From Microscope to Market: Why a Board Helps More Than You Think

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A few weeks ago, I published a 7-article series about my experience in joining a board.

Following the articles I was contacted by person who asked me what the benefit of a board is and why we have them. A great question.
She had started her own company, had hired around ten staff so wanted to know what a board would bring her, if anything.

I asked a number of colleagues on boards for their views and received some strong responses.

If you’ve ever thought “can’t we just get the science right and the rest will follow?”, you are definitely not alone.
But in biotech, diagnostics, and healthcare, “just the science” doesn’t cut it. You need a board of directors.
And not only for the prestige photo-op on the website. 

So, her first question was ‘why exactly do we need a board of directors? Is it just tradition? Or is there real, tangible value?’

In our world of lab coats, microscopes, analysers and regulatory red tape, a strong board is critical, and here are some reasons why along with some wisdom from people who sit on these boards.

What’s Different in Healthcare / Diagnostics / Biotech?

These sectors aren’t just about profit margins. They are about:

Regulatory complexity: FDA, IVDR, EMA, national bodies, CLIA, ISO, the rules come from many directions.

Patient safety: Mistakes don’t just hit the bottom line; they can hit lives.

Scientific validity and reproducibility: The science must hold up under scrutiny.

Long development cycles / high risk investments: From R&D, clinical trials, validation, to market launch, the timeline is long, costs are high, and many things can go sideways.

Reputation & public trust: Diagnostics gone wrong, biotech safety incidents, the headlines are brutal.

In short: the stakes are higher. Which means the board needs to be up to more than just approving budgets.

Why Every Lab/Diagnostics/Biotech Firm Needs a Board

Strategic Oversight in Uncertainty
When science changes fast (new variants, new diagnostics, shifting reimbursement environments), you need a board that can zoom out and ask, “Is our pipeline still relevant?”

They help test assumptions: are you betting on the right biomarker? The right diagnostic platform? Should you pivot to point‐of‐care?

While management is often focused on daily operations (and occasionally putting out fires), the board is looking five years ahead, asking, “Are we headed in the right direction?” and “Should we be in this market at all?”

As Johnson et al. (2017) put it, boards provide a “balance of support and challenge,” which is academic speak for “they don’t just nod and smile.”

Governance & Compliance Are Non‐Negotioable
Boards enforce that you meet legal, regulatory, safety, and ethical standards. In diagnostics especially, oversight is not optional, it’s essential for licensing and certifications.
Think of the board as the company's North Star, or at the very least, its GPS when the CEO takes a scenic route.

A board ensures that the company doesn’t just do what is profitable, but also what is right (Cadbury, 1987).

Risk Management—Science, Clinical, Financial
A good board helps identify risks early: trial failures, reproducibility issues, IP litigation, regulatory delays, reimbursement risk.

Accountability & Credibility
Whether dealing with investors, regulators, clinicians, or patients, having a credible, independent board sends a message: we take this seriously. It builds confidence.
Even the most visionary CEOs need someone to answer to. A board ensures that leadership is held accountable for their decisions, good, bad, or wildly optimistic.

It’s not about micromanagement. It’s about asking the right questions. A bit of “constructive paranoia.” Not Are we failing? but Could we fail and what’s the plan if we do?

Want to attract serious investment? Show them you have a competent, diverse, and engaged board.

Investors love boards because they act as a check and balance. In fact, companies with strong boards are statistically more likely to perform better in the long run (Bhagat & Bolton, 2008). A good board says, “We’ve got grown-ups watching the ship. It’s not just passion projects and ping-pong.”

Access to Expertise & Networks
Board members often bring deep scientific, regulatory, financial, or commercialisation experience. They’ve “been there” with clinical trial design, diagnostic validation, bring‐to‐market strategies, scaling manufacturing. Also networks: CROs, regulatory bodies, key opinion leaders, investors.

Driving Quality, Safety, and Innovation
Not just approving the R&D budget, but asking hard questions about lab quality control, validation protocols, patient safety, ethical issues (e.g. in gene therapy). Boards can push the culture of continuous improvement.

What Effective Boards in These Sectors Do Differently

To get full value, boards in healthcare/biotech/diagnostics should aim to:

Have multidisciplinary expertise: Clinical science, regulatory affairs, quality assurance, ethics, finance, commercialisation.

Include non‐executive / independent members, especially with deep experience in relevant regulatory systems (FDA, IVDR, EMA, etc.)

Use data smartly: Real‐time dashboards for things like lab error rates, reproducibility metrics, patient safety signals, diagnostic accuracy measures. Not just financials.

Promote a culture of challenge and curiosity: Not rubber‐stamping. Asking “why?” often, especially when the path seems too comfortable.

Stay current: Emerging tech (e.g. AI diagnostics, digital health, remote monitoring), changing reimbursement models, evolving regulatory/ethical norms.

Prioritise transparency and stakeholder engagement: Clinicians, patients, payers. Lab diagnostics affect many downstream users, biotech products even more so.

Common Pitfalls

Filling a board just with scientific stars but weak in regulation or commercialisation

Overlap between board oversight and management role (losing clarity on who does what)

Boards being passive; not updating themselves or holding management sufficiently accountable

Ignoring non‐technical risks: public perception, health data privacy, bioethics

So… Why Don’t More Startups Have Boards?

Simple. Founders fear loss of control. This was her primary concern. But as I explained, the right board doesn’t take control, they help steer it better. A board isn’t there to tell you how to run your business. They’re there to ask, why are you running in that direction with scissors?

The Bottom Line (Yes, Even for Life Sciences)

A board isn’t just a governance checkbox. In healthcare, diagnostics, biotech, a good board is a strategic asset. It increases your chances of:

Safer, higher quality outputs

Navigating regulatory labyrinths without missteps

Gaining investor trust (especially important in biotech, where funding cycles are long)

Staying nimble in disruption

Protecting patients, reputation, and ultimately, your viability

References

• Bates, T., Ross, A. A., Hickson, G. B. & Zheng, L. (2025) Effective board governance is the key to supercharging quality and safety across the health system. Management in Healthcare, 10(1), pp.6‐19. HSTalks

• Institute for Healthcare Improvement (IHI) Lucian Leape Institute (2018) Framework for Effective Board Governance of Health System Quality. IHI White Paper. ihi.org

• DiamondCut Leadership Network (n.d.) Importance of Leadership and Governance: Driving Improved Patient Outcomes. Diamond Cut Leadersh

• Galvin‑Rowley (2025) Healthcare Board Governance: Why Modern Boards Must Lead. Galvin-Rowley Executive -