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EXECUTION One Doctor's Journey

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Oh man it's a long haul. But when you finally get there it's a good position to be in. Or so I've heard....
Haha. We'll see. You've blazed a path ahead for me. Don't think that I won't be using you ruthlessly. :D

Followed up with the COO this morning with a solid, value laden offer. Hopefully this is an advancement rather than a continuance so we'll see. I'm going to personally knock on the fellow's door next week, smile, and say "Thanks again!" :)

Jamming to the Guardians of the Galaxy Awesome Mixtape, Vol 1. today. Really sweet tunes.
 

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I'm also struggling with a dilemma:

A) Keep the current gig where I work for myself and can scale my income* to the hours I want to work but with a wicked time/money trade (including travel to/from & separation from the family); also less available for working on the business directly due to the distance and time trade. (*The increased pay becomes kind of ridiculous if I commit to long stretches away from the family.)

Or

B) Job in town with an hourly rate no better than 2/3d of what I currently make, not nearly as scaleable as A, but with a 10 min commute to work, lower overall stress, and I get to be with family every day. I also would be much more available for the business and meeting with most potential clients in the area.

Or

C) Some bastard hybrid of the two.

Need to stew on this for a while...
 

tafy

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Personally I would reduce the hours and take that job closer to home, your fastlane baby needs her daddy!
 
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Personally I would reduce the hours and take that job closer to home, your fastlane baby needs her daddy!
Thanks man, I'm leaning that way was well. I'm currently on night 1/9 away from home. Ugh.
 

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Oh man that sounds terrible. That itself would be enough for me to quit. I agree with the cutting of hours. I sit at work and think to myself, if I wasn't sitting here I could be doing x, y, and z.
 

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@Iwokeup ... Just my opinion..but...don't loose the family time.
It doesn't matter how much money you make..you absolutely, positively, cannot buy the missed family time back.

Besides figuring it out logically, listen to your 'gut' and your heart. You can't go wrong.
Good luck with this.
 

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Sounds like once you get your software back you'll be ready to roll.
I think your lack of a demo is what might be cooling off potential customers. It could be marketting but, my instincts say its probably just the "oh shit it works" effect not being there yet.

Sounds like you grinded out the right value proposition early on (good stuff) and set up a network there after?

If it stalls after you get the software back, be prepared with some kind of simple explaination, demo, free trial offer. Once people are paying, offer a discount for if they can refer people to sign up.

Also, people are more afraid of missing out, than clever enough to "see a need and get in", so if you can leverage a change in standard, or "you are struggling if you don't use us" kind of paradigm you should lever your way in.


My gut says, supercharge, simplify, and strategise this next move in detail. Then hit it with a sledge hammer of justice until it breaks in ;)

Haha, fun stuff to come


How are your partners legs? Is he holdin up well? Ready for the big push?
Grrr baby, rev that engine, and soon enough you'll be off!

Great grit and chops man, enjoyed readin this thread!
 
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@Iwokeup ... Just my opinion..but...don't loose the family time.
It doesn't matter how much money you make..you absolutely, positively, cannot buy the missed family time back.

Besides figuring it out logically, listen to your 'gut' and your heart. You can't go wrong.
Good luck with this.
Awesome point. I've been missing my kids and family something awful and no matter how good the money is, it's not worth missing them. You know?
 
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Sounds like once you get your software back you'll be ready to roll.
I think your lack of a demo is what might be cooling off potential customers. It could be marketting but, my instincts say its probably just the "oh shit it works" effect not being there yet.

Sounds like you grinded out the right value proposition early on (good stuff) and set up a network there after?

If it stalls after you get the software back, be prepared with some kind of simple explaination, demo, free trial offer. Once people are paying, offer a discount for if they can refer people to sign up.

Also, people are more afraid of missing out, than clever enough to "see a need and get in", so if you can leverage a change in standard, or "you are struggling if you don't use us" kind of paradigm you should lever your way in.


