Why Clay Christensen is abandoning the traditional approach to academic research

Why Clay Christensen is abandoning the traditional approach to academic research

BY MATT MCFARLAND June 12

Professor Clay Christensen is trying something new on the Harvard Business School campus. (Kevin Ma/Bloomberg)

Clay Christensen, the Harvard Business School professor and godfather of innovation, fittingly has some fresh ideas about academic research. He scrapped the traditional academic approach for his latest paper, theCapitalist’s Dilemma, which was published in the June issue of the Harvard Business Review. Read more of this post

Transcript of Full Commencement Address by Jim Carrey at Maharishi University of Management

http://www.youtube.com/watch?v=V80-gPkpH6M

Transcript of Full Commencement Address by Jim Carrey    

Official Commencement Address Graduating Class of 2014
from Maharishi University of Management, May 24th, 2014
by Jim Carrey

Thank you Bevan, thank you all!

I brought one of my paintings to show you today. Hope you guys are gonna be able see it okay. It’s not one of my bigger pieces. You might wanna move down front — to get a good look at it. (kidding)

Faculty, Parents, Friends, Dignitaries… Graduating Class of 2014, and all the dead baseball players coming out of the corn to be with us today. (laughter) After the harvest there’s no place to hide — the fields are empty — there is no cover there! (laughter) Read more of this post

Can You Handle the Market’s Stress Test?

15 HRS AGOMONEYBEAT

Can You Handle the Market’s Stress Test?

Investing graybeards like to say that “bull markets climb a wall of worry.” This one has been sleepwalking up a wall of boredom.

By Jason Zweig

As of this Friday, the S&P 500 has gone 980 days without a 10% decline, according to Birinyi Associates, the fifth-longest such stretch on record. This past week’s nervousness, set off by the insurgency in Iraq and the surprise defeat of U.S. Rep. Eric Cantor, is thus the perfect pretext for investors to think about what they will do when the market takes a serious beating. Read more of this post

Joe Queenan’s Guide to Public Speaking: How to avoid utterly humiliating yourself in front of a bored and yawning crowd

Joe Queenan’s Guide to Public Speaking

How to avoid utterly humiliating yourself in front of a bored and yawning crowd.

JOE QUEENAN

June 13, 2014 2:24 p.m. ET

People routinely say that being asked to speak in public is their No. 1 fear, inspiring more dread than flying. The idea of speaking to a group of people, even if they know the audience, scares them…well…speechless. And when it does come time to mount the stage, inexperienced speakers only make things worse by resorting to corny jokes and sappy, improbable anecdotes. Their agony makes everyone else in the room feel uncomfortable. The room reeks of flop sweat. Read more of this post

Wharton’s Adam Grant on the key to professional success

Wharton’s Adam Grant on the key to professional success

The author of Give and Take explains why generosity in the workplace continues to be more effective than selfishness and why it is critical for personal fulfillment.

June 2014

Knowledge economy: Givers wanted

Screening out the takers

Turning takers into givers

The knowledge economy has not only spurred entirely new industries but also placed different demands on how people work effectively. In this video interview with McKinsey’s Rik Kirkland, Wharton School professor Adam Grant elaborates on his recent book, Give and Take: Why Helping Others Drives Our Success, which explores the evolving world of workplace dynamics, why selfishness fails, and how working with, for, and through others continues to be the recipe for personal and organizational success. An edited transcript of Grant’s remarks follows. Read more of this post

Business Wisdom from the Commencement Speakers of 2014

Business Wisdom from the Commencement Speakers of 2014

by Walter Frick  |   9:00 AM June 12, 2014

Commencement speakers face an impossible challenge: to inspire, advise, and entertain, without overstaying their welcome. In the age of YouTube, there’s the added pressure to craft a speech that could go viral, and perhaps even inspire a book. And this year, those invited to take the podium were no doubt aware of the student protests that forced some speakers to cancel. Read more of this post

What to Do When Success Feels Empty

What to Do When Success Feels Empty

by Boris Groysberg and Robin Abrahams  |   8:00 AM June 12, 2014

Why do career “wins” often leave people feeling empty and dissatisfied? And — more important — how can you avoid that problem? We recently asked HBR readers to share their thoughts, and several of the responses call to mind Douglas T. Hall’s classic model of psychological success.

Hall’s model suggests a number of reasons that a success might feel like a failure: Read more of this post

What Does Pixar’s Collective Genius Look Like?

What Does Pixar’s Collective Genius Look Like?

by Linda Hill, Greg Brandeau, Emily Truelove and Kent Lineback  |   2:00 PM June 11, 2014

What happens when an organization innovates? What does that process look like?

It’s an important question if you want more innovation, because the answer will shape what you do as a leader. If you think, as many do, that innovation comes from hiring a few “creative” people and implementing their best ideas, then you might assume your job is to find those people, sequester them in R&D or Product Development, review the solutions they propose, and adopt the winners. Read more of this post

Why Smart People Struggle with Strategy

Why Smart People Struggle with Strategy

by Roger Martin  |   2:00 PM June 12, 2014

Strategy is often seen as something really smart people do — those head-of-the-class folks with top-notch academic credentials. But just because these are the folks attracted to strategy doesn’t mean they will naturally excel at it. Read more of this post

The 23-Year-Old Wordsmith Behind The Hip, New Voice Of The Times Crossword Puzzle

THE 23-YEAR-OLD WORDSMITH BEHIND THE HIP, NEW VOICE OF THE TIMES CROSSWORD PUZZLE

THANKS TO ANNA SHECHTMAN, YOUR CLUE FOR “BRO” IS NO LONGER “SISTER’S SIB.” IT’S “PREPPY, PARTY-LOVING, EGOTISTICAL MALE, IN MODERN LINGO.”

