Stage 1: Creation — When You’re Flying the Plane as You’re Building It
At the beginning of any new life science organization -the energy is unmistakable. The entrepreneurial spirit is high, and everything feels possible.
There is not a robust workforce – only a few driven leaders wearing many hats. There is no facility yet — or it is steel, concrete, and makeshift arrangements. There are no established systems — only drive and strong science.
Decisions happen fast, speed is prioritized, and progress is visible almost daily. You’re inventing science, shaping a company, and solving problems that have never existed before — sometimes all in the same meeting!
At first, it feels exhilarating. You are inventing something new and the future feels expansive. Over time, something shifts.
Beneath the excitement is something heavier. The weight of responsibility for patients who will one day depend on this work. The pressure of capital timelines and board expectations. The limitations of staffing and resources with the overwhelm in all that must get done. The unwavering reality that the foundation you build today is essential in your ability to both survive and thrive.
This stage is not just about building a facility or starting an organization. It is about building the conditions that will determine whether the organization can scale safely. Most leaders underestimate just how formative this stage is. This is the time where cultural DNA forms, leadership patterns take root and silent trade-offs begin.
The Messy Middle: When Early Success Starts to Strain
As you move through this stage things begin to accumulate - complexity increases, decisions begin to overwhelm, and informal systems emerge. More people join. New capabilities are added. The science advances. Regulatory and operational realities begin to matter more.
Overtime, friction increases as role confusion surfaces, delegation gaps appear, burnout risks increase, and structure becomes necessary. And suddenly, the same informal ways of working that once fueled progress start to create friction.
This is where the core cultural tension of Stage 1 emerges: Founder Gravity, when the organization continues to orbit around a few central people. Common signs include:
Startup ways of working colliding with the needs of a growing workforce
Decision-making slowing because it’s unclear who can decide what
Informal systems becoming structural defaults
Founders and early leaders struggling to shift from doing everything to enabling others
Rising tension between speed and the discipline required in regulated environments
What once felt like agility now feels like ambiguity. What once felt empowering now creates hesitation. Work stalls.
If left unexamined, these early patterns don’t disappear — they harden. And the organization carries them forward into later stages, where the cost of ambiguity is much higher.
When What Worked Stops Working – What Leaders Often Do
In this phase, leaders are often acting from good intentions:
Staying personally involved in every key decision to protect quality and speed
Relying on trust, shared history, and informal alignment
Avoiding structure out of fear it will slow science or dampen creativity
These behaviors are often the reason the organization got this far. But as complexity increases, they quietly become constraints. Progress slows not because founders are too involved — but because others aren’t sure when and how they’re allowed to lead.
Stage 1 Jump Moves: Shifting from Centrality to Shared Clarity
Jumping the curve here isn’t about adding bureaucracy or slowing innovation. It’s about designing just enough scaffolding to hold growth — without suffocating the entrepreneurial energy that made the organization successful in the first place.
It requires a shift from personal ownership to shared clarity. The most effective leaders in this phase begin to:
Clarify decision rights and operating principles early, and consistently reinforce them
Make founder intent explicit, so others can act with confidence instead of waiting
Design leadership behaviors and cultural norms that can scale, rather than relying on individual heroics
Focus on leadership alignment, and building trust with the team
Make explicit what processes are provisional, versus those made to last
These moves don’t slow the organization down. They remove friction that people don’t yet know how to name.
The Core Insight of Stage 1
Founder involvement is often the fuel for early growth. But over time, centrality becomes a constraint. Jumping the curve at this stage means ensuring momentum no longer depends on one person — or a small inner circle — but on a system that makes leadership and accountability possible at every level. Because how you build the plane at this stage determines whether it can safely fly at scale.
