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Pharmaceutical Executive
Coaching Flag Football—And Guiding a Biotech Through Commercialization
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Useful tips and parallels for staying in the game following a complete response letter.
Coaching a team of six- and seven-year-olds in flag football might seem a world away from leading a biotech company through the complexities of commercialization. Yet as I navigated this past season with my son’s team, I found remarkable parallels in the fundamental principles of leadership. Whether rallying a group of pint-sized players or a team of brilliant scientists, success in many ways depends on three core behaviors.
Determination: Pushing beyond the bad days
Determination, to me, is not about doggedly following a plan to its logical end—it’s about refusing to accept that a setback defines the outcome. In biotech, nothing builds determination like receiving a complete response letter (CRL) from the FDA. For any company, but especially a small biotech, it feels almost existential. I’ve been through it twice in my career. The first time, we were a small team at Akebia Therapeutics, and our lead asset, after years of effort, hit a regulatory wall. Instead of folding (plenty of companies do just that in the face of a CRL), we committed to long workweeks, researching legal precedents, and iterating draft after draft for resubmission.
It’s akin to helping a flag football team bounce back from a blowout loss: You don’t retreat, you reframe—and build the comeback play by play, making sure the team understands that a single snapshot of the scoreboard doesn’t erase months of work.
After one crushing defeat this season to the Cowboys, I knew we had to change the plan of attack. Our offensive game plan focused on simple run plays that emphasized our team’s speed; however, we couldn’t advance the ball against their disciplined defense. In our next game, we focused on misdirection, utilizing jet sweeps and reverses. It took advantage of our speed while eliminating our predictability. The result was a three-touchdown victory the following week.
Discipline: Making tough choices
If determination is what gets you back up, discipline is how you make your next steps count. At Akebia, after our upcoming launch was derailed by the CRL, we had to cut our commercial budget by 60% while maintaining revenue targets because our investments were focused on the launch. We had to ruthlessly prioritize essential activities and walk away from good ideas that didn’t fit our new reality. In a competitive market, that meant we couldn’t scale our digital presence. In practice, this meant sitting with my team and confronting the uncomfortable. We needed to decide which programs truly moved the needle and which ones served only legacy interests. This discipline led to radical prioritization: We targeted our most important customers, the roughly 20% that made up nearly 80% of the market.
It’s easy to say “focus on what matters,” but far harder when it means telling high-performing teams their favorite projects are on hold. You can also lose trust, as a leader and as an organization, as you navigate lean times.
The secret sauce is being radically transparent about the decisions leadership is making and pointing to how these tough calls give the company’s broader mission hope to survive into the future.
On the football field, discipline was about teaching 6- and 7-year-olds to stick to simple plays even when they wanted to improvise—making sure they know why they have to run the route exactly as designed, every time. The payoff didn’t come after one or two games but built up over a season, as routines became second nature and panic receded in close moments. In both spheres, discipline is the force that keeps ambition channeled.
Drill: Mastery through preparation
If determination keeps you going and discipline keeps you focused, drilling—your commitment to preparation—ensures you’re ready for anything. At Orchard Therapeutics, my favorite (and most exhausting) leadership memory was the six-month “drilling” process before launch. Our team rehearsed every scenario, from patient travel logistics to reimbursement headaches. The “drill” wasn’t academic; it readied us for the inevitable curveballs of a real-world launch. We had anticipated that converting some of our clinical sites to commercial sites would be a purely administrative exercise. But through the drilling, we learned that finance would be more heavily involved, and we needed to create a workstream to ensure we had adequate treatment sites at launch.
With my young football team, we ran situational scenarios—what do we do in goal line situations where we have to pass (per flag football rules)? What if the opposition has a speedy receiver (do we switch to man or zone coverage)? What does our two-minute offense look like if we are down late in the game? By the end of the season, the kids played with more joy, knowing they’d been there before, at least in practice. The lesson: You can’t control the breaks, but you can control how ready your team is for them.
Whether leading a startup through FDA setbacks, managing through brutal budget cuts, or coaching a determined group of kids to love the grind as much as the glory, I’ve learned that these three D’s—determination, discipline, drill—are as essential in biotechnology as in football. They don’t guarantee victory, but they make real progress possible.
Bennett Smith is Senior Vice President, Commercial, at Stealth Biotech PBC
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