BY REBECCA GREENFIELD

The answers to the May 29th New York Times crossword puzzle included “epicness,” “twitter hashtag,” “where it’s at,” and “hell no.” Although the 61-year-old Will Shortz edits every single submission that graces the Gray Lady’s pages, that day’s entry (a Thursday) had sprung from the mind of 23-year-old Anna Shechtman, Shortz’s assistant and a four-time puzzle contributor for the Times. Read more of this post

Investing and the weather: Cold weather and stockmarket returns go hand-in-hand

Investing and the weather: Cold weather and stockmarket returns go hand-in-hand

Jun 14th 2014 | From the print edition

“THE weather is like the government,” wrote Jerome K. Jerome, “always in the wrong.” That may be true for those trying to organise a picnic or a cricket match, but when it comes to predicting the performance of stockmarkets, weather can be a good guide. Economists have long known that sunshine is good for stockmarkets, perhaps because nice weather makes people more optimistic. New research suggests that cold weather has an upside, too. Read more of this post

How bees navigate: Cognitive dissonance

How bees navigate: Cognitive dissonance

Jun 12th 2014, 16:37 by P.H.| WASHINGTON D.C.

LIKE Winnie-the-Pooh, bees are creatures of very little brain—just half a millimetre across and with a million or so neurons; a rat’s is a cubic centimetre and has 200m. Bee brains also lack structures, such as the hippocampus and entorhinal cortex, that play a vital role in forming the “cognitive maps” that help humans and other mammals find their way from A to B—even if point B isn’t initially visible. Yet bees routinely buzz off up to three kilometres (almost two miles) from their hives in their quest to make Pooh’s beloved ‘hunny’—and then make a beeline back. How? Read more of this post

Second wind: Some traditional businesses are thriving in an age of disruptive innovation

Second wind: Some traditional businesses are thriving in an age of disruptive innovation

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Jun 14th 2014 | From the print edition

KARL MARX’S adage about all that is solid melting into air has never seemed more apposite: even staid businesses such as law firms and universities are threatened by technology-cum-globalisation. But look at the air more closely and you can see some strange objects floating around: Swiss watches, Montblanc fountain pens, Harris Tweed jackets, Folio Society books and old-fashioned sailing boats. Management gurus may tell people to bow down before the great god of disruptive innovation. But some companies are cheerfully doing the opposite—preserving or resuscitating traditional technologies and business models. Read more of this post

Where have all the craters gone? Why Earth’s surface is less pockmarked than might be expected

Where have all the craters gone? Why Earth’s surface is less pockmarked than might be expected

Jun 14th 2014 | From the print edition

SOME 66m years ago Earth was hit by a space rock reckoned to have been 10km (six miles) across. The resulting chaos did for the dinosaurs and many other species, opening the way for the age of mammals—and ultimately humans. It also left a big hole in what is now southern Mexico. That hole is one of only three known of similar dimensions (the other two are Vredefort in South Africa and Sudbury in Canada). And this is odd. For, during the billions of years that Earth has had a solid crust, many more than three big asteroids might have been expected to have hit it. Read more of this post

X marks the spot: How to get mosquitoes to breed themselves to death

X marks the spot: How to get mosquitoes to breed themselves to death

Jun 14th 2014 | From the print edition

KILL the mosquito and you kill the disease. That is the usual approach to controlling malaria. And if done properly, it works. The problem is that the insecticides employed to do the killing destroy lots of other things as well. An old dream of those who seek to eliminate malaria is thus a way of selectively killing only what transmits the parasite: mosquitoes of the genus Anopheles, most notably Anopheles gambiae. And that, more or less, is what is proposed by Nikolai Windbichler and Andrea Crisanti of Imperial College, London, in a paper in Nature Communications. They think they have worked out how to stop A. gambiae females being created in the first place. That would break the chain of transmission in two ways: immediately, because it is only females that drink blood and so pass the parasite on; and in the longer term because without females a population cannot reproduce. Read more of this post

When science gets it wrong: Let the light shine in; Two big recent scientific results are looking shaky-and it is open peer review on the internet that has been doing the shaking

When science gets it wrong: Let the light shine in; Two big recent scientific results are looking shaky—and it is open peer review on the internet that has been doing the shaking

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Jun 14th 2014 | From the print edition

SCIENTISTS make much of the fact that their work is scrutinised anonymously by some of their peers before it is published. This “peer review” is supposed to spot mistakes and thus keep the whole process honest. The peers in question, though, are necessarily few in number, are busy with their own work, are expected to act unpaid—and are often the rivals of those whose work they are scrutinising. And so, by a mixture of deliberation and technological pressure, the system is starting to change. The internet means anyone can appoint himself a peer and criticise work that has entered the public domain. And two recent incidents have shown how valuable this can be. Read more of this post

Elon Musk Makes A Great Argument For Why Tesla Doesn’t Need Patents To Be Successful

Elon Musk Makes A Great Argument For Why Tesla Doesn’t Need Patents To Be Successful

ROB WILE MARKETS  JUN. 13, 2014, 12:57 AM

Tesla is opening up its patents for fair use.

In a new blog post, CEO Elon Musk clarified that anyone who uses Tesla patents in good faith will not face lawsuits. He makes a compelling argument for why the company no longer needs patents:

Our true competition is not the small trickle of non-Tesla electric cars being produced, but rather the enormous flood of gasoline cars pouring out of the world’s factories every day. Read more of this post

No flights of fancy for IT, airports and hotels tycoon Sir Peter Rigby

June 12, 2014 1:01 am

No flights of fancy for IT, airports and hotels tycoon Sir Peter Rigby

By Hazel Davis

Sir Peter Rigby is an unassuming man, in an impeccable black suit, white shirt – buttons not cufflinks – and tiny-checked tie. His voice is quiet and polite. He listens carefully and assumes nothing (“GE. That’s General Electric”), all the while carefully folding his napkin into a square. He could be any pleasant middle manager.

