Paul Graham – Do Things That Do Not Scale

I was forwarded the article below by a close friend as a point of perspective; Doctors are always complaining about the fact that our businesses are so difficult to scale.

There is a confluence of ideas around this point: The E-myth physician by Michael Gerber commonly critiques doctors because they’re getting caught up in the “just doin’ it” mind frame, practicing within confines of a market that has been defined by payor counter-parties who are incentivized by keeping doctors administratively browbeaten.

To steal a phrase: Many doctors don’t ship: They can’t effectively distill their value proposition for patients because they haven’t taken the time and focus to do so. They also don’t take their message to the public, and aren’t actively seeking clientele.

Some relevant, paraphrased quotes:

“For a practice to succeed, at least one founder (usually the CEO) will have to spend a lot of time on sales and marketing, delivering the value of the practice and establishing a client base.

One is that a lot of of doctors are trained as doctors, and customer service is not part of the training of doctors.

But perhaps the biggest thing preventing doctors from realizing how attentive they could be to their patients is that they’ve never experienced such attention themselves.

Their standards for customer service have been set by the companies they’ve been customers of, which are mostly big ones.”

“I was trying to think of a phrase to convey how extreme your attention to users should be, and I realized Steve Jobs had already done it: insanely great. Steve wasn’t just using “insanely” as a synonym for “very.” He meant it more literally—that one should focus on quality of execution to a degree that in everyday life would be considered pathological.

What founders have a hard time grasping (and Steve himself might have had a hard time grasping) is what insanely great morphs into as you roll the time slider back to the first couple months of a startup’s life.

It’s not the product that should be insanely great, but the experience of being your user.

The product is just one component of that. For a big company it’s necessarily the dominant one. But you can and should give users an insanely great experience with an early, incomplete, buggy product, if you make up the difference with attentiveness.

Yes. Over-engaging with early users is not just a permissible technique for getting growth rolling.


The feedback you get from engaging directly with your earliest users will be the best you ever get.


It’s not enough just to do something extraordinary initially. You have to make an extraordinary effort initially.

And most importantly, if you have to work hard to delight users when you only have a handful of them, you’ll keep doing it when you have a lot.


Original available at , originally published July of 2013.

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