Justification for infidelity and dishonesty in all their manifestations lies in the marginal cost economics of “just this once.

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.

Often they [writers on the study of management] have a point of view based upon intuition and experience. They then offer a cadence of two-paragraph examples carefully selected to "prove" their theory, and then they write "one size fits all" books. The message is, "If you'd do what these companies did, you'd be successful too."

I've concluded that the metric by which God will assess my life isn't dollars but the individual people whose lives I've touched.

It's like in biological evolution: The population will evolve, even though individuals can't. The same thing happens in the corporate world: The population of business units within corporations evolves, even though individual business units can't. That's because the capabilities of business units reside in their processes and their values, and by their very nature, processes and values are inflexible and meant not to change.

One of the factors that make great companies so great is that they have processes that allow them to solve difficult problems again and again. These processes have developed over time as teams have successfully wrestled with a certain type of challenge. Eventually, people begin to say, "This is just how we do something around here." The problem develops when that team then has to solve a very different set of challenges. The processes that are such strengths can be crushing liabilities.

Breaking an old business model is always going to require leaders to follow their instinct. There will always be persuasive reasons not to take a risk. But if you only do what worked in the past, you will wake up one day and find that you’ve been passed by.