We meet in the decidedly unswanky private jet area at Coventry Airport, which is owned by his multibillion-dollar turnover company, Birmingham-based Rigby Group. The only tell-tale sign of this is the lunch he has had drafted in from one of his nearby hotels, the Mallory Court in Leamington Spa. It is a Michelin-starred buffet, including parsley jelly and a particularly delicious smoked salmon quiche. I want to go hell for leather on the cheeseboard but Sir Peter does not strike me as a man of excess. Read more of this post

A fragmented corporate culture is the villain of the piece; The business structure is such that employees have little interdepartmental contact

June 12, 2014 5:44 pm

A fragmented corporate culture is the villain of the piece

By Gillian TettAuthor alerts

The business structure is such that employees have little interdepartmental contact

Everybody loves to boo and hiss a corporate villain; especially amid scandal. Five years ago the hunt was on for baddies in banking. Then when BP caused a terrible oil spill in the Gulf of Mexico, there was more hand-wringing – and a search for villains. Read more of this post

The Eccentric Genius Whose Time May Have Finally Come (Again): Resurrecting the legacy of a man who understood, and feared, the future of automation

The Eccentric Genius Whose Time May Have Finally Come (Again)

Resurrecting the legacy of a man who understood, and feared, the future of automation.

By Doug Hill

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I’ve been preoccupied lately with thoughts of marauding broomsticks, genies in bottles, and monkey’s paws.

All are literary images the scientist Norbert Wiener used to make the point that we fool ourselves if we think we have our technologies firmly under control. That Wiener was instrumental in creating the technologies he warned about demonstrates the insistent obstinance of his peculiar genius. Read more of this post

Anti-Overdose Drug Becoming an Everyday Part of Police Work

Anti-Overdose Drug Becoming an Everyday Part of Police Work

By J. DAVID GOODMAN and ANEMONA HARTOCOLLISJUNE 12, 2014

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A rescue kit with naloxone

Amid the weeknight bustle of a Walmart parking lot in Centereach, N.Y., a young woman in a pickup truck had lost consciousness and was turning blue.

Her companion called 911. Possible drug overdose; come fast. Read more of this post

The Franklin Institute’s new permanent exhibition, “Your Brain,” immerses visitors in the human body’s most complicated and astounding part

A Show That Really Gets Into Your Head

‘Your Brain’ Opens at the Franklin Institute

By EDWARD ROTHSTEINJUNE 12, 2014

PHILADELPHIA — Clambering upward in dim violet light, stepping from one glass platform to another, you trigger flashes of light and polyps of sound. You climb through protective tubes of metallic mesh as you make your way through a maze of pathways. You are an electrical signal coursing through a neural network. You are immersed in the human brain. Read more of this post

Taking on Teacher Tenure Backfires; Firing bad educators won’t close the achievement gap

Taking on Teacher Tenure Backfires

California Ruling on Teacher Tenure Is Not Whole Picture

By JESSE ROTHSTEINJUNE 12, 2014

BERKELEY, Calif. — IN his decision on Tuesday to strike down California’s teacher-tenure system, Judge Rolf M. Treu of Los Angeles Superior Court ruled that laws protecting teachers from dismissal violated the state’s constitutional commitment to provide “a basically equal opportunity to achieve a quality education” and drew parallels with prior cases concerning school desegregation and funding levels. Read more of this post

Whole Foods’ CFO dishes on the early days

Whole Foods’ CFO dishes on the early days

Colleen Leahey

@FortuneMagazine

JUNE 12, 2014, 12:16 PM EDT

Glenda Flanagan’s been at the organic grocery chain for 26 years. In a rare interview with Fortune, she discusses her career.

Glenda Flanagan became Whole Foods Market’s chief financial officer in 1988, when the organic grocer had only six stores. Today, its pesticide-free products are sold through some 375 locations in the U.S., Canada, and the UK. Flanagan, who rarely talks to the press, sat down with Fortune at the company’s Austin, TX, headquarters to chat about her early days at Whole Foods and what it’s been like working there for almost three decades. Below is an edited transcript. Read more of this post

Fixing the ‘I Hate Work’ Blues

Fixing the ‘I Hate Work’ Blues

by Bill George | Jun 13, 2014

Many employees report they are overworked and not engaged—a recent New York Times article on the phenomenon was titled, “Why You Hate Work.” The problem, says Bill George, is that the way we design work stifles engagement. Here’s the fix Read more of this post

Elizabeth Holmes founded her revolutionary blood diagnostics company, Theranos, when she was 19. It’s now worth more than $9 billion, and poised to change health care

New blood

Roger Parloff

@FortuneMagazine

JUNE 12, 2014, 7:37 AM EDT

 Production in Theranos’s 262,000-square-foot manufacturing facility in Newark, Calif. ; Laboratory scientists perform biochemical experiments in a Theranos R&D lab in Palo Alto. 

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Elizabeth Holmes founded her revolutionary blood diagnostics company, Theranos, when she was 19. It’s now worth more than $9 billion, and poised to change health care.

In the fall of 2003, Elizabeth Holmes, a 19-year-old sophomore at Stanford, plopped herself down in the office of her chemical engineering professor, Channing Robertson, and said, “Let’s start a company.”

Robertson, who had seen thousands of undergraduates over his 33-year teaching career, had known Holmes just more than a year. “I knew she was different,” Robertson told me in an interview. “The novelty of how she would view a complex technical problem–it was unique in my experience.”

