10 Years As CEO: 3 Guiding Principles That Transformed Exact Sciences

Ten years ago, I took a phone call that changed my life.

In-between jobs, I wasn’t sure what was next. The company I led had been acquired, offering time to catch my breath. Looking ahead, I was committed to staying in Madison, Wisconsin, where my family had put down roots.

The phone call came from a recruiter working on behalf of Exact Sciences to find a new CEO who would be responsible for leading the company through a monumental transformation. What I knew about Exact Sciences made that first phone call brief: they had twice failed to develop colorectal cancer screening tests, were running very light on cash, and the pipeline did not provide a clear path forward.

The world has a serendipitous way of working. Around the same time, three friends were diagnosed with colorectal cancer, which led my conversations with the Exact Sciences Board of Directors to take on new meaning. While the company didn’t look like much on the surface, the feeling something was there wouldn’t leave me.

I took a leap, and in April 2009, joined Exact Sciences as the new CEO. A decade later, I’m immensely proud of everything the Exact Sciences team has accomplished. I’m often asked, “How’d you do it?” After reflecting on the past decade of transformation, here are three principles that guided Exact Sciences to where we are today:

1. Defy convention.

Part of the reason I decided to join Exact Sciences is that going against the grain is in my nature. I’m the guy at the table who will question the status quo and choose the road less traveled.

Exact Sciences wouldn’t be the company it is today if not for the team’s early ability to think differently and forge a path where others might see the end of the road. While wrestling with the decision to take this role, Maneesh Arora and I traveled to Mayo Clinic in Rochester, Minnesota to meet with gastroenterologist and researcher Dr. David Ahlquist. It’s there we came to understand, if we were going to do this, we needed to be a company that defies convention. Shifting the colorectal cancer paradigm would require outside of the box thinking. The opportunity and challenge were so complex that Graham Lidgard, our newly hired Chief Science Officer, moved from California to join us in our quest. There wasn’t a path to follow, and we needed to be willing to push, make mistakes, and try again.

The visit with Dave also made clear that Mayo Clinic needed to be an integral part of our future. When we launched our collaboration with Mayo Clinic, we believed that the opportunity to meaningfully improve both the detection and prevention of colorectal cancer was very real. Today, more than 2 million people have been screened using the technology that we developed together, showing what happens when you focus on a bigger mission instead of individual priorities.

We made our fair share of mistakes going against the grain, but we learned. It’s the learning that helped us grow and mature. Whether you’re at the peak of your career or just getting started, seek out opportunities to defy convention. You never know where they may lead.

2. Take risks if you want big change.

One theme that appears repeatedly in our history is the willingness to face a problem head-on with creative solutions. We never just stayed the course and hoped for the best. We greeted each challenge with big thinking and the requisite tenacity to see it through.

By 2011, we needed to validate the science for our potential screening test on a large scale. We embarked on a 10,000-patient study to satisfy the evidence requirement for the FDA and CMS and, ultimately, give patients and providers the confidence in a potential new screening method.

There was considerable risk in moving ahead with a study of this size. It would be the largest private trial for colorectal cancer and the future of the company rested on our ability to show similar results from our smaller, case-control research. As we started planning, consultants suggested it would take three years to meet our recruitment goals. We didn’t have three years. We set our goal at, an unheard of, 18 months.

We wanted to make a big change—playing a role in the eradication of colorectal cancer—and it required big risks. It paid off: we met our patient recruitment goals and the pivotal study ended up validating our test and leading to the first-ever parallel FDA/CMS review process and joint approval/coverage.

3. Focus on three priorities.

At Exact Sciences we have a mantra: if you have more than three priorities, you really have none. It’s been a guiding principle throughout my career and, especially, the last ten years at Exact Sciences.

In 2009, we set our first company priorities: develop a successful screening test, advance clinical trial planning, and create a performance culture. Every year our executive team outlines company priorities that are shared in January and tracked throughout the year. Even as we’ve grown to more than 2,000 team members, everyone focuses on these three annual priorities, aligning their individual goals and performance with the company’s priorities.

In the early days, a Post-it on my computer screen served as a reminder of those priorities. We have priority posters throughout our office spaces now. This focus, coupled with the team’s passion for our early detection mission, fuels our success every year.

Remind yourself WHY every day.

Reflecting on the last ten years, I frequently wonder what my friend, Jamie Truesdell, would say about Exact Sciences’ transformation. Jamie was diagnosed with Stage III colon cancer at age 49—right around the time I took that recruiter phone call in 2009. I keep a message from Jamie pinned to the bulletin board in my office. It says, in part, “To feel part of Exact Sciences’ evolution is something you will never understand how grateful and meaningful it was to me.”

In that same message, I was encouraged that Jamie was looking forward, sharing his goals for the upcoming year. A week later, while skiing with my family, I had to capture the surreal scene in front of me when I received the devastating call that Jamie passed away. The view was so peaceful and calm, just like Jamie’s outlook on life. He’s my motivation to keep looking forward and to defy convention; to meet every challenge with tenacity; and to stay laser-focused on our priorities. Because Jamie’s story is too familiar for millions of Americans, and earlier cancer detection has the possibility to make a difference. I can’t wait to see what the next ten years bring for Exact Sciences and our ability to change the course of disease detection.