Quite often startups were first out of the gate with a sustaining technology. But somehow the leaders got the technology and stayed atop their industries. Sometimes they acquired the startup; sometimes they just developed the technology as a follower and used their muscle and mass to win. But they always won.

If a company truly wants to resolve the innovator's dilemma, it does need to be able to create wave after wave of disruptive innovation. And those disruptive innovations will typically grow to the point where they do cause some pain for leading companies. But most disruptive innovations create substantial new growth before they cause that pain.

There are other dimensions of biotechnology. If you think of biotechnology like the Internet, it's not a category - it's an infrastructure that can be deployed to sustain or disrupt. In health care, the most complex problems at the high end have to be dealt with in a problem-solving mode by the best, most experienced physicians you can find.

Steve Jobs and Apple taught us that profit is not the ultimate goal, but rather a consequence of something greater.

It is a company's customers who effectively control what it can and cannot do.

In a large successful company where your power base as CEO isn't all that secure, it's hard for a CEO to pursue a truly disruptive strategy.

Every disruptive innovation is powered by a simplifying technology, and then the technology has to get embedded in a different kind of a business model. The first two decades of digital computing were characterized by the huge mainframe computers that filled a whole room, and they had to be operated by PhD Computer Scientists. It took the engineers at IBM about four years to design these mainframe computers because there were no rules. It was an intuitive art and just by trial and error and experimentation they would evolve to a computer that worked.