Holmes had then just spent the summer working in a lab at the Genome Institute in Singapore, a post she had been able to fill thanks to having learned Mandarin in her spare hours as a Houston teenager. Upon returning to Palo Alto, she showed Robertson a patent application she had just written. As a freshman, Holmes had taken Robertson’s seminar on advanced drug-delivery devices–things like patches, pills, and even a contact-lens-like film that secreted glaucoma medication–but now she had invented one the likes of which Robertson had never conceived. It was a wearable patch that, in addition to administering a drug, would monitor variables in the patient’s blood to see if the therapy was having the desired effect, and adjust the dosage accordingly.

“I remember her saying, ‘And we could put a cellphone chip on it, and it could telemeter out to the doctor or the patient what was going on,’ ” Robertson recounts. “And I kind of kicked myself. I’d consulted in this area for 30 years, but I’d never said, here we make all these gizmos that measure, and all these systems that deliver, but I never brought the two together.”

Still, he balked at seeing her start a company before finishing her degree. “I said, ‘Why do you want to do this?’ And she said, ‘Because systems like this could completely revolutionize how effective health care is delivered. And this is what I want to do. I don’t want to make an incremental change in some technology in my life. I want to create a whole new technology, and one that is aimed at helping humanity at all levels regardless of geography or ethnicity or age or gender.’ ”

That clinched it for him. “When I finally connected with what Elizabeth fundamentally is,” he says, “I realized that I could have just as well been looking into the eyes of a Steve Jobs or a Bill Gates.”

With Robertson’s blessing, Holmes started her company and, a semester later, dropped out to pursue it full-time. Now she’s 30, and her private, Palo Alto-based corporation, called Theranos–the name is an amalgam of the words “therapy” and “diagnosis”–has 500 employees and has raised more than $400 million from equity sales to investors who have effectively valued the company at more than $9 billion. All these numbers, confirmed to me by an outside director, are being published here for the first time. Though Theranos is largely unknown even in Silicon Valley, that is about to change.

“This is about being able to do good,” Holmes says to me about her company. “And it’s about being able to change the health care system through what we believe this country does so well, which is innovation and creativity and the ability to conceive of technology that can help solve policy challenges.”

At first glance it’s hard to see the connection between the patch that wowed Robertson and what Theranos does now. But as we will see, to Holmes they are simply different “embodiments” of the same core insights.

Theranos today is a potentially highly disruptive upstart in America’s $73 billion diagnostic-lab industry, which performs nearly 10 billion tests a year and is estimated to provide the basis for about 70% of doctors’ medical decisions. Medicare and Medicaid each pay roughly $10 billion annually on reimbursements for these tests.

Theranos runs what’s called a high-complexity laboratory, certified by the federal Centers for Medicare & Medicaid Services (CMS), and it is licensed to operate in nearly every state. It currently offers more than 200–and is ramping up to offer more than 1,000–of the most commonly ordered blood diagnostic tests, all without the need for a syringe.

Theranos’s tests can be performed on just a few drops of blood, or about 1/100th to 1/1,000th of the amount that would ordinarily be required–an extraordinary potential boon to frequently tested hospital patients or cancer victims, the elderly, infants, children, the obese, those on anticoagulants, or simply anyone with an aversion to blood draws. Theranos phlebotomists–technicians licensed to take blood–draw it with a finger stick using a patented method that minimizes even the minor discomfort involved with that procedure. (To me, it felt more like a tap than a puncture.)

The Theranos “wellness center” at the Walgreen’s drugstore in down­town Palo Alto. Theranos’s prices for tests are often a half to a quarter of independent lab prices and a quarter to a tenth of hospital lab prices. Photograph by Drew Kelly for Fortune

The company has performed as many as 70 different tests from a single draw of 25 to 50 microliters collected in a tiny vial the size of an electric fuse, which Holmes has dubbed a “nanotainer.” Such a volley of tests with conventional techniques would require numerous tubes of blood, each containing 3,000- to 5,000-microliter samples.

The fact that Theranos’s technology uses such microscopic amounts of blood should eventually allow physicians far greater latitude when ordering so-called reflex tests than they have previously enjoyed. With reflex testing, the physician specifies that if a certain test comes up abnormal, the lab should immediately perform follow-up tests on the same sample to pinpoint the cause of the abnormality. Reflex testing saves patients the time, inconvenience, cost, and pain of return doctor visits and additional blood draws.

The results of Theranos’s tests are available within hours–often matching the speed of emergency “stat” labs today, though stat labs, which are highly inefficient, can usually perform only a limited menu of maybe 40 tests.

Most important, Theranos tests cost less. Its prices are often a half to a quarter of what independent labs charge, and a quarter to a 10th of what hospital labs bill, with still greater savings for expensive procedures. Such pricing represents a potential godsend for the uninsured, the insured with high deductibles, insurers, and taxpayers. The company’s prices are set to never exceed half the Medicare reimbursement rate for each procedure, a fact that, with widespread adoption, could save the nation billions. The company also posts its prices online, a seemingly obvious service to consumers, but one that is revolutionary in the notoriously opaque, arbitrary, and disingenuous world of contemporary health care pricing.

Precisely how Theranos accomplishes all these amazing feats is a trade secret. Holmes will only say–and this is more than she has ever said before–that her company uses “the same fundamental chemical methods” as existing labs do. Its advances relate to “optimizing the chemistry” and “leveraging software” to permit those conventional methods to work with tiny sample volumes.

