Meatball Surgery and other interesting practices of Start-ups

One of my favourite phrases from the M*A*S*H  was "Meatball Surgery". It referred to the shortcuts that the surgeons of the 4077 developed to keep their patients alive while they quickly performed surgery. While there were better ways, "Meatball Surgery" allowed them to finish with one priority case so that they could move on to saving the life of the next priority case.

"Meatball Surgery" is a great analogy for operations in a Start-up. I was recently reading Seven Keys to Switching from a Big Company to a Small One  in the Harvard Business Review blogs. Having spent 17 years at IBM, followed by 10 years at PeopleSoft, and the last five years advising Start-ups, people often ask me about the transition from large to small companies.  While I agreed with the seven points raised, I think the one item that is often missed is that you have to adapt to "Meatball Surgery".

Many skilled and successful senior executives in large organizations have prospered because they have the breadth and depth to develop complex strategies and apply available capital and talented resources to create exceptional outcomes. Unfortunately, in most start-ups, while problems requiring complex strategies may exist, rarely does the same level of access to capital or talent resources. As a result, the strategy complexity often needs to be "dummied -down" into implementable chunks that are within the resources of organization. Many converts from large companies struggle with this, not because they can't handle it, but because they don't want to.  It is not as much fun to wage a one-dimensional war as it is to attack on multiple fronts simultaneously.

One of my clients currently has an experienced start-up CEO advising them. During a recent strategy session, his advice to them was "Not to sound like a broken record but I'd really encourage you to keep trying to pare down the list and fight the urge to do more…". This is great advice but not always in the DNA of a successful executive from a large company.

In another case, a very successful large company executive confided that he would love to move out of the rat-race of the large company world into a CEO role in a small company. I advised him against it. His talents would be stymied by the constraints of a small business. He is capable of managing large complex environments but he has always surrounded himself with immensely talent teams and access to resources. I told him he would be frustrated by the constraints of a small organization. After explaining this, he laughed and told me that he had been approached by a large VC looking for CEOs for some of their portfolio companies. After a number of meetings, they apologetically told him they had nothing for him because the largest company in their portfolio was only $60M. He never understood why they turned him down until he and I had our conversation

If you are a senior exec in a large company who is thinking of making a jump into start-ups, my advice is decide now if "Meatball Surgery" is one of your core competencies. If not, your transition may not be a smooth as you expect.