My gut says, supercharge, simplify, and strategise this next move in detail. Then hit it with a sledge hammer of justice until it breaks in ;)

Haha, fun stuff to come


How are your partners legs? Is he holdin up well? Ready for the big push?
Grrr baby, rev that engine, and soon enough you'll be off!

Great grit and chops man, enjoyed readin this thread!
Thank you. I love this post. I'm going to print it out and remind myself of this every day.
 
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Sounds like once you get your software back you'll be ready to roll.
I think your lack of a demo is what might be cooling off potential customers. It could be marketting but, my instincts say its probably just the "oh shit it works" effect not being there yet.
THIS. So much this. I think that once we can show a demo on the web page and in person that we'll be in so much better shape.
 
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Ah, Fate. You are a tricky b!tch.

So after returning from 10 days away (working for the Man) I checked in with the Partner, and learned that he hadn't heard from (or really poked) our developer for the entire time. Even though the alpha was due 1 Dec. So we had a Come to Jesus talk today and the partner FINALLY managed to get a hold of our dev...who's been having medical issues of some sort. Bottom line is that he gave us the source code (which is about 80% done in my estimation) and said "Sorry. I cannot finish."

SO.

Have to find another developer mid stream, which is going to delay the rollout for who knows how long. Bummer.
 

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GrensonMan

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This is just one of many setbacks that you will face. Keep moving forward and taking action!
 
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Thank you!
 

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o I've gotten off my a$$ and picked up the phone this week. Cold calling dental practices in the area with the pitch that we're inviting folks to our CFG in December to help us out. Getting emails has been much easier this way versus a pre-sell versus a idea extraction call (I've been split testing). Getting some very positive "I'm interested" feed back which is kind of surprising:

- 50% of calls are giving emails out
- 40% are "leave a message"
---> 25% call backs + interested (giving email out)
- 10% are "really not interested."

So, slowly building our list (which is fine at this early early stage) and getting out there. Who knew that cold calling could be fun? :) Hopefully going this route (providing value ahead of time) will be a successful "pre-sell," especially as @throttleforward stated, the medical/dental space is really reluctant to part with their $$ for an unproven product. Of course, the only way to know is to continue split testing so that I get enough calls to make the numbers mean something.
Could you explain this part a bit?

I am currently emailing and calling my market with idea extraction in mind (I have no product yet).

I think in the beginning of this thread you wanted to do that, but you ended up doing something else.

Correct me if I am wrong, now your cold calls are for a different purpose, to validate the product you are building?
 

mikekob

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You haven't talked to your partner in 10 days?

That is a problem right there. You to need to be talking every couple days. If this could've been prevented or seen 9 days ago you would be in a much better place. I would fix that right there first. We currently meet twice weekly and talk almost everyday. If there's a hiccup or even a thought of a hiccup I know about it. You need that.

What language is your software being written in? I have had good success with Odesk and would recommend that. I might be doing that with a Droid app in the near future. Only issue there is having to go through the pre-existing code to get acquainted and find bugs. That might not be that bad though.

Good luck and just keep putting one foot in front of the other.
 
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Thanks to everyone for the overt and behind the scenes advice and help. You guys rock!

Quick updates:

* Took the in-town job. Feels GREAT. Will start in March and I expect my stress levels to drop even more. Massive thanks to @tafy, @mikekob, @Bigguns50 for the excellent advice. @Bigguns50 especially. We're of nearly the same age and the time argument really hit home for me. Cheers!

For those keeping track, this is the stress level from making the last two job moves: Massive--> much better --> very agreeable. Bottom line is that while the money was better I was trading massive amounts of TIME to get it, which as we all know is a bad trade. OTOH, I do still have this job as an escape hatch should I need it.

* Met with our Small Business Dev Co mentor and she is proving to be EXCELLENT. Just the direction that I needed at this time. She's really great at going, "Well that hasn't been working for you. Have you tried this thing that I told you about before?"

LOL. I guess that you have to beat this Marine in the head a couple of times before it sticks.