The scale of Theranos’s operations at the moment is modest. Its phlebotomists currently take physician-ordered blood draws (and saliva, urine, feces, and other samples) at collection centers the company operates at its headquarters in Palo Alto and at 21 Walgreens–one in Palo Alto and the rest in Phoenix. But these are only the advance guard in a gradual national rollout that Walgreens committed to last September; it plans to establish Theranos outposts in a substantial percentage of its 8,200 drugstores in all 50 states. It is the first step in Holmes’s audacious plan to place a Theranos center within five miles of almost every American and within one mile of every city dweller. Walgreens CEO Greg Wasson told me in an interview that he hopes to eventually put them in the pharmacies of the company’s European partner chain, Alliance Boots, as well.

At least as significant, three hospital groups are now working closely with Theranos with the aim of deploying its lab services–UCSF Medical Center in San Francisco, Dignity Health’s 17-state hospital group, and Intermountain Healthcare’s 22-hospital system in Utah and Idaho.

“I just think this is so exciting,” says Mark Laret, the CEO of UCSF Medical Center, about what he’s seen so far. “I mean, here it is. This is the true transformation of health care, right here in front of us.”

“The first time I heard about this, I thought it was snake oil and mirrors,” says David Helfet, the chief of orthopedic trauma at the Hospital for Special Surgery in Manhattan. But after reviewing voluminous validation studies supplied to him by the company, he has become a believer and is urging his hospital to consider adoption.

“It’s real data,” he says. “It’s not their interpretation.” (Theranos has invited Helfet to join its medical advisory board, he says, but he has not yet decided whether to do so.)

Helfet sees an opportunity to enlist Theranos lab services in the identification of so-called hospital-acquired infections–a major scourge in health care today. Conventional methods of identifying germs and figuring out which antibiotics will combat them–growing bacteria on agar in petri dishes–can require three to five days, during which patients languish in hospital beds, take ineffective antibiotics, and incubate antibiotic-resistant bacteria. Using DNA profiling Theranos can, for less than the cost of the conventional tests, identify a bug and its resistance profile within four hours, says Helfet, according to the data he has seen.

“That would be huge,” he says. “That would change the way we practice medicine.” (Though Theranos did not invent DNA testing of this kind, Holmes says, it has found ways to make it cost-efficient.)

Importantly, it’s not just the blood draws that are tiny. It’s also the analytical systems Theranos uses to perform the tests. They take up a small fraction of the footprint required by a conventional lab today.

“It takes at least 10 times–and maybe 100 times–less space for doing the same thing,” says Laret of UCSF Medical Center. That makes it possible to imagine one day placing Holmes’s labs right by the operating rooms in hospitals or in military evacuation helicopters or on ships and submarines or in refugee camps or in tents in the African bush. (The analyzers look like large desktop computer towers. Holmes declines to explain how they work, or even allow them to be photographed, citing the need to protect trade secrets. The company manufactures them at an unmarked facility I toured in a research park across the South Bay from Palo Alto, in Newark, Calif.)

What do incumbent players in the blood-diagnostic space think about all of this? The most frequent criticism is that Theranos is using purportedly breakthrough technology to perform tests that are relied on for life-and-death decisions without having first published any validation studies in peer-review journals. “I don’t know what they’re measuring, how they’re measuring it, and why they think they’re measuring it,” says Richard Bender, an oncologist who is also a medical affairs consultant for Quest Diagnostics, the largest independent diagnostic lab.

Holmes counters that because, as noted, her tests employ “the same fundamental chemical methods” as existing tests, peer-review publication of validation studies is both unnecessary and inappropriate.

The backdrop for this dispute is an unusual regulatory structure that does, in fact, confer upon some–though not all–conventional lab tests an extra layer of validation that Theranos’s do not yet have. Most labs, like Quest and Laboratory Corp. of America, perform many of their routine tests using analyzers they buy from medical-device manufacturers, like Siemens, Olympus, and Beckman Coulter. Before those manufacturers can sell such equipment, they must obtain U.S. Food and Drug Administration approval for the tests those analyzers perform–a process that is in addition to, and more searching than, the audits and proficiency tests required to win CMS certification for the lab itself.

At the same time, for other procedures conventional labs will devise their own lab-developed tests, or LDTs, which they do not have cleared by the FDA. While the FDA takes the position that it could require approval for LDTs, for many years it has said it would forgo that right in the exercise of its “enforcement discretion.”

Theranos, which does not buy any analyzers from third parties, is therefore in a unique position. While it would need FDA approval to sell its own analyzers to other labs, it doesn’t do that. It uses its analyzers only in its own CMS-certified lab. All its tests are therefore LDTs, effectively exempt from FDA oversight.

Holmes sees no basis for criticizing Theranos for acting within this framework, since no other labs seek FDA approval of their own LDTs. “Existing labs use thousands of assays that are neither FDA approved nor peer reviewed,” she says, referring to their LDTs. (In fact, the American Clinical Laboratory Association, the trade group for traditional diagnostic labs, adamantly opposes any effort by the FDA to start requiring approval of LDTs and even takes the position that the FDA lacks legal authority to do so.)

Moreover, Holmes stresses, Theranos is currently seeking FDA clearance for every one of its tests, even though it’s under no legal obligation to do so. (She has submitted many hundreds of pages of validation data in this effort, and has shown much of that data to Fortune.) Theranos may, in fact, be the only lab to have ever sought FDA clearance for LDTs.

Beyond the validation disputes, skeptics also question Theranos’s business model. They doubt its ability to scale up anytime soon to the levels necessary to become a serious competitor, especially since the business has so many unglamorous aspects unrelated to testing–billing, customer service, sorting, regulatory compliance, and the logistics of transporting samples from physicians to labs. Quest, for instance, employs 45,000 people; owns a fleet of 3,000 vehicles and 20 airplanes; and runs eight regional hub labs, 150 satellite labs, and 2,200 patient service centers.

