Early-stage founders often mistakenly hire senior talent from large corporations. These executives are accustomed to resources that don't exist in a startup. Instead, hire people who have successfully navigated the stage you are about to enter—those who are just "a few clicks ahead."

Delaying key hires to find the "perfect" candidate is a mistake. The best outcomes come from building a strong team around the founder early on, even if it requires calibration later. Waiting for ideal additions doesn't create better companies; early execution talent does.

A common failure mode for well-funded biotechs is growing headcount too rapidly. Immunocore's CEO advises new leaders to pace themselves, emphasizing that drug development is a marathon. Prematurely scaling creates fixed expenses that can drain capital before key scientific milestones are hit.

In Biotech, risk is removed pre-FDA approval via clinical trials, making a Chief Development Officer (clinical, regulatory, manufacturing) the most critical hire. In many MedTech sectors, risk is removed post-FDA approval via market adoption, making a Chief Commercial Officer paramount.

Founders often chase executives from successful scaled companies. However, these execs can fail because their experience makes them overly critical and resistant to the painful, hands-on work required at an early stage. The right hire is often someone a few layers down from the star executive.

The transition from a resource-rich environment like Novartis to an early-stage biotech reveals a stark contrast. The unlimited access to a global organization is replaced by a total reliance on a small, nimble team where everyone must be multi-skilled and hands-on, a change even experienced executives find jarring.

Actuate Therapeutics maintains high capital efficiency by keeping its full-time headcount low. The company is built around a trusted core team and supplemented by an extensive stable of "best of breed" consultants who are engaged on an as-needed basis, minimizing overhead costs.

Early founders resist basic financial or HR controls as 'big company stuff.' However, these systems prevent avoidable, costly mistakes, much like car brakes don't just slow it down but enable it to safely travel at higher speeds, as illustrated by a former CFO.

Hiring someone with a prestigious background for a role your startup isn't ready for is a common mistake. These hires often need structure that doesn't exist, leading to their underutilization and boredom. It's like using a "jackhammer when all we needed was a sturdy hammer."