I’m a physician. I really appreciate Tom’s enthusiasm, but I think that enthusiasm led him to overestimate the significance of the problem. Moreover he didn’t really understand for whom he was building this product. At first he thought it would be a consumer product. But he realized that consumers would not pay/subscribe and later learned that advertising wouldn’t work. Next he thought doctors would pay because “Doctors have money, right?” Again paying for this or any service is an expense. Its value has to justify the expense. We pay hundreds of dollars a year for UpToDate because it’s valuable. Cochrane is the gold standard for meta-analyses and they’re publishing for topics that are of clinical significance. Ultimately I doubt anyone is going to change their practice based on this product because there isn’t a compelling reason to do so.
My major observation is that Tom tried to make a healthcare startup with negligible understanding of healthcare: the players, how payments work, how physicians practice, and what patients want/need. By not understanding the environment you’re not going to be able to understand the Problem which means your Solution will probably fail. This is a mistake repeated by most of the engineer founded health startups I’ve read about.
Finally for anyone wondering I usually recommend ibuprofen 800mg every 8 hours and Tylenol 1000mg every 8 hours. This isn’t medical advice, just something you may find from a quick search.
If the COVID-19 pandemic has taught me anything about science, it's that if you do a "meta-analysis" without reading each paper carefully and critically, you can end up proving anything regardless of its veracity. You cannot replace domain-expert scientists spending huge amounts of time painstakingly going over every detail of many papers to weed out mistakes and fraud in order to write a meta-analysis, with a computer program. Well, at least not until we figure out AGI. Until then, it would be irresponsible to rely on such a program for any clinical decisions.
I think the generalised lesson to be learned is that in reducing complexity (and all modelling requires reducing complexity), you get to make decisions about which bits of data are cut out, and this is a decision that can introduce bias. We can't just blindly trust reductions, especially in areas where there are competing interests. This is why transparency is so important! If I can reproduce your methodology, I can critique it for bias.
I agree. And what Tom didn't realize is that Doctors aren't financially incetivized to give better healthcare. There is no money in it for them. If anything, return visits because of a partial prior resolution make more money.
Now clearly I'm not saying that doctors try to give bad diagnoses for profit (because they don't). But beyond a certain minimum bar, and on a purely financial basis, improving diagnostics or prescription accuracy doesn't not make a medical practice more money. And the responses here illustrte that.
Now, whether that's the right/wrong incentive strucgture is a whole 'nother discussion. And I personally can't think of something better than what we currently have - but it is a truth of the current system.
I see this take all the time but it’s kind of misleading. Realistically things like uptodate, clinical journals and conferences mint money. Doctors are one of the prime demographics of people who do things for non monetary gains. Yes if you want to be nihilist you’ll find a minority of docs where this isn’t true, but the point is there’sa huge market to doctors willing to improve care without direct monetary gain.
This startup product failed because it wasn’t shown to improve outcomes— it just compiled study results by a non expert. At the very least the founder should have at least attempted doing a study on the tool showing using it resulted in better outcomes. But it didn’t make that link and so people didn’t know what to do with it.
> Doctors aren't financially incetivized to give better healthcare.
I think that's an overly nihilistic and not entirely accurate viewpoint. Good doctors get more patients through referrals, and once they have enough patients they can be more selective about which patients they take on. And they make more money. Bad doctors will lose trust and patients.
What doctors aren't incentivized to do is provide marginally stronger drugs. If aleve works a little bit better but tylenol is easier on your stomach, then is Aleve really "better"? If you actually need a stronger painkiller you can just up the dose. Medicine is rarely a black and white "best" situation.
He actually received a clue from 'Susan', one of the doctors he demonstrated his application to: "in many cases I’ll just prescribe what I normally do, since I’m comfortable with it"
He should have sold his tool to sales and marketing at pharmaceutical companies who would use it to convince doctors to prescribe their product.
But if you're selling a drug, aren't you going to rely on just the studies that show the efficacy of your product? If your drug _isn't_ the best according to the meta-analyses, this tool is of no help to you. And even if your drug _is_ the best according to the meta-analyses, that's because there are already multiple studies that show how good your drug is, and you can overstate your product's value by throwing out the rest of the studies.
> If anything, return visits because of a partial prior resolution make more money.
I don't know what system you are referring to, but in the EU, for common physician services, this is (fortunately) not how it works. Physicians are by and large being paid per case, not per visit. In Germany a case is being defined as the same patient visiting the same physician in the same quarter of the year (https://www.kbv.de/tools/ebm/html/3.1_1623969609994938562151...)
The financial incentives behind care differ greatly between states and health systems, so you can't just make blanket statements like that. Look up accountable care organizations and value-based care. We're still in our early stages, but our country is trying to figure out how to properly incentivize care, I hope.
your comment makes sense from a layman's perspective of logic and economics. but in the industry you'll find most doctors actually do not want to see patients for revisits and would rather a pill or injection solve the problem in one go. unfortunately due to biology this is rarely the case, and managers/pharma reps/business dev are keen to capitalize on it- not the overworked doctors.
> But beyond a certain minimum bar, and on a purely financial basis, improving diagnostics or prescription accuracy doesn't not make a medical practice more money.
But giving better diagnostics and better prescriptions can result in improved profits if it's marketed in an efficient way. Would you go to a clinic that will give you the best diagnostic and prescription possible or to one where you are unsure about the result?
Some mediocre restaurants in tourist areas are doing well because they are vouched for and have TripAdvisor stickers on their front door. What if clinics had GlacierMD stickers on their front door? To sell GlacierMD to doctors you have first to convince the patients that is something great about it.
Barring that aside, at least the doctors I'm related to would love nothing better than to give better care. I always hear about how they need to stay up on the latest stuff.
For private practitioners, you forget that referral is another source of income. That relies on maintaining good relationships and being seen as competent enough amongst your peers. So there are various avenues for making money, and each private practitioner has different motivations for pursuing those different venues.
Yeah I adopted my confused face from the 'problem' statement/'killer' start-up pitch on. Have a headache and don't know which drug to buy? Come on. You have a headache and you take either acetaminophen or ibuprofen, both of which you already have. You don't buy anything.
I'm not a physician, I just take (rarely anything other than max dose) them per the label, which is different to your suggestion (1g/4h, max 4g/day) at least where I am. Ibuprofen if something seems 'inflamationy' or if I have drunk/will drink alcohol (on some sort of naïve hand-wavy basis to lighten the livery load).
I’m not a doctor but I watched a friend’s startup have the exact same experience. My personal experience was an early job selling online advertising to all categories of businesses. I quickly learned that medical offices are absolutely inundated with salespeople like pharma reps, and doctors time is already scant. Naturally they tend to want to see evidence in a way most other SMB decision makers do not. Since at time, bundled payments have gone into effect and consolidation means that the purchasing process is exponentially more complex.
Startups: don’t sell to medical offices without deep domain experience, deeper pockets, and rigorous evidence.
> By not understanding the environment you’re not going to be able to understand the Problem which means your Solution will probably fail.
Yes it boils down to politics. Having built a platform for accelerating routine histocompatibility analysis (providing customers a profit from the start) I got to see this firsthand. Risk aversion across the industry, small armies of established technicians working manually, administrators making purchasing decisions with no understanding of the science or impact, the myopic insular bent of academics, the massive gap between healthcare and modern technology. One could pay labs to save time, improve outcomes while reducing risk and they still wouldn't use your product if it doesn't map onto their political priorities.
I think this startup would have more of a chance if it was able to solve the Google/trust problem with medical advice.
From my perspective as an ignorant consumer, Googling medical things always leaves me unsatisfied. I get too much mixed advice when I poll multiple websites and my final feeling is that I've learned no new information, there was no clear information winner. Part of that is the SEO spam problem, part of it is not knowing accurate Google words for medical stuff.
I am developing a non invasive diagnosis tool that uses infrared absorption, electrical activity and a few other sensors with machine learning.
As it stands there are some physicians who think it has potential.
I am also using it to identify people which would make it useful in its own right.
My question is, do you think a quick diagnosis tool would be helpful and would someone be prepared to pay something for it?
This was a fun read, but I think it came to the wrong conclusion. The real issue imo was "I had practically only weeks of runway". You just don't have time to make it happen.
As a fellow start up founder, I see most of my job being just buying time for the business. Buying time to make, to talk, and to think.
It wasn't like the tool had no value to Susan, maybe with a booth at her go-to annual expo, mentioning a few past lawsuits the tool could avoid, and an affinity partnership with her industry association, the tool would have become a fact of life for her.
It's a lot of work, I'm not denying that. Yet, this is the sort of thing YC's idealized startup stories often fail to say. If "instant Product Market Fit" is so good, then how come practically every new high flying SV startup is using loads of VC money to "bend the market to the product"?
Exciting Startups have to venture far, it's not about "we let you buy your potatoes online" anymore. Chances are you won't get deals by talking to people once. I wouldn't say that means your idea is bad.
I agree with your comment about the wrong conclusion. Google didn't have a monetization plan, it launched in 1998 and didn't do adwords(ads) until 2000. It's always better to have positive cashflow, however, enough capital lets you have more runway. At the end of the day you do need someone who will pay.
Not that I dislike attorneys but they could have been a client. If you can show that a doctor didn't prescribe the best drug for their malpractice lawsuit it could bring in some money.
It's not 1998 anymore is the thing. It's obviously better to have positive cash flow but unless you come up with something that is that huge of a hit, in a market where people both understand your product, but also there aren't entrenched competitors to squash you, there's a lot of hard work to get to a place where your product is worth something your customers. Which is expensive, in both time and money. Both of which OP didn't have enough of.