Critics are likewise puzzled by the cosmic vastness of Holmes’s end-to-end business model. If Theranos is making breakthrough analyzers, they wonder, why doesn’t it just sell them to existing labs? To these critics, for Theranos to compete in the lab business itself while making all its own analyzers sounds implausible, if not crazy–like FedEx trying to manufacture all its own airplanes and trucks.

Still, Holmes has convinced a lot of people that she’s onto something. She has assembled what, in terms of public service at least, may be the single most accomplished board in U.S. corporate history. It includes former U.S. Secretary of State, Treasury, and Labor George Shultz; former Secretary of Defense Bill Perry; former Secretary of State and National Security Adviser Henry Kissinger; and former U.S. Senators Sam Nunn and Bill Frist (who is also a heart transplant surgeon), among others.

As a bonus, board meetings are also attended by the company’s de facto legal adviser at large, trial lawyer David Boies. At 73, Boies may be the most eminent living trial lawyer, when one tallies up such cases as his civil antitrust prosecution of Microsoft from 1998 to 2000, his role in the historic Bush v. Gore matter of 2000, and his fight to legalize same-sex marriage.

Because of his admiration for Holmes and what her company is trying to do, Boies says, he agreed to represent Theranos personally in its first challenge from patent holders claiming infringement–something of a coming-of-age ritual for tech startups. In a rare if not unprecedented rout this past March, the patent holders unconditionally surrendered midtrial, stipulating to the invalidity of their own patent. As a kicker they agreed–though the presiding judge would have been powerless to order such a thing himself–to bring no additional patent suits against Theranos for five years.

Though Holmes faces enormous challenges, she seems to consistently attract the service of extraordinary people and to inspire extraordinary fealty in them.

“She really does want to make a dent in the universe–one that is positive,” says retired U.S. Marine Corps Gen. James Mattis, explaining why he signed up last fall as another of Theranos’s strikingly illustrious outside directors. Mattis had stepped down just months earlier as commander of the U.S. Central Command–the chief of U.S. military operations in the Middle East and Central Asia, including Afghanistan–a post he had taken over from David Petraeus in 2010.

“The strength of the leader’s vision in the military is seen as the critical element in that unit’s performance,” Mattis says. “I wanted to be around something again that had that sort of leadership.”

In a conference room at her 140,000-square-foot, open-floor-plan headquarters at the Stanford Research Park–a former home to Facebook and, before that, to the iconic Palo Alto tech firm Hewlett-Packard–Holmes grips a plastic cup of unappetizing green juice. Her first of the day, it is made from spinach, parsley, wheatgrass, and celery. Later she’ll switch to cucumber. A vegan, she long ago dropped coffee in favor of these juices, which, she finds, are better able to propel her through her 16-hour days and seven-day weeks.

She admits–laughing nervously at the eccentricity of it–that after a meal she sometimes examines a drop of her own or others’ blood on a slide, and says she can observe the difference between when someone has eaten something healthy, like broccoli, and when he’s splurged on a cheeseburger. When we dine one night at an Italian place downtown with $14 pastas, the manager knows what she’ll have: a spartan, dressing-less mixed salad and an oil-free spaghetti with tomatoes, prepared from whole-wheat noodles she has provided the restaurant in advance, since it doesn’t stock them. No wine.

During my four days at Theranos, Holmes dressed identically every day: black jacket; black mock turtleneck; black slacks with a wide, pale pinstripe; and black low-heel shoes. Steve Jobs, because of his vision and perfectionism about “great products”–words Holmes punches out with precisely Jobs’ brio–is obviously a hero to her. As an apparent memento mori, she hangs in her office a framed screenshot of his Apple Internet bio, printed out on Aug. 24, 2011, the day he stepped down as CEO because of pancreatic cancer.

From still photos of Holmes herself–young, blond, and blue-eyed–cynics might be excused for thinking, “Oh, I get it. I see why all these geezers are gushing about her company.”

And from small talk with her, one might still wonder what all the fuss was about. She is polite and soft-spoken. She listens. She laughs naturally at other people’s jokes and doesn’t try to trump them. Her voice is lower pitched than you might expect, but that’s about all you notice at first. That, and her youth.

“She looks like 19,” says board member Henry Kissinger, 91.

Asked to assess her as a leader–because he’s seen a few–he responds, “I can’t compare her to anyone else because I haven’t seen anyone with her special attributes. She has iron will, strong determination. But nothing dramatic. There is no performance associated with her. I have seen no sign that financial gain is of any interest to her. She’s like a monk. She isn’t flashy. She wouldn’t walk into a room and take it over. But she would once the subject gets to her field.”

And she does, when she begins explaining to me the “mission.”

“Consumerizing this health care experience is a huge element of our mission,” Holmes says at our first meeting in April, “which is access to actionable information at the time it matters.” In our conversations over the next two months, she comes back to that phrase frequently. It is the theme that unifies what had seemed to me, at first, a succession of diverse, disparate aspects of her vision.

“There’s a lot of ways we’ve focused on access,” she explains, including the use of the minimally invasive finger stick, the affordability, the convenience of a drugstore location. The Walgreens “wellness centers,” as they are called, are open evenings and weekends so that people won’t have to miss work to get their blood test done. Each center is, within its Walgreens, an oasis, playing calming music–vaguely Eastern recorder melodies when I was there–and displaying nature scenes over a high-def LCD monitor (an aquarium video, in my case). The phlebotomist envelops the patient’s finger in a cozy, warming wrap, massages it with a soothing, milking motion, then pulls the trigger on an unusually shallow, narrow-gauge lancet.

“Anywhere from 40% to 60% of people, when they’re given a requisition by a doctor to go get tested, don’t,” asserts Holmes, “because they’re scared of needles or the locations are inconvenient or the cost is too high. And if you’re not even getting tested, how is it possible that we’re going to move toward an era of preventive medicine?”

