Diagnose Before You Prescribe, in Business Too
Before I ever looked at a balance sheet, I learned to look at symptoms. That was the training. An animal comes in and it can't tell you what's wrong, so you're left piecing together evidence: a lab result here, a subtle behavior change there, something in the history that doesn't quite add up. None of it means anything on its own. It's only when you lay the pieces next to each other that a pattern starts to show itself, and that pattern is what points you toward what's actually happening. You don't treat the fever. You treat what's causing the fever.
That habit never left me. It just changed subjects.
Walk into almost any struggling business and watch how decisions actually get made, and you'll see people skip straight past the puzzle-solving part. Revenue is down, so the answer is a marketing push. Cash is tight, so the answer is cut costs across the board. Both can be the right call. They can also be completely useless, because nobody stopped to gather the evidence before deciding on the treatment.
Take revenue and cash flow problems, probably the two most common issues any founder will run into. They get treated as the same problem because they show up looking similar, both feel like "there isn't enough money." But they're rarely caused by the same thing. A revenue problem can come from pricing that's misaligned with the market, a sales process that leaks prospects at a specific stage, or a product that solved yesterday's need and not today's. A cash flow problem can exist even when revenue looks healthy, because the real issue is sitting in collections timing, inventory tied up too long, or payment terms that were negotiated without thinking through the working capital cycle. Treat a collections problem by chasing more sales, and you'll grow your way into a worse cash crunch, not out of one. I've watched that exact mistake happen, and it's the business equivalent of treating the wrong disease and wondering why the patient isn't improving.
Other common startup problems follow the same pattern. A team with high turnover isn't automatically a compensation problem, it might be a management or onboarding issue several steps upstream. Slow growth isn't automatically a marketing problem, it might be a retention problem quietly undoing everything new customer acquisition is bringing in. The symptom tells you where to look. It rarely tells you what to do.
I've applied this same instinct to investing, starting with stocks back in 2013 and later crypto in 2018. Both markets reward people who react fast to headlines and punish people who don't do the diagnostic work first. A stock dropping isn't inherently a signal to sell, and a coin pumping isn't inherently a signal to buy. The question I keep asking is the same one from the clinic: what evidence actually explains this movement, and does that evidence point to something temporary or something structural. Earnings miss versus a broken business model. Regulatory noise versus a genuine flaw in the protocol. Piecing that together before acting has saved me from a lot of decisions I would have made on instinct alone, and crypto in particular punishes instinct-only decisions with brutal efficiency.
The framework, whether it's a patient, a business, or a position in a portfolio, stays roughly the same. Describe the symptom without attaching a story to it yet, just what's observably happening. Trace it backward, asking what would have to be true for this symptom to appear, and keep going until you reach something you can actually verify rather than something that just sounds plausible. Then resist the pull to act until the cause is confirmed, not just suspected. Plausible and confirmed are not the same thing, and that gap is where a lot of money and time gets lost, in medicine, in business, and in markets.
None of this is about moving slowly for its own sake. It's about respecting that the wrong prescription doesn't just fail to help, it costs you the resources you needed to apply the right one, and sometimes it costs you the window in which the right one would have worked at all. The businesses, and the investors, who recover fastest from a real problem are rarely the ones who moved first. They're the ones who did the work to understand what they were actually dealing with before they moved at all.
Diagnose first. The prescription only works if it's for the right disease.