You're right that doing a startup is expensive especially when you look at opportunity costs. Google was going up against Microsoft that was killing off competitors to the point it was on the Simpsons. There are many factors and one of them can be luck. I respect anyone who does a start up because it's easy to be a naysayer. I wouldn't have invested in GlacierMD but I wouldn't have invested in SnapChat because I still don't get it.
One thing I did notice is that he was the sole founder. This is the number one mistake according to Paul Graham: http://www.paulgraham.com/startupmistakes.html oddly enough I'm interviewing for a position that is using the same inputs as the OP but with slightly different outputs and we have a corporate buyer lined up.
This is why I don't like health related business models. In a similar scenario, who's stopping Susan from sueing over a "bad" outcome from the platform recommendation. When people's health is on the line, shit can get ugly really fast.
Getting back to the product at hand - there was no value, as much as a minor cost saving.
A semi-reliable recommendation on the medication that Susan could prescribe doesn't save nearly enough money. You should realise that medicines aren't 100% reliable and people acquire tolerances to many medications over a longer run.
Basically this product suffered from the get go - because the person who started it wasn't an SME.
In all honesty, I don’t think the author correctly identified his error. And I think that’s a shame. It’s right here:
> Here I was, living the Silicon Valley dream: making the world a better place through technology.
I don’t know how this has become a thing people believe, however widely it might be believed. But if it’s representative of SV or tech innovation at all, it’s either wildly distorted through a wealthy person’s pet futurism project—or held in the imagination of someone aspiring to that stature. SV is about making money, that’s it, that’s the whole story.
The totally overlapping error here was assuming those things—making the world better, and making money—aren’t inherently in conflict. And overlapping that: assuming that a profit driven health care system has altruistic goals as such, rather than in concert with its profit-driving priorities.
This project could have been successful (and could still do if the author or anyone else wants to pursue it). And it could have been a valuable contribution to society.
The author would probably have realized this error if he’d considered entering a global market where health care has different economic incentives. Programs like this which help people are funded by government contracts and grants, not by payment from arbitrary people acting on their arbitrary interests.
> I don’t think the author correctly identified his error.
This is his error right here:
“It had been a bit of a working assumption of mine over the past few weeks that if you could improve the health of the patients then, you know, the doctors or the hospitals or whatever would pay for that.”
Or this tech founder isn't much of a salesperson. Sellers won't say "So you don’t think this product is useful?" and certainly won't be left speechless as OP was,
> So I’d sorta just be, like, donating this money if I paid you for this thing, right?
>> I had literally nothing to say to that.
There may be a sales angle for the product that he could not find.
Improving patient outcomes is absolutely in the interest of doctors, patients, and hospitals. The question is who to sell it to, and how.
That’s just one facet of the error I pointed out. He repeats the same error in different ways every step of the way. He started with consumers before this point. He may have gone after other incentive-conflicted or fickle revenue sources too if he’d had more runway.
> The totally overlapping error here was assuming those things—making the world better, and making money—aren’t inherently in conflict
They're not in conflict. Competition makes better products. Apple benefited from Microsoft's existence, and vice versa. There's a lot of great free software, but it comes from people who already earned enough to spend time on it.
Better products don’t necessarily make the world better. They often make the world worse. I don’t have a particular chip on my shoulder about Apple, or Microsoft, or free software. There are things I appreciate that all of them produce, and good in the world because of some of those efforts by each. But yes, making the world better and making money are inherently in conflict. That doesn’t mean there isn’t a way to reconcile them acceptably for this endeavor, I even addressed that.
Ugh I have half a mind to post a Wikipedia link, but it’s going to be really upsetting if I play a part in dialectics becoming another inscrutable topic on HN like monads.
> Better products don’t necessarily make the world better.
It depends who you ask. Someone is buying those products. We use money and public opinion to proxy for what we value. Without freedom to use those someone would need to dictate what's valuable.
If money disappeared overnight, a lot of people would die (almost all of them). So, money allows the survival of people. If you are not a misanthropist, then, the world is better with money, since it allows people to live.
Therefore, making money is simply something that must be done to allow the existence of human life. This is not in conflict of making the world better, it's in service of it.
> If money disappeared overnight, a lot of people would die
If asbestos disappeared overnight lot of people would die. I almost made this a list but it would detract from the point. Making something disappear overnight is almost always harmful in any systemic context. There are a lot of things I want to eradicate from existence, and I don’t think I could name one which I would want eradicated overnight.
But I wasn’t even advocating for eliminating money. I was acknowledging a tension between incentives. Please don’t make me elaborate about dialectics. No one will enjoy it.
Let's make this simpler: If money disappeared, a lot of people would die. I don't care how long you make the transition period; even if it's a change spread across 20 years, without a database of resources and how many belong to each person (which is what money is), you aren't going to be able to coordinate people well enough to feed billions of people each day. How would the deletion of the database serve anyone?
You claim that "making the world better and making money are inherently in conflict." My understanding of this sentence is that one cannot make money while making the world better. It follows then that it is bad to be making money, since it makes the world worse. If it is bad to be making money, it would be better to not be doing so. If money is not being made, this is the same as money being eliminated, as it ceases to serve its purpose.
Things can be in conflict without being in combat. Acknowledging that one thing conflicts with another doesn’t mean one must extinguish the other. My whole point was to identify how the two could be reconciled for the purpose of the endeavor, even while still being in conflict. Please tell me where you still don’t understand why I’m not arguing with a strawman argument you keep trying to assign to me.
> Acknowledging that one thing conflicts with another doesn’t mean one must extinguish the other.
Conflict does imply one thing stands opposed to another. I would not agree that making money inherently makes the world a worse place. Rather, the existence of money facilitates trade and makes the world better because it allows us to specialize in our respective trades. If I'm a farmer who raises chickens, money makes it so I don't have to trade for things with chickens.
From where I stand, there isn't a conflict between making money and making the world better. Money is a proxy for what people think makes their world better. And, since what people think is entirely subjective, there may be conflicting ideas about what makes the world better. If I want the city to spend $100k on shareable bicycles and you want it to spend $100k to build a recycling center, who is right? Money does not introduce conflict. Different ideas might.
That is a bizarre distinction, one I’ve never heard of and certainly can’t find any information about “logical combat.” I’d be interested to know where you learned of this dichotomy.
If this semantic issue is the source of the disagreement, what we have here is a failure to communicate.
My goodness there is a wealth of literature specifically available from the link I posted. Counterposing ideas is a basic tenet or philosophy. The tension between them is a fundamental underpinning of the complexity of living in society. It’s a whole world of ideas to explore if you want to. Grab a book if you’re curious.
Money doesn't allow people to live, shelter, food, water and friends are what allows people to live. Do you think that you plant dollar bills in the ground and they grow food?
You can't grow enough food for everyone, house everyone's friends, and keep them alive without money. You could maybe do one of those without money, but at the expense of the other two. The money is a critical part of keeping track of how much of each thing you can do without running out of resources. There are too many resources in the world to keep track of them all in your head.
Money doesn't "keep track of resources." If it did, the Fed would not have been able to create $2 trillion in "Quantitative Easing."
It's an imperfect analogy, but I think dollars are more like inches - useful to measure and compare things, and subject to redefinition at the whims of power. (Imagine a carpenter telling you he can't finish building your bookcase because he's "run out of inches." They are not the things they measure.)
The fact that the underlying number of resources changes dynamically is not related to whether money keeps track of those resources. The quantitative easing is akin to when an OS overcommits memory and starts doling out more memory than actually exists in response to malloc() calls.
This works because people (programs) aren't going to start using the money/memory right away, or even necessarily at all. Yet, it prevents the system from locking up (or crashing). The fact that not that much memory exists doesn't mean that your malloc() call doesn't let you keep track of how much memory you are allocated. You can't just start writing to memory that hasn't been allocated to you, in essence. The memory (and money) put a bounds on what kind of behavior you can do, what kind of resources you can use.
Money doesn't keep track of resources. It is a fake system that has no correlation to how many resources are available to each person, and in fact it is ripe with abuse to hoard resources for those that don't actually need them.
Computer systems and databases are what keeps track of resources, as well as communities. This idea that we should focus on money rather than morals or value is absurd and part of the issue that will end up causing the 2nd fall of rome.
But it does track the relative allocation of resources between all parties, which is all you need to grow food, etc. (and yes, that balance can be changed by printing money, but again, it is simply changing the relative allocations). Communities cannot really keep track of how many plots of land that Corporation X has bought, especially if they are a national establishment buying plots all over the country. You would have to have a distributed mechanism for tracking that, which would somehow involve each district protecting its own data sources very carefully. Luckily, people already carefully guard a data source: dollars. So we don't need this.
Of course we should focus on morals and value. But value is something that cannot be measured accurately using any real world metric, so we only have approximations, of which money is one. As for morals, I'm not sure where you got the idea I said we shouldn't focus on them. One moral I have is that keeping people alive is good, and in the industrialized world, money is the only way to do that, whether you earn it or steal it.
I think the takeaway from the blog post is wrong and comments focusing on building a faster MVP miss the point.
Not everything is a startup. This is a research project - and should be approached that way. There should be donors, a foundation, free access to all participants, reputation-building by writing (& publishing in reputable journals / conferences) studies about its efficacy, a board of doctors actually reviewing & cross-checking recommendations, a doctor-to-doctor helpline, etc.
As the author found out - it's not something people want to buy, but the public. So I think if you approach it from that direction - it might just work.
This was a startup that would have required a 2 year run way to get into the B2B sales of a tricky market.
There was clearly value on the table, working out how to make money form it would have been 80% of the effort, but I suggest there's something there.
He should have given it away for free.
There's a 1000% chance that if all of a sudden, doctors all over the place start using a tool because they think it's useful, and recommend it to their friends, that it would find a way to be successful.
Are there really any significant acquisitions happening just for some database? I don't think this happens unless the data is absolutely massive and very unique.