So out of that came:

* Working to find alternative developers: she has two candidates, and thanks to @tafy and @mikekob for your offers. We'll see what shakes out. Holiday season and all. :/

* Time to revisit what I'd planned to do but hadn't followed through on: building social presence in my community and online by leveraging my personal "brand" and the physician/entrepreneur angle. Starting with twitter, my own website, and starting a "Cool Cat MD" meetup group. This is actually something that I have extensive experience in as I've built many very large online/in person social groups before (think www.studentdoctor.net), my medical school class, and a lot others. This ought to increase the brand and hopefully open networking opportunities. As they taught me in the Marine Corps: Knowledge only takes you so far. Personal networks get you across the finish line (interpret how you will).

* Got to start blogging for the company's website as well. All part of, "Wow, these guys provide massive amounts of value."

* Please don't try learning code as it's not a good use of time. Fine, but I'm at least going to have a much better working knowledge than I've had to this point. Back to www.codeacademy.com
==================================

* Now reading "The Founder's Dilemma." Hat tip to @mikekob.

* Can't stop waking up at 4-430 AM EVERY DAY. So, rather than fighting it, I'm just rolling with it. Working out, reading, etc. (Of course, that means that it's lights out nlt than 2100).


Big challenges these last weeks:

* TIME
* Developers
* Being a leader not only with the company but within the family. Leadership is hard and making the right decisions (or bringing the team/family along toward the right decision) takes time, patience, and grind grind grind.

I'll quickly close with TI's "Go Get It." W3rd.

 

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Good for you man ! Cut that path right through the jungle !

Leadership is hard...
Indeed it is. There is a lot to leadership. It's a topic I find fascinating and have read a lot about.You'll be fine.

Can't stop waking up at 4-430 AM EVERY DAY.
Good for you. Most people are still in dream land and while you"re working out...they're hitting the SNOOZE. Haha.
 

tafy

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Nice, so in 2 months you will have some extra time for your family and business
 
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Good for you man ! Cut that path right through the jungle !


Indeed it is. There is a lot to leadership. It's a topic I find fascinating and have read a lot about.You'll be fine.


Good for you. Most people are still in dream land and while you"re working out...they're hitting the SNOOZE. Haha.
All good points. Thank you sir
 
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Nice, so in 2 months you will have some extra time for your family and business
Yep. To say that I'm excited would be a massive understatement
 

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If you are looking to get fast feedback and exposure you should get a booth this March at the American Medical Group Association meeting. This is where you can meet and talk to people that are running these groups.

http://www.amga.org/

Here is a link to exhibit.

http://www.amga.org/AC2015/EX/AC2015/index_exhibiting.aspx

I don't know if you've been contemplating tradeshows or not, however there are few things that can get you connected with the real decision-makers faster. You just have to select trade shows carefully. The key really is to find out the membership demographics and who is expected to attend, and ensure that there's an adequate number of your target contact that will be attending.

Be prepared for both very short conversations as well as a thorough explanation of what you're doing. I would bet money that you can find someone in an event like this willing to be your launch partner.
 

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One other thing, I believe one of the most valuable things you can possibly do is learn to code. You are a physician, you have insights into the flow that makes sense for medical data collection and processing. You can't hire someone that has this inside understanding.

Coding is art, as you program it's like painting on a canvas, you massage the paint around and the only way to figure out what's going to work best is to actually get your hands involved and be intimately involved. There is a massive difference between a product and a good product.

Think of all the medical softwareyou have used, the majority of it has been designed by software engineers who have no clue about medicine, and it SUCKS. The way the menus are designed, the flow of information, everything about it tends to be inefficient and clumsy. These programs were all developed by a similar model that you were setting up, where you as a physician sit as an advisor over some programmer. You can expect you will get a similar result going this route as you have seen and other products you have used.

The most powerful programs I've ever used in my life, have been designed by physicians who are programmers and understood both the flow of medical practices and information, and the constraints and capabilities of information technology and programming.

