeth Holmes, the founder and CEO of Theranos, and entitled: "How to Usher In a New Era of Preventive Health Care". (I cannot provide a link to the article but, if you have a WSJ online subscription, you will find it in the Opinion section of July 29. Otherwise, let me know and I'll send a copy.)

     In her rather bizarre piece, Ms. Holmes argues for the following self-serving changes in lab medicine:

• All lab tests should undergo review by the FDA.
• Innovation needs to be unleashed by allowing individuals to order (and interpret) their own lab tests. Prices will thereby become transparent and apparently lower.
• Diagnostic information needs to be more accessible by accelerating the process through patient-directed ordering, localized testing, and rapid reporting.
• Preventive care will be enhanced because asymptomatic individuals can cause tests to be run without provider intervention.

     Where to begin? Here's a start:

1. Individuals are generally incapable of interpreting the results of lab tests. For example, how will false positives and false negatives be handled? How can test results be understood in their proper clinical contexts?
2. Evidence of the clinical value of asymptomatic testing is rare; the primary exception is genetic testing, which may not fit the Theranos model.
3. How does the Theranos business model actually enhance preventive medicine?
4. How does a massive new FDA role stimulate innovation? Lab-based diagnostics, an incredibly effective and cost-efficient modality, is nicely regulated by CLIA and CAP today.
5. How can insurers deal with such a different model if at all. If they are not involved as payers, will individuals really jump on this bandwagon?

     In summary, I think we are seeing the beginning of the end of the Theranos idea. But I've been wrong before. Share your thoughts.

     It's not always essential or even relevant. However, in the case of physician prospects, it can surely by helpful. For example, it can support your understanding of their perceptions of value.

     Of course you have. Everyone commits errors in converting thoughts and emotions to written words. That process, which can have embarrassing or even catastrophic results, can be greatly improved by just spending time re-reading and reconsidering your word choices before you hit send.