Yes, and Doctors are the most valuable segment in the world, a bit more than bankers. Because while bankers have $ to spend on consumer stuff, it's a bit hard to target them with financial services. But Doctors are gateway to the entirety of Healthare.
There are companies that specialize in how Drug Sales teams are organized - who to target, what regions. That's 'very valuable'.
Literally just ads for drugs. That's it. If Pfizer had a tool that was used by 10% of Doctors, and literally just slipped in some sponsorship, it'd be worth a fortune.
No doubt everyone involved would be wary of a 'drug recommendation engine owned by a drug company' ... but that could be mitigated. And frankly, some 'bad actors' wouldn't care.
There are ample opportunities.
If I were a VC someone came to me and said 'I have a tool that Doctors really like and 2% are already using it on a weekly basis, and we are growing and this could be 10% or more in the future' ...
... I would just write them a check.
So long as the CEO was not insane, and they looked legit.
It'd be worth a fortune.
That said, it's hard to tell if it's that kind of tool.
That said, my 'spidey sense' says there are big opportunities there because Doctors and Pharmacist are overwhelmed, but it's probably a hard problem, and there must be other participants.
Yeah. Tons of people use Web MD, but its also free. I'm pretty sure I would use glacier MD if given the choice, but if you asked me to pay for it I likely would not.
There is a similar enough service called labdoor. They review protein powders and tell you which one is best. As far as I know it's free and still in business.
The business plan the author came up with here is just bad.
It looks like labdoor makes money through affiliates or letting companies list on the site.
Glacier could have done similar.
It would also work if it included delivery.
If you're sick at home with the flu or a migrain and can get an uber eats style delivery that's already a great product. Couple it with the "science" or "maths" choosing the right product for you and it could have lift off.
I'd love to read a similar article that discussed a wide range of possible business plans.
As it is I'm not sure the author had multiple (or even one??) business plans
Sure, and a faster and less bloaty MVP made in a couple of weeks and subsequently presented in front of customers as soon as possible- would've let the blog author know that their idea was very flawed, so that they could either abandon the idea and/or pivot to a different idea.
yea it's like asking doctors to pay for drug efficacy testing and research. he would have more luck with drug reps and big pharma as clients though with obvious conflicts of interests.
The interesting lesson here is that this could have been avoided, including the building by just going and collecting cash upfront irregardless of who customer was supposed to be.
That's exactly what I was thinking! He couldn't make it viable as a business but it could still be remodeled as a non-profit and make the difference in the world.
The main reason this didn't work is that the founder didn't identify a customer willing to spend money.
A lot of startups fail because they never identify a customer. Or even a problem. This one failed because before writing a line of code the founder did not take the next step and ensure that the prospective customer was willing to spend money on a solution.
This is why so many failing startups try to pivot to two-sided business models like advertising. That's one of the hardest businesses there is to start. And it's what the founder did here, too.
It sounds obvious stated as follows, but every startup failure I've read or heard about fails to get these ducks in a row:
- problem to be solved
- customer who has the problem
- customer willing to spend money to solve the problem
- enough customers willing to spend money on solving the problem to fuel a startup
Oddly enough, many of the startup success stories gloss over these fundamental components. The net result is that there's way too much emphasis on the idea and not nearly enough on the customer.
This is right, but it's also clear why this happens: a lot of the best known success stories from a decade or two ago were "if you build it they will come and you will one day figure out how to make money from that". Google, Facebook, Instagram. It takes awhile for the conventional wisdom borne of a mythology like that to shift. Heck, we're probably in the process of shifting it too far; we may well be lamenting a decade from now that nobody is doing anything besides B2B because it's too hard to find customers who want to pay for things outside that space.
The barrier to entry for advertising was pretty small when Google entered it. They worked hard on pricing models, ads relevance, ads quality, and making it unobtrusive to users (in the beginning). That's what allowed them to gain traction. The barrier to entry in advertising is much higher now, but if you have a standout product (like TikTok) then it's possible to gain enough eyeballs to get you through the initial period with advertising.
Over the last 20 years I've consulted with maybe 30 entrepreneurs, and what I find is that some of them get too caught up in the dream of some day being rich and famous. The ones who are successful are the ones who remain pragmatic and stay focused on what they need to do today. The irony is that, even for the dreamers, all their dreams can come true: they might some day be rich and famous and yet, perhaps paradoxically, the best way to make that happen is to not think about it, and instead stay focused on what you can do for your real customers, right now, today. (At the risk of too much self-promotion, I recently wrote a book, "One on one meetings are underrated; Group meetings waste time" and I devote a long chapter to 2 stories of pragmatic success contrasted with 2 stories of failure due to dreaming.)
Then you'll just end up with samey expensive garbage. People don't know what they want until they're told what they want. It's important to create a society where ideas that have no current market can be developed. This is how the future is made. Not by making it aluminum and jacking up the price.
> People don't know what they want until they're told what they want.
That's not exactly true. This sentence only covers fro value generating products, not cost saving products.
It's easier to sell cost saving product, but the profit margins on those are much lower. As an example in the article - the product is a cost saving product, but the cost it saves is very small.(Finding the right headache medicine is once in a lifetime $1 investment for most, or even less)
When it comes to value generating products - that is where you need someone who can sell their own idea of value to the masses. That is where this sentence starts to make sense.
It is a value generating product, better medicine is more valuable. If a genie popped up and offered to make sure I always got the best medicine available in exchange for $100 I'd give him the money for the improved health.
It's just that I am not sure this random startup guy and his four doctor friends are such a genie.
This is not the "value" you're thinking of. Value of having perfect health is not the same as business value. Valuable medicine isn't the same as a trip to Seychelles - even though both may cost thousands of dollars.
You're also forgetting that medication is almost exclusively a cost issue. Unless you are taking performance enhancing products - other medication is a cost to getting to your "normal". (Even antidepressants exist to get you to a baseline mental state, not to give you extra - that's performance enhancing drugs)
You already give your doctor that $100 and they literally do the research... and other than getting a better doctor, you will not get any better tool.
But back to the reason for the product and it's very clear where the idea came from. Identifying what painkiller you prefer isn't a constant issue neither it is of great value to the vast majority.
Sure, but in order to do that, you need to know how to teach people how to want; and then, you have to be able to do that. NB, those two things generally comprise two different skillsets.
You need a product that is powerful enough to give you the leverage to change deep-seated bits of human psychology.
Henry Ford knew how to do this. So did Jobs.
$0.02. I don't want to discourage anyone from building something and making money on it; just adding on to your comment.
Henry Ford and Steve Jobs can have the mindless market they've created. Adjacent to that, a system that detaches the need for marketing would unlock more human creativity. Why is google so valuable? Because the system is designed to optimize for Google-like local minimums, and not for creativity or the unknown future.
I’m not sure I agree with you about your extra > and will pay for.
People want Reddit, people want FB and Insta. Do they pay for those? I’m not saying those are good or realistic models to follow but I think the scale of your product needs to be taken into account with your statement. ie landing millions of users can forgive the lack of a business plan _at that scale_ whereas a SAAS platform targeting B2B customers should probably require your statement to be true.
Advertisers want eyeballs, and will pay for it on the spot.
People aren't the customers of Reddit/Facebook, they're the product, that's why social media has such negative effect on mental health, the users aren't a concern beyond how many minutes they dump in for advertisers to pay for.
Reddit would be a fairly unique one - it would be hard for anyone to predict a single forum would take over for most other smaller forums. Then again forums in general were already very popular and I bet many made quite a bit from advertising.
Although you're technically correct [1], your objection is a bit tired – in particular because in this context, "customer" clearly meant "target audience for a product". Building something that attracts millions of daily visitors to a website is much harder than selling advertising space on that website.
>landing millions of users can forgive the lack of a business plan _at that scale_
yeah, if your business plan lands millions of users you better have more than $40k ready to fund it. Since most people don't have that at hand it's actually a really problematic plan, because you've got to be able to secure the funding for it right when it starts to hit, if you don't you're done, if you do you might have to do it by giving up too much control, if you won't then you're done.
>>People want Reddit, people want FB and Insta.
I think in OP's case his issue was that his content required funding to keep up to date and his user base couldn't support those costs with ads. With FB, Reddit etc. the end users generate the content.
I've noticed this a lot - I think people are far too quick to take face-to-face positive feedback at, no pun intended, face value.
To me, it seems like a pretty elementary mistake, but I think that oftentimes people are more subconsciously desiring external validation than accurate assessments.
can't remember where I heard this but the advice was basically this: When pitching your idea, and generating excitement, ask for money (or a commitment) on the spot. There's a big difference between saying you'd pay for something, and paying for something.
The flip side is that sometimes it takes awhile to build the perception of value, hence free trials/freemium models. Get people hooked, then ask for $.
There are many ways to be successful (and even more ways to be unsuccessful).
This chimes a lot with what I've seen, and indeed, what I do myself. I had a few friends plough hard-earned money into a really bad start-up idea (basically an inferior pay-walled Wikipedia), and instead of telling them what I really thought of it, I weaselled out saying something bland, non-committal and mildly supportive.
That's true, but it's hard. Many people won't pay for what does not exist. Selling what does not exist is risky. Before it exists, you don't always know, and it's not always easy to produce an MVP people will pay for.
the last 10 years of internet history show however that you can create something that one group wants, which creates value and a product that another group will pay for, they are not necessarily one in the same
To be fair, those "ducks-in-a-row" questions are NOT easy to answer and it's easy for someone to fool themselves with a BS answer. Moreover, there are plenty of ridiculous ideas that someone would never think anybody would "pay for" that make tons of money in spite of themselves.
In the end it's all about taking calculated risks. Should the OP have learned more about the market he was trying to operate in AT SOME POINT before quitting his day job, hiring five "contractors" and writing 200000 lines of code in 9 months? Sure. Was it a worthwhile experience that gave him more wisdom? Hard to say. To be honest I am surprised he only blew 40K, it could have been a lot worse.