Preventive medicine–and this relates to the “at the time it matters” portion of her mission statement–is crucial to the mission. She is making diagnostic testing so accessible in all these different ways precisely so that people can eventually do it more often, almost the way they might use a bathroom scale to watch their weight.

Today people might have their blood tested once a year, she explains. They get a snapshot of certain key values and learn whether they are “in range”–that is, statistically normal–or “out of range.” But if they were tested more often, they would begin to see a “movie” of what’s going on inside them. Sudden, rapid changes in some protein concentration–even when technically still in range–could tip off the doctor that something was amiss, and do so before it was too late to address the problem. (Theranos plans soon to display results in a way that maps them against all previous results from tests it has performed for that patient.)

“The movie goal is absolutely core to what we’re working to do,” she says. “When you have that trend, it is a much more meaningful clinical data set for the physician to use.”

She knows that, she says, “because we’ve seen it.” She’s referring to the fact that since 2005 Theranos has been doing work for major pharmaceutical companies, including Pfizer and GlaxoSmithKline, that are conducting clinical drug trials. Early on it was a way for the company, working under confidentiality agreements, to stealthily refine its technology while earning revenue needed to build out infrastructure. Theranos would test drug-trial subjects three times a week–which wouldn’t have been feasible using venipuncture–and catch adverse drug effects quickly, before they became dangerous.

“We’re building an early-detection system,” she explains. “I genuinely don’t believe anything else matters more than when you love someone so much and you have to say goodbye too soon. I deeply believe it has to be a basic human right for everybody to have access to the kind of testing infrastructure that can tell you about these conditions in time for you to do something about it. So that’s what we’re building.”

Holmes was born in February 1984 in Washington, D.C. Her father, Christian Holmes IV, has devoted most of his life to public-minded government service–disaster relief in Africa, international development projects in China, environmental work in this country–and is currently the global water coordinator for the U.S. Agency for International Development. He met Elizabeth’s mother, Noel, on Capitol Hill, where she worked as a congressional committee staffer.

When she was young, Elizabeth read a biography of her great-great-grandfather, the first Christian Holmes, who was a decorated World War I veteran, engineer, inventor, and surgeon after whom a hospital at the University of Cincinnati Medical Center is named. When she was 8, her family took a trip there to see a display about him.

“He ultimately worked himself to death,” Elizabeth tells me–he died at 62–“but he was so passionate in what he did. I wondered, Would I want to be a doctor?”

But she soon discovered she couldn’t handle the sight of blood, even fainting when friends arranged an opportunity for her to watch some surgeries performed. Though her parents remember Elizabeth as a fearless child, the lone exceptions, they say, were getting shots and enduring blood draws.

“The concept of sticking a needle into you and sucking your blood out,” Holmes says, has always been profoundly disturbing to her. As a child, she says, “when I knew I needed to get a test, I would really be focused on that for weeks in advance.” As an adult, she refused to get them. In fact, the last time she endured a venipuncture was in 2007, she says, when her board demanded that she get key-man insurance.

When Elizabeth turned 9, her father took a private sector job with the industrial conglomerate Tenneco. He went to Houston to find a house for the family to move into. He remembers feeling guilty about forcing Elizabeth and her younger brother, Christian Holmes V, to uproot themselves from their happy lives in D.C. So he was profoundly touched when he got a letter from Elizabeth reassuring him that “I love adventures,” that she was looking forward to having “new ones in Texas,” especially since Texas was “big on science.” But the most striking thing about his 9-year-old’s “Dear Daddy” letter was its first sentence: “What I really want out of life is to discover something new, something mankind didn’t know was possible to do,” she wrote.

Elizabeth and her brother–who is now director of product management at Theranos–had both been intrigued by their father’s work in China. So when Elizabeth was about 9, her parents found them both a tutor to teach them Mandarin on Saturdays. Elizabeth then supplemented those lessons with summer language programs at Stanford and, later, at two universities in Beijing. Captivated by computer programming in high school, she was struck by how the Chinese universities’ information technology facilities lagged behind what she was used to. To rectify that situation, she started her first business while still in high school, selling C++ compilers to Chinese universities.

Whether it grew out of her father’s experiences at Tenneco or family lore–they are descendants of a founder of the Fleischmann’s Yeast company–Elizabeth grew up admiring private industry. “At a relatively early age I began to believe that building a business was perhaps the greatest opportunity for making an impact,” she says, “because it’s a tool for making a change in the world.”

Holmes was admitted by early decision to Stanford. As she headed off to college, her father gave her a copy ofMeditations, by the Roman emperor and Stoic philosopher Marcus Aurelius. “I wanted it to reinforce the message of a purposeful life,” her father explained to me. “I think it really affected her.”

Upon admission, Holmes was named one of an elite group of freshmen denominated “president’s scholars,” which meant that Stanford would spot them $3,000 each to use on a research project. While still a freshman, Holmes persuaded her chemical engineering professor, Robertson, to let her use the stipend for a research project in his lab, though it would mean working mainly alongside Ph.D. candidates.

That summer she departed for Singapore to work in the lab at the Genome Institute, which was developing novel systems to detect the SARS virus in blood or nasal swabs. “I had not had much formal biology training,” Holmes recalls, so she had to bring herself up to speed in that respect on her own. At the same time, her engineering and technology background at Stanford led her to believe that “there were much better ways to do” the tests she saw being performed at the institute.

As soon as she got back to the U.S., Holmes started writing a patent application embodying the ideas set in motion by that experience. “I saw her sit down at the computer, and for five to six days she barely got up,” recalls her mother, Noel. “I would bring her food occasionally, and she slept maybe one or two hours a night for five nights.”

