Howard Marks describes the downside of being a public company as receiving a constant, often arbitrary, 'report card' from the market. Daily stock price movements, driven by people with limited understanding of the company's long-term strategy, create noise and pressure that private companies can avoid.

The public markets exhibit extreme short-termism. The immediate post-deal performance of follow-on financings heavily influences investor sentiment for subsequent deals. Poor performance one week empowers insiders to demand steeper discounts the next, creating a volatile feedback loop.

Biotech leaders often fixate on share price after an IPO, but trading volume is the more important metric for long-term health. High liquidity attracts institutional investors and makes it easier to raise future capital. A stock that "trades by appointment" due to low volume signals a lack of interest and severely limits a company's financial options.

Klarna's CEO candidly revealed that his management team vowed never to watch the company's stock price after its IPO, but they immediately broke that promise and checked it daily. This highlights the intense, almost unavoidable psychological pressure that public market fluctuations exert on company leadership.

The stock price and the narrative around a company are tightly linked, creating wild oscillations. Investors mistakenly equate a rising stock with a great company. In reality, the intrinsic value of a great business rises gradually and steadily, while the stock price swings dramatically above and below this line based on shifting market sentiment.

A massive disconnect exists where scientific breakthroughs are accelerating, yet the biotech market is in a downturn, with many companies trading below cash. This paradox highlights structural and economic failures within the industry, rather than a lack of scientific progress. The core question is why the business is collapsing while the technology is exploding.

Market dynamics, like investor fixation on AI or predatory short-selling, pose a greater risk to biotech firms than clinical trial results. A company can have a breakthrough drug but still fail if its stock—its funding currency—is ignored or attacked by Wall Street.

As a public company CEO, Dylan Field actively avoids focusing on daily stock fluctuations. He believes the only controllable factors are the business inputs—improving the product and creating customer value. This is an application of Bill Walsh's philosophy, "the score takes care of itself," to public market management, prioritizing long-term fundamentals over short-term sentiment.

While success is celebrated publicly, some of the best leadership happens privately when a CEO makes the tough, candid call to shut down a program or company due to unfavorable data. This "truth-seeking" decision, often against their personal interest, is a hallmark of excellence.