Right, even VCs don't know the answers. But the difference between a VC and a founder is that a VC invests in 100 companies not knowing which will succeed, but a founder only is investing in one.
And since VCs make practically all of their returns from that one hypergrowth 1000x company, they can push founders to swing for the fences even though that also makes startups more likely to fail.
For many founders, a 5x return would still be a life altering result, but to most VCs that doesn't really move the needle. It's nicer than 0x of course, but no more than that.
Yes... All things considered, he got away pretty cheap. I know guys who spent most of their life savings and millions of investor money, working on an incredible opportunity that didn't pan out.
Strongly agree! Often ppl don’t even make it to your second criterion.
I was helping a friend’s son start a consumer service business (automating a manual process for postoperative and elder care with a conversation backed by GPT-3). Seemed like a great idea to me. I asked my M.D. mother if she’d use it. Definitely would, and would pay for it if it worked.
If it worked? Uuuh… I asked my mum a different question: if your doctor told you to use this would you? “Definitely not”.
The kid has a dozen people using the MVP. He knew them all of course, or they were the parents of his friends. So I suggested he let me know when he had n people whom he didn’t know using this for more than 30 days.
First n was 50 people, then 25, finally I said just anyone. So far, nope.
The important thing is that the founder (and probably many of us would think similarly) is that even now after it failed they still think there are other reasons it failed and that there was a great idea that failed due to ... technicalities. But as you mention and seems to be widely believed is that this is a bad idea in general, or at the very least not as good as the OP thinks.
That's the fundamental problem of any startup. How can you identify a customer without any product to show them?
You can define the existence of a market. You can know that there exists some customer with money and a problem you can solve. But that's not the same as being able to say, "Hey, wait a couple of years while I implement this thing. I don't suppose you'd be interested in paying up front?"
Every successful startup has that moment of bravery where they commit their own money and hope that the customer still exists, and is actually willing to cough up money rather than continuing to do whatever they had been doing while they waited. Every failed startup had the same moment, only the customer turned out not to be willing to spend the money.
There are obvious cases where they should have known that no customer existed. But there are also a lot of cases where they simply weren't in the right place at the right time. I think it's a nice myth that the business majors tell themselves that they would always have known beforehand, but it seems more like survivorship bias to me.
You really need a very deep understanding of the pain points in the industry. If you're solving a problem that you yourself have, that gives you a higher probability that others in the industry has the exact same problem.
In the startup world, founders have been taught that "success" means things other than making money, such as large "valuations" that are not tied to profit or even revenue.
Another founder "success" is VC or angel funding, or getting on some list ("top founders under 30!") or media coverage.
"Exit" is also a "success" even if the sale is underwater or not worth much.
> You could also say they didnt identify how to make money.
For a time, there was a school of thought that as long as you had incredible growth/usage for your app or service, making money wasn't important because someone would buy you.
I believe the answer rests in offering a solution to a problem that is worth more time than money to solve on one's own, or a new solution that creates more opportunities for a customer to grow their profitability.
Not an MBA or anything, but IMO startups glossing over their early business practices indicates luck rather than hiding good practices. That touches on another big, counterintuitive trap: listening to successful founder’s personal-myth-derived advice on generating success. Important skills attributed to founders— e.g. recognizing opportunity and talent, vision, etc.— are meaningless without simultaneously having the requisite resources and personal/professional circumstances to act. Chance changes our paths in complex, unknowable ways.
It’s probably not psychologically feasible or even useful for them to precisely examine the unearned factors in their or their company’s success, but so many citing ‘hard work’ as the primary factor proves they don’t try. Implying they committed as much, let some hundreds of times more cognitive, emotional, or physical effort, or even as many hours as an NYC line cook aspiring to be a chef, is laughable. Not discounting these folks’ value, but asserting those with less simply have less ambition or work ethic without providing reasonable points of comparison is justification, not reason.
Even the most straightforward occurrences are contingent on many factors. If they wasn’t true, science would br pretty easy. Saying founders heavily discount the importance of luck is different from saying it was entirely random.
What matters is the succession of factors that are in founders or companies control. The objection is that most of Google's success is luck - uncontrollable good fortune. It's precisely the motivation towards gaining fortune that leads to conscientious decision-making in principling the action of one's mind to will the body into organizing itself with others in the future society - positively.
Sure, not just anybody could have founded Google, even if born to mathematics and computer science professors prioritizing their educations and offering enough of a safety net to start a company rather than toil to pay off student loans for their Stanford computer science graduate educations which facilitated a relationship with a professor willing to connect them with Andy Bechtolsheim right at the Internet’s precipice… but it sure did help.
What they did required hard work, intelligence, creativity and discipline to execute... But implying those are the only factors worth considering is garbage. Their circumstances guaranteed they’d be able to reap greater rewards than nearly anybody else for the same output even if google had failed. Just look at the Opportunity Atlas. Do you really think talent is that geographically focused? If you don’t consider their circumstances lucky or don’t think they made much difference, I’m not really sure what else to say.
If Google wasn't a result of massive amount of lucky circumstances, beyond the control of its founders - you'd be able to launch a successful competitor to Google right now and become a billionaire in a few years.
It's actually because Google had predetermined intrinsic value to human beings in filtering through the world wide web which demonstrates one cannot simply launch a competitor without offering substantially significant more value in achieving the same objective.
Yea I agree. You can even be solving a problem in a super amazing way but if there are no customers willing to spend the money for it then you are just making a home project for yourself.
I also see a lot of people fail because they solve a problem that THEY themselves are having but that does not actually happen to a large enough set of people that it translates again to something businesses or individuals will pay for.
Realistically I think the best way to do a startup is being willing to pivot hard and fast and early if necessary or to completely drop a project and move on to something else. If it is a passion project you are doing for yourself that is one thing - if you actually want to start a real business you cannot get caught in the time-already-sunk mentality.
It’s bonkers. I have the opposite problem. I have a live customer (which is an accident, I was sort of doing him a favour), but now I have a waiting list for new paying clients and not enough spare time. I can’t quit my job yet. I’ll get there!
I have a half-baked product in the making for 4 years but never had enough time (and skill) to fully make it, every time I asked potential customers all of them wanted it right away except I could not finish it. Tried to apply for HN to no avail. I just need some investment(500K should do it in one year) to hire one or two developers to help to ship the product really, but I don't know how, which is why I'm back to work full time these days.
Do it in your spare time without burning so much capital. As much as YC wants you to think otherwise, VC money isn't some magical gatekeeper to innovation. Just build.
I'm fairly technical myself, mostly I need someone good at frontend(vuejs), where I need help to design nice UI for the (embedded device) product. I spent my own time learning vuejs but, not as fast as I wanted so far, I am a low level developer coding in c/c++ basically. I have been thinking about hiring a (cheaper) overseas vuejs3 developer for a while using my own money, the reality is that, hiring is more challenging than learning vuejs, so I stuck with the latter, but, it's slow.
Hardware is an order of magnitude (or nine, twelve) more difficult than a software startup. Expensive rev'ing, long turn arounds, supply chain mayhem, overseas production, profits thinner than the paper they are printed on.
The hardware graveyard of kickstarter is chock full of dreamy eyed hardware guys for good reason.
Understood, my model is to buy existing solid hardware in volume based on orders received and load them with my own software(and UI) for certain vertical markets. Making hardware is a totally different market where cash burning is real and fast, small players simply can not afford.
This is why MVP exists. However validation is often needed much earlier. I think a prototype that works visually only, then collecting pre-orders, is the way to go.
As the name implies, the Minimum Viable Product exists as a way to build the least amount necessary to start generating enough revenue to keep the business viable while you expand the scope of the product to realize your full vision. The MVP isn't for proving the market, but rather capturing a small segment of the market to fund expansion into the much larger market. The validation that there is a market should take place before creating the MVP, like you say.
Proving what needs to be proven is the role of the prototype. That can also be an important step on your journey, but the MVP is about building a product that is considered viable. Literally. If you don't yet know what is viable in the market, how could you even begin to build something that is viable? You don't yet know what viable means.
I've had this argument before, from the same side you're coming at it from, and I was wrong.
It's really not about building a viable product in that sense - the Dropbox demo video is the classic example of an MVP that isn't a "product" as such.
The Dropbox demo video was a prototype at best, and probably more accurately thought of as an advertisement. Definitely not a product, let alone a viable one. MVP meaning "something I did to make my business successful" isn't meaningful. The first version of Dropbox that landed into users hands and started to generate revenue could be accurately thought of as an MVP. It didn't do everything imaginable, but did just enough that customers wanted to pay for the service, allowing the business to grow into something more.
> A minimum viable product (MVP) is the most pared down version of a product that can still be released. Product demos, crowdfunding projects and landing pages are all common examples of MVPs.
> I know exactly what you mean, but this is not what Eric Rees means by the term.
Frank Robinson coined the Minimum Viable Product. This is what he had to say about it:
"The MVP is the right-sized product for your company and your customer. It is big enough to cause adoption, satisfaction and sales, but not so big as to be bloated and risky."
Steve Blank is credited with popularizing the term. Here he emphasizes that the MVP is about reaching sustainability for the company. What he calls an 'MVP tree', which produces potential MVP candidates, may be closer to what we're discussing here.
"An MVP tree is a way of methodically breaking your mission into smaller components and formulating MVP candidates that may get your company sustainable and scalable."
Ries, whoever he is, was free to make up his own definition, just as I can define the sky to be the hot molten lava deep inside the earth, but his definition does not match the usage of its originator nor is it in alignment with how (most) everyone else uses the term.