The day after Elizabeth finished the draft, Noel started driving her from Houston to Stanford, hoping to enjoy some mother-daughter quality time. But Elizabeth just slept for two days in the car.

Noel and Chris knew then that Elizabeth wanted to start a business, though they didn’t understand the details. It therefore came as no shock the following semester when she told them she needed to suspend college to pursue the company full-time. They let her take the money they’d saved for her education and put it into her business.

“What do you want for your children?” says Noel. “You want them to do something they’re passionate about. To follow their dream. To help people. To change the world. So we said, ‘Of course. Go do this.’”

In what respect, then, does Holmes’s first patent application–the wearable patch that would radio the doctor what is going on in your blood in real time–lead to Theranos, a player in the $73 billion diagnostic lab business?

When one returns to her core mission–making actionable information accessible at the time it matters–one glimpses part of what she means. The patch permitted physicians and patients to see the “movie” of what was going on inside patients’ blood. The original name for her company was Real-Time Cures, though she soon scratched that, after deciding that too many people had a “cynical” reaction to the word “cure.”

“Elizabeth has had a very clear vision of where she wanted to take this since the time I met her,” says Sunny Balwani, who met her in 2002 and has been Theranos’s president since 2009. “The business strategy, the tactics of what to do first, what to offer when–that has changed, but the overall goal and direction has been linear.” Balwani, who founded and sold his own e-commerce company in the 1990s, is an expert in building software products.

For 10 years Holmes patiently raised money and refined her technologies. As much as she needed money, she turned down many offers, she says, because so many investors wanted quick returns.

“Too often the question is, What’s your exit strategy?” she recounts, “before you’re really understanding what your entry strategy is.” She is building a company, she explains, that “30, 40, even 50 years from now will be defining new standards in terms of the way in which people will be able to get access to actionable information.”

Early investors included venture capitalists Draper Fisher Jurvetson (which has funded Tesla and SpaceX), ATA Ventures, Silicon Valley legend Don Lucas Sr. (Oracle, National Semiconductor, Macromedia), and Oracle’s Larry Ellison. She will not identify later investors other than to say they include private equity funds and “strategic partners,” by which she means “entities working with the company as we scale.” Though she has now raised more than $400 million, she says she has retained control over more than 50% of the stock.

All the while, Holmes has continued to invent and to upgrade her earlier inventions. “As she likes to put it,” says board member Shultz, “the best patent is making yourself obsolete. So the person who steals your patent steals yesterday’s technology.”

Today Holmes is a co-inventor on 82 U.S. and 189 foreign patent applications, of which 18 in the U.S. and 66 abroad have been granted. Those are in addition to another 186 applications Theranos has filed worldwide that don’t list Holmes as an inventor, of which 18 have already been granted.

Although I believe Balwani when he says that Holmes’s “overall goal and direction” for the company “has been linear,” I don’t believe that Walgreens wellness centers represent the ultimate target of that vector. There are pieces of the puzzle we haven’t seen yet. In some cases she may be waiting for regulatory approval, while in others she may just be waiting, like Steve Jobs, to finish perfecting her next “great product” before unveiling it with a flourish.

As Holmes relentlessly pursues the next “embodiment” of her vision, her old chemical engineering professor, Robertson, sits about 20 yards from her office, helping her. After years of volunteer service to the company as a director, he became a paid consultant in 2009. Last June he signed up as an employee.

“I gave up two endowed chairs to do this,” he says. “I think that’s a statement.”

Then he adds, “To me, I wish I wasn’t 70 years old. I wish I was her age and could be in on this. Because this is going to be a long, exciting, fascinating, exhilarating ride.”

 

A hereditary knack for creating highly addictive games has kept Jaques of London in business for eight generations, and despite the growth of computer games the family firm insists there’s an increasing demand for old-fashioned fun

LET THE GAMES BEGIN

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ARTICLE | 12 JUNE, 2014 05:29 PM | BY TESS DE LA MARE

Some of Jaques’ history sounds just too fanciful to be true. Over eight generations its family members have invented ping-pong, croquet, tiddlywinks, snakes and ladders and ludo to name just a few. The British secret service even stepped in to ensure its survival in its darkest hour. Yet all the evidence and artefacts from its 219-year history are displayed in glass cabinets in its showroom in its low-key headquarters in Kent, southeast England. There’s no denying it, there’s something in the Jaques family’s DNA that gives its members a powerful creative streak. Jaques remains 100% family owned and is currently run by three members of the eighth-generation; Joe, Ben and Emmett Jaques, who are marketing director, sales director and managing director respectively. Read more of this post

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Is Google Replacing God? There are some things that the all-knowing Internet can’t provide

Is Google Replacing God?

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Updated June 12, 2014 7:31 p.m. ET

Digital technology might have been slower to arrive in churches, temples, synagogues and mosques than in other areas of life, but many religious institutions are now embracing the opportunities it offers. Carmelite nuns, for instance, take prayer requests via Facebook FB -2.27% and some pastors encourage their congregations to live-tweet sermons. In many faith communities, evangelization and outreach are as likely to occur online as off. Read more of this post

The Daddy Juggle: Work, Life, Family and Chaos; Fathers Are Finding Their Struggles to Manage Home and the Office Are Getting Similar to Mothers’

The Daddy Juggle: Work, Life, Family and Chaos

Fathers Are Finding Their Struggles to Manage Home and the Office Are Getting Similar to Mothers’

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June 12, 2014 7:40 p.m. ET

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A new generation of fathers with corporate jobs is joining the debate about balancing work and family, a conversation long driven by working women. As the number of dual-earner couples grows and more men make sacrifices to support their wives’ careers, some fathers are asking employers for guidance and action or tapping flexible-workplace policies originally designed for working mothers. Others are curbing their career goals to spend more time at home. Read more of this post