The Chief of Staff Role in the Biotech Industry

Despite being a nebulous and somewhat new role in the startup world, the Chief of Staff role is starting to become more accepted in the industry.

Uday Suresh
Oct 14 · 4 min read
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Image Source: Lokavant

Despite being a nebulous and somewhat new role in the startup world, the Chief of Staff role is starting to be recognized and opined upon in a patently tech-forward Medium/Substack type of way — and even in the Harvard Business Review.

My experience as Chief of Staff (CoS) to the President at a small healthtech company, Lokavant, focused on optimizing clinical trials is very niche and definitely not one-size-fits-all. My immensely subjective take on building a company with the backing of another company, Roivant, as well as the very domain-specific nature of my experiences in the clinical trial industry will quickly ensure that my thoughts on the nature of being a CoS are provincial. In fact, the inherent fluidity of the role guarantees that the CoS role is defined by the relationship with the Principal.

The principal is best defined by this piece by Rob Dickins, which is basically the seminal text on CoS theory. Though the scope of the CoS role is defined by the Principal, the role of a CoS can vaguely be bucketed into three major items: driving strategic initiatives, supporting the Principal, and handling special projects.

I think that the Objectives and Key Results (OKR) framework that we (and many other successful individuals and companies) use is stellar. John Doerr’s book is required reading for our team. The amount of cross-team alignment that can be achieved by adhering to the OKR process is impressive. And more importantly, it is measurable.

A CoS will live and die by the OKRs. The goals that are set and the process of setting goals itself will ensure that the weeks of work add up to something. As a CoS the onus is upon me to make sure that items are tracked and projects are in view of the Principal such that no work is repeated or wasted. Moving the needle on large items that require input from the whole company can seem daunting but OKRs break them down into pieces for me to shepherd into completion.

Similar to how database tools like Notion are used as a sort of extension of the brain, a CoS must be a sort of business-based extension of the Principal. I think this is where empathy and communication kick in. As CoS, it is important for me to get a grip on how the Principal will react to various items and use this to benefit the Principal and the company as a whole. On a very basic level, the ability to mimetically predict the Principal’s reactions will allow you to offer the staff the ability to run items through you as a first pass. However, I think that this is only a starting point for improving the productivity of the Principal.

As CoS you learn to write like the Principal and subsequently think more like the Principal — which is a funnel for accelerated learning patterns. I find myself more adeptly able to defend the time of the Principal as I catalog items mentally for them and expand the range of workstreams they are able to context switch through. In all of this intermixing of thought, though, one of the most important exchanges as a CoS is offering alternative approaches to tactically driving key initiatives, with the overarching purpose of bringing about some positive change.

A level of trust and access is afforded to the CoS and that can be used to do business planning and contingency/risk management in a way that protects the best interest of the business. Ultimately, Lokavant is a mission-driven company that needs to get things done. As CoS you have to sit down and get a lot of those things done.

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Image Source: Lokavant

I think that a good CoS realizes that nothing is beneath them; ego and deadlines are the only enemies here — you just have to do the work at hand. Being CoS requires humility. You are the jack of all trades, master of none. Being CoS is essentially being a cross-functional product manager — with the product being the company itself. I am constantly learning how to product manage in a modular fashion and let the charters that govern the world of product be the framework that inspires CoS innovation.

My experience as CoS has been rooted in trying to reel in and construct something from the loose fabric that holds together a startup company when it is still in the storming and forming part of Tuckman’s Stages of Group Development and not yet experiencing norming. I think this is the most enriching part of company development. This is the stage where ownership is high and learning is even higher. The low ego environment allows for a lot of collaboration between team members and systems like OKRs allow for maximal output from a lean group. The Chief of Staff role, in this sense, is really not about any sort of chiefly attitudes in relation to the staff, but rather about positioning the staff as chief, cardinal, preeminent. I feel very fortunate to have a Principal that I’m eager to represent the interests of and a team that makes sure that my growth is in tandem with the evolution of Lokavant.

Uday Suresh is a bioengineer & health technology product manager working as a Chief of Staff in New York City.


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