> Ries, whoever he is, was free to make up his own definition, just as I can define the sky to be the hot molten lava deep inside the earth, but his definition does not match the usage of its originator nor is it in alignment with how (most) everyone else uses the term.
It would be very at odds with the current use of the term MVP to define what dropbox did as not an MVP.
This isn't becoming hugely productive, so I'll leave it where I started - I've had this argument before from your side, and the dropbox video is an MVP. It is not a niche view.
My understanding of Flexport’s journey is the same as this. Ryan had insight into the fact that shipping stuff across the globe is difficult from his previous businesses. He created a landing page offering to import shipments into the U.S., first shipment free, and had a couple major signups. He had someone build him a prototype and he continued to validate his idea while he waited for an import license. Flexport did all 4 MVP steps listed above, but they also identified and established a moat early on.
His enthusiasm overtook everything. He felt the pain, rushed/designed a solution and everything. But he never followed the money trail. I felt like this was a glaring omission.
Another consideration is you consider : your solution, the end-consumer , and stop there ... and if you forget there's a middle-man (the doctor in this case) thats a miss too.. Middle-persons always complicate the situation.
OK, how about a startup that built something that was better for a completely solved problem on the web?
They had no idea at all how they'd make money but there was a significant cost building and running the product.
Yet VC's had no problem funding this moonshot startup. Then another startup invented a solution that could allow them to monetize. Only problem was that it was very controversial and there were dozens of blog articles criticizing the idea. But they adopted it anyway and found incredible success.
That company if you haven't already recognized it was Google. Anytime you try and take your experience and generalize it across all startups you would be wrong.
somewhat implicit in "customer willing to spend money to solve the problem" is: are they willing to spend time to solve the problem right now (integrating your software into their application, migrating to your app, etc). Often times customers will have the problem you can solve, but it's far down on their list of priorities.
before spending $40k and his own time he should have made a mockup of the software invested just a few hundred bucks in interviews with his intended customers, would have found out quite soon that it had no product-market fit
You can do user testing, you can call up people in the industries and ask them, you can do a Kickstarter and spend a little on advertising it to see if it gets any traction, but mostly the reaching out to people in the target market and compensating them for a user interview
I built a very niche monitoring product for sysadmins. Actually I built it for myself three years ago, but I want to explore if others would pay for it.
If you are in the space, or anyone else who reads this I'd be grateful to receive some feedback on a 10 minute video call.
Feels like a failure of business model imagination or just not enough runway to try something different to me. OP didn't even take three swings at bat.
It's not the sexiest market if you're looking to win a Nobel prize (lol) but insurance companies seems like a potential customer with a large financial incentive...
I mean I guess it wasn't really that "fantastic" of an idea, but that aside it feels like OP was lacking imagination in terms of the addressable market. He tried the two markets with the most obvious business model -- consumers and doctors.
But if consumers weren't going to work because the advertising revenue wasn't lucrative enough, and doctors weren't willing to pay for the solution, then it's time to get creative.
What about insurance companies? Insurance companies have a vested interest in picking the right drug because they are on the hook if the outcome isn't good. Or what about the pharmaceutical companies themselves? Would they pay for the data for use in their own marketing campaigns much like "4 out of 5 dentists agree"?
TLDR; OP went all in on two obvious markets but didn't think out of the box in terms of who might be willing to pay for his product.
I always feel discomfort when this gets parroted. It's clearly not true, unless you're willing to shift the definitions of "idea" and "execution" around after-the-fact.
Indeed the article comes to the conclusion that the idea is near-impossible to execute – due to realities within the business domain of healthcare. If the idea was "nothing", good execution could've fixed it.
Well, in this case, it was the "brilliant" idea they thought it was. At first, they thought end users would pay but never even stopped to think about what they would pay to be recommended Aleve over Advil, (probably $0.00). Secondly, they thought Drs (providers) would be key but then were somehow dumb founded that they wouldn't pay for this service because it doesn't really solve a problem they have in the current fee-for-service model. Now, there are companies that plug into EMRs that do medication reconciliation (MedRec) that help look for conflicting medicines and tracking patients current med and compliance, etc. There are lots of players and they need a way to differentiate. They mostly all have very similar offerings. THIS is who wants want the person was making. Additionally, they could probably get the pharma companies to give them the clinical data so that their more effective medicine shows up higher in the list when meds are suggested. So, yes, I think execution could have fixed this. But they were selling to the wrong person because they don't have any background in healthcare and didn't hire a consultant who did before they hired 5 contractors to make a website and database.
Yeah, not disagreeing. But the way I interpret the conclusion of this story, is that this wasn't a particularly startup friendly idea. I'm sure it's somewhat salvagable with the right strategy.
My greater point is that ideas set the boundaries for what's possible in execution, which in turn means ideas are critical. If they were unimportant a shit idea would have little impact on the outcome, which is clearly not true. They could still be "overrated" though, but then we should use that language.
That's fair. The place most people are coming from when they start a business is usually that their idea is "brilliant" or "world-changing". Some ideas are better than others and most aren't as good as people think they are. Yet, even if the idea is actually brilliant, it doesn't matter at all without execution. Even the brilliant ideas will eventually change quite a lot during the execution of product / market fit to find those first few customers who will actually pay you money. People would be best served by convincing the first customer to buy something that actually doesn't even work and is just a webflow of what could be. Ask them what they want changed and promise to do that and then and only then starting making what they have agreed to buy.
Yes, my original post was not verbose, but I think people are better served by hanging signs all over their start-up that say what I wrote. Ideas are fun, ideas are hopeful, ideas can be magic, ideas can fill your heart but success comes from out-working everyone else. I have several truly great company ideas but I've never started them because I know in my heart that I don't want to go do all the work required to make it success.
The founder pitched a great idea at the start – help consumers who don't know what kinds of common drugs to buy at the store, but then immediately pivoted to selling the service to doctors and medical practices. They should have realized that the second one would be impossible to break into.
> But then I look at WebMD’s 10-Qs and start to spiral. Turns out the world’s biggest health website makes about $0.50/year per user. That is…not enough money to bootstrap GlacierMD. I’m pouring money into my rent, into my Egyptian contractors, into AWS—I need some cash soon.
The take away here should have been not to pivot entirely, but raise money. You are in Silicon Valley! This is literally why this entire ecosystem exists. Sometimes bootstrapping can be beneficial, but when you have spent $40K of your money, have a good enough prototype with a clear story, and are going up against giant established competitors, forget customers for a while and sell to VCs instead.
If you are really sure that the service adds value for doctors, give it to them for free for a year and prove it. Open up your service for users without worrying about AWS bills or ad revenue. A boatload of money in the bank makes all of this trivial.
You're not wrong at all, but this line at the end really stuck out to me:
> If I’d articulated at the beginning how I expected to extract value from GlacierMD, maybe I would’ve researched the economics of an ad-based model, or I would’ve validated that doctors were willing to pay, or hospitals, or insurance companies.
The impression I got was this failure was induced by a complete lack of planning. It looks like the author had an idea, got some positive feedback, then drove the entire project based on random inputs they got from people. At no point do they talk about sitting down and doing the boring stuff. Like feasibility analysis, market studies, and developing a very, very basic concept of where the money will come from. The fact that the project had to fail before they realized they didn't think of how to monetize it is... baffling. That should be the one of first things you consider when trying to start a business: how will it make money?
> They should have realized that the second one would be impossible to break into
Why is that impossible? I had a long time idea of making a software for doctors in my country, it's not in Silicon Valley, everyone here use cash and it's hard to keep up with how many visitors they have or patient history (everything is stored in paper), my idea is to make a website for them, i can see how hard it would be to sell this but will it be impossible?
Software for scheduling, accounting, payments – sure. He was trying to sell a service which would suggest medical advice for doctors to give to their patients.
Like the last time this was posted, OP didn't have the right co-founder who could sell this. Drug Formulary management is a legitimate problem and a business, currently someone pays a pharmacist 6 figures to present and clean drug study data to hospitals and insurance companies who decide what to include/exclude from their drug formularies.
The work flow currently is Drug A comes to market with expense X, it is competing with older Drug B with expense Y. There are no head to head trials, but an expert (usually a pharmacist) can reach solid benefit/harm conclusions. That pharmacist writes up a nice summary with a recommendation and present to a committee made up of other experts (usually doctors w/ academic background). They discuss and come to a formulary decision for the whole hospital.
In insurance companies, some background financial shady stuff can take place (kickback schemes) that influence this process, but some form of honest data analysis takes place anyway.
I used to do this for a while, it can work. Just have to convince the right people that your software would be better than the pharmacist. The market incentives doesn't really encourage that kind of automation/savings, so it will be an uphill battle that need experienced sales folks and good VC money.
My first thought was "you know who would want this? Insurance companies!"
Doctor have a moral incentive -- often a strong one! -- to maximize your health, but they actually don't have the economic incentive to keep you healthy. Their incentives are similar to those of drug companies.
But insurance companies want you to need as little care as possible. They are the ones who will sponsor your checkups, may encourage you to exercise, etc. They also tend to have some sway over healthcare providers, or at least an ability to offer helpful information. And they have loads of money. Your operational costs should be peanuts to them. My insurance company (in Europe) offer me a free hotline of 24/7 medical workers for asking minor health questions, because they want to make sure I stay healthy, and the operational cost of that staff is probably way beyond what you need. Abd private insurance companies compete on customer features, so it could actually be a selling point for them to lock up customers, who tend to stick around for a long time.
I realize I'm a total armchair advisor here and what the hell do I know. But reading how this person approached potential customers I kept thinking "oh man I wonder what will happen when he talks to the insurance companies, why would they not be interested?"
>But insurance companies want you to need as little care as possible.
Sadly this isn't true. Regulated insurance companies that must pay out a minimum percentage of premiums (in other words their profits are limited by cost plus pricing) don't care if prices stay down. They only care about stability and no surprises in a given year and are okay with prices continuing to go up and up and up.
