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Avoiding pitfalls when scaling a startup


Dr. Robert Faiella, EMBA '17

 The intersection of unrelated disciplines offers an opportunity to apply the frameworks of one field to develop innovative solutions in another. The primary driver for me to attend MIT Sloan was to do just that — apply those learnings to avoid pitfalls, work smarter, and make an impactful difference. 

After graduating from MIT, I came on board as chief dental officer at a rapidly growing startup company called Overjet, founded by two fellow MIT PhD alumni to apply AI powered technology to the dental industry. Fortunately, with frameworks learned at MIT, I am working with a growing team to not only avoid potential pitfalls, but to grow successfully.Here are four examples of how I am applying knowledge from MIT:

Managing information overload

The entire healthcare system is based upon a knowledge economy, one that is expanding at an exponential rate. A quick glance at your own email inbox is probably a good indicator of the volume of information we receive on any given day. We are at the point where humans simply don’t have the bandwidth to accept all of the information available, much less make full sense of it all to drive the best decisions.

One way to avoid this challenge is to use the power of analytics. In the Analytics Edge course, my final project was to use machine learning to analyze breast cancer diagnoses from needle biopsy samples. Skilled pathologists looking for cell characteristics by light microscopy correctly diagnosed breast cancers 62% of the time. Using machine learning to evaluate meaningful cell attributes, our diagnoses were accurate 97% of the time. Artificial intelligence outperformed the human element to make more accurate diagnoses, which could improve patient outcomes.

Today, my company is using artificial intelligence and deep machine learning to reduce costs and improve quality of care.  We apply machine learning and analytics to dental radiographs to identify decay, bone loss, and root canal issues – among other dental diseases – across the entire database beyond the level of human cognition. We analyze hundreds of thousands of images from multiple providers, across multiple practices or insurance payers. Using AI, we can quickly determine the need for a crown against configured criteria and validate dentists’ recommendations for treatments. And dentists can use our annotated images and metrics to educate their patients on the need for procedures.

AI helps mitigate the risk of missing something. In our case, the algorithms are constantly reviewing the radiographs to provide immediate recommendations.

Avoiding the “Capability Trap”

Another major challenge that can be avoided is a focus on short-term results, particularly in the early stages of growth. In System Dynamics, we learned how many early and mid-sized companies try to meet increasing demands as they grow by hiring more and working longer hours. The default is usually to work harder. But that won’t build capability. Instead, people will “burn-out,” risking loss of quality and missing deadlines, with a diminishing capability over time. 

The key is to work smarter to avoid these costly mistakes at a time when, to paraphrase Peter Drucker, “a growing company can least afford it … and needs to put every penny into tomorrow.”

At Overjet, we are growing fast and adding more people to increase our machine learning capabilities. However, as we grow, those of us in senior leadership positions are focused on expanding our capability, iterate with new methods, and refine our models. As we do, new models are developed to capitalize on learnings from re-iteration and experimentation.

The challenge of negotiations

Most of us never think of negotiating as a learned skill, but rather as inherent to some people, and not to others. However, it occurs on a daily basis, from scheduling time for lunch with a friend, planning a family vacation, or closing an important contract with a business affiliate.

In Negotiations and Influence, the skills learned are the same – whether in that family vacation discussion or in high-level contract development. Everyone wants to feel like a “winner,” even at the expense of the other party — unless you are the “other party.” While the outcome of a negotiation is important, you want the other party to feel good about working with you. Since your relationship rarely ends at the negotiating table, we need to end with something referred to as “subjective value.”

When customers investigate our product, it is a form of a negotiation. We spend time listening to their business needs, educating them on the value it will bring to their workflow, and expressing our understanding for their corporate structure and culture, whether they are a large national insurer, a large multi-location practice with multiple providers, or a single practitioner. We develop strategy to “claim” value, calculate our best alternative, and define the zone of possible agreement. In the end, if all parties feel good after a negotiation, it is a good outcome with another opportunity to work together in the future.

Failure to evolve

As for competition, we all know it will arrive soon enough.  I am using what I learned in Competitive Strategy to claim our value and maintain competitive advantage. This means really understanding the space we are in to ensure we have interesting and evolving models that set us apart as the leader in the field. Going back to capabilities, we are constantly evaluating our products and services to improve.

At Overjet, we have developed a strategy to create and capture value to establish a sustainable competitive advantage within the dental industry. As mentioned previously, we look to differentiate our product by re-iterating and developing our models while expanding our capabilities through hiring the best people to match our culture and commitment.

These are just a few examples of the challenges and pitfalls that startups and developing growth companies need to avoid. It is exciting to apply the principles and frameworks I learned from MIT Sloan to ensure we do not fall into those traps and can successfully scale our business.

Dr. Robert Faiella, EMBA '17, is Chief Dental Officer of Overjet and Past President of the American Dental Association.

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