CEO Spotlight: Iain Miller, CEO of PreSymptom Health

  • CEO of PreSymptom Health
  • Extensive commercialisation experience, and a history of entrepreneurship, including the leadership of three medtech SMEs
  • 30 years of experience in medical technology

What has your experience in startups and business taught you about anticipating problems?

You develop an instinct through your career. Like an experienced driver, you start to see problems before they happen, you come to know that the car at the junction ahead might come out, even though they shouldn’t. There are a whole bunch of common challenges that can pop up repeatedly. With experience, you have a sense of what they may be and you’ve also got a grounded perspective about the risk profile of different things you’re doing.

I’ve learnt that there’s value in having a portfolio of programmes so you’ve always got other mitigation measures if one of them has a hiccup, which it will in the first stages of a company. The downside of that is that some investors will say you haven’t got the bandwidth to focus on more than one thing. It’s always a balance between defining your core work but having a set of related activities to support it, should you meet setbacks. 

How have you personally approached setbacks and what have you done to overcome the difficult ones?

You really do need to be someone who doesn’t sleep well at night if your startup baby is not thriving. It’s your job to keep on it, no one else will take it forward. It’s about tenacity, staying power, constantly thinking of novel approaches to increase your odds of success. And in the case of fundraising, it’s a constant challenge.

My approach is always to signal problems early, but also communicate and be credible about the solution you’re working on to make those problems go away. Credibility is everything in life and having that credibility with your backers is so important. Once you lose it, you don’t get it back.

What would be your advice to younger or less experienced CEOs and entrepreneurs?

Be humble about the gaps in your knowledge and recognise what you don’t know. You may be very bright on the technology you’re trying to exploit, but you are probably less bright or inexperienced about what the market is going to throw at you – the regulatory issues, economic issues, and so on.

Get some more grey hair in the team in the form of advisors, or mentors. Investors will want to see that core brilliant scientist, or engineer, but they will also want to an experienced and diverse team around them. Have a mixture of backgrounds, in, in gender, ethnicity, but also terms of background, and geography.

You need to constantly refine your messaging. People talk about the elevator pitch and being able to capture what you’re trying to do and its benefits in a succinct and compelling way. For all the years that I’ve been around, I still work on that. Have a clear answer to the question of what difference your new technology is going to bring and why people should care or invest.

There can be a lot of pressure on startup CEOs. How do you deal with pressure or stress at times?

In some ways it is both the best and the worst job in the world because everything’s on you but at the same time, you have a great deal of influence and get to make things happen. I think it’s a wonderful job to have. The worst thing is when you get people blaming you for things that you are unable to influence, that can be hard to take, but you need to develop a thick skin and understand that life is not fair.

It’s a bit of a cliché, but exercise, rest, and stepping away from things can help you cope, don’t be a slave to your phone and carve out separate time for other things. Hobbies, exercise, fresh air and mindfulness, keeping perspective on your problems and how they fit in the bigger picture.

If you were to advise your 22- or 23-year-old self who started running a company, what would you say?

Make sure you never miss an opportunity to learn. It’s a cliche to say continual education, but I think it’s important. We all have to deal with stuff we don’t enjoy, but you must constantly be learning and growing, otherwise you’re not going to move forward. There are a lot of bright people around you, so grab the opportunity whenever you can.