*Amount of care and prices/costs are not exactly the same thing but they are highly correlated.
i am not sure if this is true from incentive pov. Insurance would love to tuck in as much premium as possible, and if it comes at greater cost for care, be it.
Can you apply that to all kinds of medication, is this is a lot of more work or can you plug it in or let a student do the data entry?
It will take a while to gain traction, but if you go to conferences, add more kinds of medications, establish a brand and gain reputation, this could be very successful. The contribution to modern medicine is invaluable.
How many big kinds of medications are there? For the Top20 most common cancers, IBS, Neuropathy, acne, MS, heart disease, hypertension, arthritis and you've got most of the big ones covered. You can also add beauty treatments such as hair loss, skin rejuvenation and you are already in the beauty sector with much lower barriers to entry.
Might be a couple of months of data entry but then you would have this invaluable neural net no?
I wouldn't work on this full-time, but sending out emails here and there, developing it further here and there could be quite fruitful with a very good time spent/impact ratio.
i feel like it's something that, on its own isn't worth much, but could be sold to a group like goodrx or webmd or something like that for a decent payout.
This was an easy pivot away from being a runaway success. The founder couldn't figure out who the right customer was and ran out of cash. This is why so many companies are venture backed. It's not that people just want to give away pieces of their company because it's cool, but that extra cash prevents you from giving up while you go through the sometimes long process of finding product market fit.
Like honestly, this product could still reach that type of success. No idea if this guy still has the code base around, or is chilling in thread, but hit me up if so lol, I'll happily buy it off you. Or at least point you towards how to make this make money
Can someone provide an example of where this would provide value? I'm not sure I understand.
The examples I see in the article (picking the 'best' pain medication or antidepressant) aren't all that interesting to me. Like, of course naproxen wins, it has the longest half life of all of the listed medications...and the comparison of SSRI are well known at this point. I find it hard to believe that a board certified psychiatrist (Susan) wouldn't know which medication has better efficacy in which scenarios.
Perhaps this is meant for providers that don't understand the pharmacology and evidence behind the drugs they're prescribing. If that's the case, maybe we should be asking ourselves if we should be the ones prescribing that medication or if a specialist should.
And maybe it can elucidate useful findings quicker than academia, but I doubt by much. And funnily enough, there are already tools that exist to make meta-analyses and systematic reviews a lot quicker than they used to be.
>I find it hard to believe that a board certified psychiatrist (Susan) wouldn't know which medication has better efficacy in which scenarios.
The field of medicine is constantly changing with new drugs and studies coming out all of the time. So no Susan might not know that and if she does she learned the new information from somewhere.
The problem that the guy in TFA has is that the business he wants to build already exists. Uptodate provides phsyician references, Cochrane does a lot of meta/review studies, and I'm sure there's others.
Thank you for trying this, and even more for writing it up.
People talk about bad startups that do happen, but not nearly enough about good ones that don’t. We should be at least as outraged at the systems that quietly steal what could have been.
I swear there was a story like this 7-8 years ago on HN where a young fella had tried to barge his way into big pharma via data science. As I recall, he had his lunch eaten and his spirit beaten, just like this one.
I remember thinking about how sad it is that companies could succeed, or fail, off the basis of good, or bad, marketing.
There's a weird effect where data-driven decision making becomes essentially unstoppable given a big enough sized company, and it essentially condemns companies small enough when they believe that their decision making and technical prowess alone can earn them respectful competition against the "big boys."
And then they find out everything is corrupt, everything is about money, they don't have nearly enough money for the real players to even stop laughing at them for a moment, and they quit and cut their losses.
US healthcare is honestly a big fat joke right now. If we had gotten rid of this private payer situation a long time ago, many of the parasites would have just died off. It truly is a system of how much we can steal from the taxpayer/patient rather than actually providing healthcare.
As developers we often confuse "startup idea" with "solution to a problem". A fantastic startup idea includes a way to monetize the idea. Without a way to monetize the idea, it's a feature.
Sometimes it is simple - make a piece of software so valuable, businesses or consumer are willing to pay money for it. Sometimes you have to be more creative. For example, Brex makes software for managing business credit cards. It's handy, but I'm not sure I would pay for it. But the Brex model takes a cut of credit card processing fees, so they can give their product away for free.
In this case you could target consumers and give it away for free, then when someone wants a prescription for a medicine they found on your site, you can "recommend" local doctors. Doctors will pay a lot for the patient leads.
"What's relieving pain the most" is just not the right question. Ibuprofen for example has more severe side effects, especially when used often, than aspirin.
Also other factors apply, because a "headache" is really a rather complicated phenomenon...
It's not clear at all that the founder had any understanding, beyond the most basic, of the market they were entering. You don't have to start out with a path to monetizing a business -- but if you don't understand the possibilities that you're opening up for yourself, then the odds of success go way down.
Once money was desperately needed...the response was to cold call small doctors offices? That, clearly, shows the deep lack of understanding of the market for this type of product.
I loved story. And you wanna know what? I like people with a pulse. The guy tried something out. He took a chance. He tried to make his own luck. And you co-re-discovered some foundational truths along the way that the experience has made more immediate and penetrating for him. Which helps us/me because he can convey it with conviction.
I wanted to riff of a couple of points:
'“Yeah okay that’s great but nobody cares about this math crap. You need doctors.” Goddamnit he was right. If nobody could be bothered with the math, then I was no better than Gwyneth Paltrow hawking vagina eggs. To build trust I needed to get endorsements from trustworthy people.'
This slightly miscommunicates how it works; it's even more annoying. True you need the people usually first. But one day it will come down to math/science. And if you don't have that right the same people will roll their eyes at that too even if they can't spell math.
And "Occasionally I like to disconnect from the IV drip of internet pseudoknowledge and learn stuff from books. I know, it’s weird—maybe even a bit hipster. But recently I read Wharton’s introductory marketing textbook, Strategic Marketing Management."
I'm sending this in from the engineering cheerleading club: Never apologize or down play reading (a book) or writing. It's good! The other side doesn't get it? That's why you need a pulse so not to care about such things.
In the alternative? Get a 12-pack and re-watch the 'Breakfast Club' with the other side. In the end we all play more than one roles and we all could use help on the way.
Surprised to see this pop up again. Last time it came up, it prompted me to jot down my thoughts. Basically he built the wrong product but never came to that realization even in the post mortem (https://satyam.substack.com/p/why-glaciermd-actually-wasted-...).
What about the right congressman? Find whichever one's constituents are most likely to vote based on health related legislation, and try to suggest they get it adopted by a government agency. Through political ads people can see they immediately support the idea, visit the platform as-is, and that will influence their vote. Even if legislation doesn't ultimately get through that's still a lot of attention. Goes for any elected position whether it be federal, state, or even some smaller board of some kind. Pitching voter influence is a much stronger drive than simply suggesting people pay for something.
Mismatch of incentives I think. Insurance companies and drug companies may not be interested in evidence-based selection. I suspect they would prefer biased results i.e. insurance would want the cheapest and deug companies would want the most revenue generating. Neither may be the optimal choice for the patient.
Yeah, but if his tool showed – hypothetically – that in 75% of cases the generic (or just the cheaper medication) was just as good or better, that seems like it would have been a slam dunk?
- Invest (a lot of) capital to develop the product, make data more readable, refine the UX etc
- Invest (a lot of) capital to market the service to doctors, offering it for free to them, with the angle of improving their patient outcome
- Invest (a lot of) capital to market the service to patient, offering it for free to them, with the angle of letting them check what their doctors are doing
Once everyone is using it and it becomes the de-facto source :
- Market that to drug companies, asking for (a metric ton of) capital to "better manage your product reputation". Magically, the "better managed drugs" suddenly are shown under a better light than the others.
He got lucky, he only wasted $40k. Some people waste some of the best years of their lives chasing startup ideas, paying huge opportunity costs and retarding their progress in life. He got off cheap.
I read this when it was originally written. I have since founded and failed at a startup. Throughout that experience, I thought about this article.
I don't even think "have a business plan" is the takeaway, because no plan survives first contact with the market. All business plans are built on the assumption that people want what you're currently building.
To me, the takeaway is you need a good 2-3 year runway for startups today. Maybe it only took a year to find PMF a decade ago, but it's much harder now. "The digital X" isn't enough. "X for mobile" isn't enough. "Uber for X" isn't enough. I think this is why web3 is partly as big as it is. It's very easy to say "X on blockchain" and get money for it.
You need to have a strong idea of the community you're serving, and those communities are becoming more and more nuanced. Once you find it, it'll take you a fair amount of time to win it over.
I could not help the feeling he was selling to the wrong people? Shouldn't this product be sold to Healthcare providers instead of doctors? The providers have an actual interest of reducing doctor trips, cost of treatments and this type of hard optimization. Heck, someone got to sell step-counting-bracelets to health care providers.
Possibly a lot of the 40k went into branding and other fluff, but something in the core engine might have intrinsic value even if its extrinsic value wasn't properly realised or couldn't find a place in the market as a standalone product.
It would be nice if there were some kind of universal project "retirement home" where these sorts of things could go to pasture, caretakers could prod at the idea and pull it apart, find the intrinsic value if any, and integrate the guts of it into some broader universal API. Such a platform of trinkets that solve tiny everyday problems that individually have little value might actually be useful in any sort of recommendation engine. API calls could be metered so the original creators of each piece get some kind of return however small.
Give me 40k and some failed IPs to play with and I'll deliver a prototype in a few months...
I'd like to discuss one of the problems the author encountered on its own. Here a doctor was presented with a tool that would allow them to prescribe better treatments to her patients, but there was no incentive for her to adopt that tool.
How could we change medicine so that such tools could be adopted? Patients probably won't individually notice any difference, and they don't control what they pay. Insurance companies might be motivated to provide something like this to doctors under the theory that better results are probably cheaper in the long term. A single payer system might perhaps provide certain solutions to doctors and hospitals in various manners, but adopting novel stuff like this from small shops might become effectively impossible. What models would allow for an inventor inventing something like this?
You don't need a single payer system for this. We have a solution today via quality metrics. There are a number of quality metrics from places such as NCQA. They attach performance in these metrics to payments (or penalties). ACO's are one example.
Interesting. I'm unfamiliar with quality metrics. Do they affect individual doctors? Say this one doctor's patients tend to recover from colds 50% faster or slower than other doctors. Does this affect her practice in any way?
Here's another way to classify this mistake. Usually, engineers first get good at "technology". Then they learn to get good at "product". Somewhere in their careers, they learn about "distribution". And then they invariable wish they had learned these lessons in the reverse order: Start with the distribution opportunity, devise a product around that opportunity, and as a last resort, some times, you need some tech to build that product.
I find the distribution->product->tech pipeline a more constructive way to think about building a business than "product-market fit", or "starting from a pain point". And it's a lot more productive than the reverse tech->product->distribution pipeline.
Actually I was surprised when I read: "Make something people want. [...] The idea is that if you build something truly awesome, you'll figure out a way to make money off of it." That sounds to me like he got it backwards. Instead of building something that people want, he built something that was truly awesome. And I think that's the problem. When all those people encouraged him, I think he misinterpreted their enthusiasm at his awesome idea for a "want".
Either way, I think for all the shortcomings and faults the VC and accelerator world has, this is a good example of a mistake that's much more easily avoided when following a proper development plan for your startup.
I'm glad he didn't succeed. Because prescribing medication to patients (who might suffer from a serious illness) should be based on years of learning, carefully vetted information from medical peers, judicious thinking from the doctor and not some statistic models which can analyze dubious quality data.
What if your model has small errors? What if the data is wrong? What if the data is good but people you've payed cheaply to enter it in the database did some small mistakes? It's not like we are dealing with consumer goods, where small mistakes might not be so important. We are dealing with people lives and health, where any kind of mistake should not be tolerated.
This is exactly the kind of project a google employee would do with their 20% free time. It would also fit perfectly with the hundreds of custom search options in google search. But that is it. It doesn’t fit as a business by itself. Google has spoiled our brains into thinking anything that sustains user interest is a business. It’s valuable to google not for us!
It also doesn’t scale well as more papers come out they need more consultants to populate the database with it. So one option for OP was to sell to google but I dont think it scales well enough for them to buy either.
On a sidenote I really had to smirk when I read "painkillers". So american!
But let's stay on track: The thing with painkillers is that they are not really predictable (so I don't wonder that he failed). Even if a study suggests that a certain kind of medicine might help better, this doesn't mean anything. It especially does not mean, that the painkiller will help me.
I've tried a lot of them, based on recommendations from the doctor, from the internet, from the pharmacist. In the end I found one agent that really helps me and I sticked with that.
I also smirked at the 40,000 USD figure. Some people has bills bigger than that for staying at a hospital a few days, in other country they could have financed a startup.
there was a huge huge problem with his startup, and it wasn't the economic model but the fact he was providing medical advice without any medical expertise. I don't know if it's allowed in the US, but it's at least ethically troublesome.
And I guess the doctors had no reason to use a service made by a guy without expertise, the data coming from some outsourced workers without any third party validation (no putting the face of few doctors isn't a validation).
It is entirely possible to provide analysis without crossing the line into giving advice: Eg. "Drug A works for more patients in your demographic¹, Drug B has fewer and milder side effects²."
You built something that competes with doctors, not compliments them. If the medical industry was unregulated, you could pair this with a prescription service and make an automated online doctor's office.
You're unfortunately dealing with an unfree market, which is why the psychiatrist tended to her nails instead of shitting her pants when you revealed tech that could potentially make her obsolete.
You know what would make this less of a waste? Release the source (whatever is reasonable without leaking sensitive information) under a permissive license.
It could potentially provide tremendous value for someone else solving for an overlapping problem - and strengthen the recognition of the author. There are no requirements to give a single second of your time to it after that. Just dump it on some free place online. No need to provide contact details, if you prefer not to. Maybe someone will eventually rummage through the dump, find it and appreciate it, maybe not. Maybe someone will figure out a way to use parts or insights from it into a crowdsourced public good which does not rely on VCs, ads, or paying customers.
There are countless valuable learnings that are lost when founders abandon their projects and just wipe their efforts from the earth.
Imagine how much further and faster we could progress as a species if there was a culture to release your abandoned projects like that.
I've also spent a lot of time on a side project (gravametrics.com). I never spent $40k on it but I've instead done everything myself and it appears to be a non-starter.
I think you need something with a very concise value prop I'm working on that for my next thing right now. Something simple.
FYI don't use AWS for these sorts of projects use something cheaper.
For cost-effective startup/small scale infra, I love this method:
- get a dedicated or colocated server (can be cheaper than you think... e.g. mini PC colo with endoffice, joe's datacenter, etc.)
- install microk8s on ubuntu LTS
- write yaml files and deploy to microk8s
The main benefit of this is that infrastructure is very cost effective for early stage projects. Once the project needs something bigger, all of the infra is encoded in the k8s yaml files and can be deployed to a "real" k8s cluster.
Of course, the yaml needs to be carefully written and made as portable as possible so that it can be deployed to other clusters in the future.
Backup of state can be as simple as using HostPath volumes for state, and running syncthing as a deployment.
Run syncthing on other hosts (e.g. your home machine/laptop, some other cloud node, etc.) and state will be synced in realtime. Syncthing has options for keeping older versions of files/directories, so it's reasonably protected in the case the server gets hacked or deleted by accident.
This is not perfect, of course, but it's a very pragmatic and cost-effective approach. I've used/am using it and am very happy with the end result. I use cert manager, let'sencrypt, and wildcard DNS so that I can deploy new apps with their own TLS endpoints just by deploying a bit of yaml.
I used Scaleway. They don't offer the hyperscale that AWS does but you don't need that for a side project. Just get started then if you suddenly have 100,000 users then switch to something like AWS. Also there are no hidden costs it's like $2 a month for a tiny little server to get you started.
I'm definitely in the minority here, but I'd probably have paid up to $15/month for access to this. I care very strongly about picking something that will be maximally effective when buying OTC or talking to doctors about trying specific medication.
Is there any chance of the remaining data and possibly code being released/sold?
I signup, search a product and a day/week later get a mail "Did X Help? If so, care to donate a few dollar for the info we generated for you? If not, try Y, 7 studies have shown it works better than X in some cases."
1) Things that help people make money are 100x more valuable, i.e. something that helps the Docs generate more revenue.
2) This was insulting: "So I’d sorta just be, like, donating this money if I paid you for this thing, right"
Seriously a professional talking about a 'donation' if it didn't actually increase her revenue? What a jerk. "I care about my patients but in the end I just give them Zoloft!" I mean that might say a lot about that line of work.
That said, I think they might actually use it, if it's institutionalized - i.e. they use it Med School, doctors everywhere use it, two doctors 'unsure' about something both check it etc. it becomes 'something needed' at the office and everyone is expected to have it.
I suspect there's opportunity there, it's just take some time and structuring.
There are already other resources which we (I’m an MD) already pay for and use to help make decisions when there is ambiguity about the best course of action. UpToDate was previously mentioned and it’s something we pay hundreds of dollars a year for (unless our hospital has a subscription). You’re not wrong about introducing these tools to medical students but the value needs to be there because it’s actually a very crowded space.
Yes, the Elephant in the Room was how crowded this space ought to be.
That said, Healthcare is 17% of the Economy and it's growing. There are lots of different spaces for lots of different things.
Insurers want risk mitigation, researchers want data, MDs desperately want help, Pharmacies want automation and a bit of oversight, drug companies want ad/sales potential etc..
Like others below have said, this seems like the absolute wrong conclusions to come to. Someone else mentioned he didn't have enough runway and that's what it feels like to me, too. Someone close to me has terrible migraines and has spent years trying to figure out how to treat them to no avail. If this tool could have shown me data that would have helped the person I love, I would have paid a lot of money for it.
I have no idea what kind of marketing he did and for exactly how long, but it feels like there's a lot of people, organizations, and companies that could have been interested here beyond a few doctors in SF. Like, not to put too fine a point on it, but how many disabled people did he talk to? How many industry groups (American Lung Association, etc.)?
If you don't have any legal hurdles you should consider making it open source or running a freemium version (limited by number of patients, medications, class/popularity of medication, etc.). I could imagine a few doctors and armature researchers using it and perhaps a small could be converted to paying $10/month. At $10/month you only need ~350 people to pay a years subscription to break even depending. Certainly depends on how more development is needed and what the operating costs look like.
Another option is to augment the product to allow consumers to track their existing medications. Using their demographic data + current prescriptions, you could then used their self reported drug efficacy to recommend possible alternatives.
I remember reading this story at the time (2020) and wondering if the project was released on Github in the public sphere at least as some positive net benefit of all the work that was invested. To me going into a risk environment like this you have to think, well at least if it all goes wrong then there will be this new body of knowledge available that wasn't there before so all your hard earned blood sweat tears and treasure won't just evaporate in to thin air. Not sure what this guy did but I hope e was something!
As a tiny little start up, dumping 40k on product development is (to me) a significant chunk of change. I do wonder if the author could've pulled in the MVP, tightened up the release cycles, before discovering that he was unable to "Make something people want".
My one question there would be was he certain he could figure out the statistics to get to what he wanted? I feel like you need to get a rough idea of that much at least before you start pitching. Obviously you don't need every bell and whistle, all the data pipelines and so on. But basic proof would still be good to make sure you can deliver something vaguely in tune with what you're promising. But dropping all that money on contractors before you've done any REAL market research is wild to me.
> was he certain he could figure out the statistics... I feel like you need to get a rough idea of that much at least before you start pitching.
I disagree. The latter is a huge investment. You're not burning any bridges by asking if something would be useful even if you don't know if you can do it yet.
Of course even this is a wrong framing. Ideally he'd actually have sold the idea, by which I mean have actually taken money for the idea, before building it.
Then, if he couldn't build it, he could give the money back.
This founder is obviously book smart, but street stupid. I can't imagine any other outcome here. The fact they wasted 40k on this is amazing to me. If they had been forced to raise that money, maybe they would have been forced to answer the important questions first.
> So I built something people wanted. Consumers wanted it, doctors wanted it, I wanted it. Where did I go wrong?
You wanted to sell to practitioners directly. Your market is suppliers. They are in the position to sell it to doctors by the thousands for next to nothing.
Given that it is actually possible to implement this idea, I imagine medicine professionals would appreciate it, and there should be enough to make his startup viable.
When talking to doctors, he's not selling his idea or service - he has to first sell his own credibility, and then the credibility of his service. He is claiming that the intended/unintended effects of medicines can be coded into a big searchable table, that his "contractors" have done this, and his service is now usable and valuable.
This too bold a claim, especially from "some random guy". That's why none of the doctors were interested.
In his blog post, he's assuming his product actually has value, but somehow has opposing stakeholders.
Not just 40k, also the opportunity cost of the time spent on the startup, which is more than $30k/mo in lost income. so $40k + $270k (9 mo, estimated) = $310k lost
Not saying it wasn't worth it. People should take risks. Just be sure to fully account for them.
I loved reading the story, but it sounds like the founder targeted the wrong customer.
Individual doctors are not the customer. When the incentive for the customer doesn't outweigh the investment, that's when you need to scale up the customer.
The customer for this product is a business that deals with tens or hundreds of thousands of patients: health insurance companies, government healthcare purchasing departments (large market outside the USA), the sales department at the drug companies themselves, etc. These companies are all incentivized by getting better treatments for their patients because that either lowers their costs, or sells more of their drugs (when they're the best option).
I wonder if he could have made money working with the marketing depts of various drug companies instead of trying to sell stuff to the doctors. Especially if he added the right visuals the ad depts could use in commercials/print ads/etc.
One thing I don't understand: he said he 'bought clinical trials'. What does that mean?
Imho, the main thing that prevented this product from being useful was the lack of evidence that using it actually improves treatment outcomes compared to what doctors/patients already do. If he could have pointed to studies showing this, the doctors might have reacted differently. Even better, if he could have used his fancy statistics to create personalized recommendations and then demonstrated that they improve outcomes, he might have been on to something. The current tool was optimizing for the average patient, but nowadays we want personalized medicine.
> We worked at a startup that leveraged autonomous blockchains to transfer money from naïve investors to slightly less naïve twenty-somethings. There are worse gigs.
... are there? I mean, I guess you got paid handsomely, but still. Leaving that aside there aren't many tech jobs I would be ashamed of having more than that one.
Anyways, I wouldn't pay for this as I love doing the research myself. Google for the plebs and pubmed and more specialized websites for the patricians is usually good enough.
I would pay for Doppelgänger though. I would pay more than 1 € even! Maybe 4.99! I would even consider 9.99 if the database is huge. The idea of finding my doppelganger sounds amazing.
There's surprisingly little money to be made in truthfully and honestly informing people even though it's clearly what they want.
If you can convince people to buy the higher margin drug? Yeah, there's lots of easy money to be made in that even though customers don't want that.
Google for "best X" and in a ton of markets all you will get is a bunch of skeevy affiliate sites promoting the best deals for them and a good look at who is willing to lay down the most $$$ on adwords.
Even for branded sites with a rep (e.g. like tomshardware) i have my suspicions that they weight their recommendations towards companies that buy advertising on their sites.
As someone who worked in healthcare, this outcome is not unexpected.
My experience in that industry taught me to never go to a hospital, most of the staff don’t care about patient care at all. It’s just another workplace and everyone is worried about keeping their job, internal politics or money. Patients always seemed to come last. So why would they be interested in better outcomes by using a software? They aren’t really incentivized to do better in any way. Aside from gaming government requirements, wrapped around patient care, to get more money, only then do they care about outcome.
It is one thing to idea how the idea world should be, and quite another to develop a feasible strategy how to get there from the current state of affairs; a startup needs both.
What I would do if I was you is go back to your first step: your unhappiness with Google's search for medical drugs. Have you talked to GOOG about integrating your data into their search? You might be able to sell a subset of your data and code to them for a small sum, and assist them with the integration of your idea into their universal search.
I don't like the title. The author didn't waste the money. He learned a lesson that cost $40k to learn. (Less than many failed start-ups.) He doesn't say what he learned and would do differently next time.
It seems to me this is a classic case of spending too much on the tool and thinking that users will just somehow come. Too much on the tool; not enough on the marketing. A more streamlined MVP would have sufficed to see if there was a product/market fit and to figure out how to monetize it.
>Make something people want. It’s Y-Combinator’s motto and a maxim of aspiring internet entrepreneurs. The idea is that if you build something truly awesome, you’ll figure out a way to make some money off of it.
To me, "make something people want" is a proxy for "make something people are willing to pay for." To truly want something, you have to be willing to expend resources to obtain it. Anything less than that is people blowing smoke.
1. do marketing: convince patients that GlacierMD is the greatest thing since the discovery of antibiotics and insulin
2. sell it to doctors: Dear Susan, this is the biggest thing to happen in the industry in the last 10 years, you don't want to be left outside, as you can lose lots of patients. Trust me, having an GlacierMD on your front door for just $99 /month is a great deal I am making to you as one of our first customers.
Maybe he should try to sell the service as an API to search engines. E.g. I just tried the question "what's the best headache medicine" on the front show hn article: Andi https://news.ycombinator.com/item?id=30832589 and the result was "the best medicine is what your doctor subscribes you"
"So I borrow my parents’ car" made me chuckle. Also, do not quit your job before you make money from any one of your side projects. Also, do not trust contractors if you cannot handle it yourself without them.
I can see why so many things wrong but I believe the author also noticed these major flaws/mistakes and wrote himself.
And if I called all my tiny projects or websites I built startups, I'd be the startup king of America.
The problem is the author built a full scale product before vetting it. He could have built a few examples with scripts and spreadsheets, put together a deck showing mocks of the product and examples of how it works, then pitch it to potential clients. This would have cost a lot less money and time, and they would have reached the conclusion earlier that this wasn't a viable product market fit.
With a moonshot idea like this, your customer is the investors, not the customer/user/people who might wanna advertise. I think the mistake was trying to make money too early? Just take a few mill from an angel, and get coding.
If you want a rent-paying idea, then that looks more like a boring 'me too' idea. Yet another Pingdom clone should do the trick.
Interesting, fun also some of the reactions I got to my many ideas.
I have realised that one needs some sort of monopoly to make any money.
https://www.youtube.com/watch?v=3Fx5Q8xGU8k
I'd try marketing it to the Gate's foundation or the Wellcome Trust for grant support, rather than selling it for profit. Also look at other countries health systems. The UK's NHS has a department called "NHS Digital" who might be interested.
Sad. Funny. All too familiar. Assuming too much about people's motives
is a sure way to fall on your face. In the end _you_ cared about it
more than even the doctors and patients who you assumed put health
first. But well done for trying all the same.
I work for an emr company, integrating this with an emr might have been an alternative as a value added subscription service. There are many profitable value added services on top of industry specific applications (dental, medical, etc).
We worked at a startup that leveraged autonomous blockchains to transfer money from naïve investors to slightly less naïve twenty-somethings. There are worse gigs.
This reads like a parody to me. This whole thing is real, though, right?
The author needs to sell to publishers and R&D firms, not direct to doctors and patients. Think: MayoClinic, Mount Sinai, and other players who are big on medical research. Health magazines and publishers.
I mean, why not try to go the pure consumer route and raise some VC money? Get the doctors on board, add them to your pitch deck, put the site up, drive some paid traffic towards it, and raise a seed?
I am sorry, but this just a good research topic... maybe some team in NCBI will do this and publish one article, and then finish. It can't generate any value for people who is not researcher
It would depend on tests. Antidepressants work in different ways. If your body is not producing enough serotonin, you'd want drug class x. Or Dopamine a completely different class of drugs.
I don't like the title. The author didn't waste the money. He learned something that cost $40k to learn. He doesn't say what he learned and would do differently next time.
It's not a bad idea. Probably would have at least been self sustainable if it was sold to hospital administrators. Sell it as a "risk reducing" measure.
Were the operational costs very high? Why not just keep it going until someone buys the tech from you (like WebMD perhaps)? It seems like a good idea in any case.
This almost sounds like it could have been a side project that could last a while longer but rather he had contracted out work and ran out of money fast.
Agreed. I think insurance companies would be the better customer for this idea. They're in the business of paying the least amount possible for medical care.
I feel like I've done this exact story before... more than once.
The problem is you don't ever make something NOBODY wants. Then it would be so easy to walk away.
You make something a few people want, and a lot of people SAY they want, but they don't want it enough to pay you so much that your company can succeed rapidly, so you waste a lot of time and die slowly.
I enjoyed reading his self-deprecating enthusiasm as he flipped from one disappointment to another before he could fall off the tip of his Dunning-Kruger joyride. At least, I hope it was self-deprecating.
This is a tragedy of the commons. With my years of dedicated scholars research I keep contemplating more and more how much the human condition is miserable because absurd non-allocation of financial and cognitive resources where it matters.
Humans beings will keep suffering, a direct product of their buggy/broken brains.