Of course this doesn't mean that you have to program everything, however when you get stuck being able to sit down and sort out the problem yourself will provide you infinitely more powerful solutions. Most of my real breakthroughs in coding have come as I have been in the actual process of programming. It's the way the pieces are coming together, it's just not quite right, you shift things around, you massage it, you make the flow better, it's really truly a dynamic process that is hard to explain if you haven't done it.

Good luck, I'm looking forward to see your final product. Who knows maybe I'll even use it someday.
 

tafy

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One other thing, I believe one of the most valuable things you can possibly do is learn to code
I dont think he can wait a few years until hes learnt enough to code a full-stack SaaS application for the medical industry, then the year to code it properly and without bugs.

Easier to employ a superstar coder from Russia that can code the baby up in a few months for $40 an hour.
 

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Your right, it is faster to do that, and that may be the answer to get rolling, but great products don't come from outsourcing your creativity. There's a whole lot of mediocre to downright bad products out there, especially in medicine, and the problem becomes more pronounced when you're dealing with very specialized industries were intimate knowledge of that industry itself is key to the production of the software you're trying to produce.

Certainly even crap software sells in specialized industries, in part because it may be the only or one of a small number of solutions. But at the end of the day, crap software sells far less, and is much more poorly received than software that is sexy and elegant in what it is and how it does what it does.

Now if I was trying to produce a game, or blog system, or something with a broad appeal that is easily understood by nearly any programmer, then this would be a reasonable project to outsource in it's entirety, although you are ultimately ceding control for the outcome of your project to a third-party, which in itself is considerably risky.

And as far as it taking years to produce a workable program for the medical industry, this is entirely dependent on the amount of time and effort dedicated to the process, as well as the aptitudes of the person undertaking that task. I can speak from personal experience and tell you it can be done, I have done it.

One other thing to strongly consider when relying on outsourcing has to be the nature of the project. A project like this will be ongoing throughout its life, the project will have to be reworked, some areas will have to be entirely rewritten and remodeled because they are either ineffective or there are new needs that necessitate these changes. Additional modules will have to be added to keep the product relevant and feature-rich. Having at least one of your programmers, namely you the founder, you maintain control over the creation process and there is at least one person always associated with the product that understands the code, and knows how and why thing were done the way they were to begin with.
 
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If you are looking to get fast feedback and exposure you should get a booth this March at the American Medical Group Association meeting. This is where you can meet and talk to people that are running these groups.

http://www.amga.org/

Here is a link to exhibit.

http://www.amga.org/AC2015/EX/AC2015/index_exhibiting.aspx

I don't know if you've been contemplating tradeshows or not, however there are few things that can get you connected with the real decision-makers faster. You just have to select trade shows carefully. The key really is to find out the membership demographics and who is expected to attend, and ensure that there's an adequate number of your target contact that will be attending.

Be prepared for both very short conversations as well as a thorough explanation of what you're doing. I would bet money that you can find someone in an event like this willing to be your launch partner.
Thanks for this suggestion. I've done a booth at a huge national meeting before and it was spectacular. Could be good for us.
 
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@tafy and @trepine (heh), I appreciate the debate. It's honestly one that I've had with myself for a long time. I wonder if I could be my "own engine" if I learned coding. But it'd be like going to medschool and residency.. Years of work to get to the "10,000“ hour level of mastery.

Our solution would be to start and learn as I go... Because the road does go on forever...
 

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You honestly don't need 10,000 hours to mastery, probably like 200 to solid competence. And I think the start and learn as you go method is really the best anyway because it is real world, just don't divorce yourself from that part of the business. As a reference for you, I taught myself PHP and coded my first commercial application during the first 6 months as a surgical intern. On the flip side, I did already know HTML, so that gave me a small leg up. The code was kinda ugly, but hey it worked and I made sure the front side (HTML) was pretty. Later I went back and rewrote it when I was a better programmer. If you can master the

If(this) { do that }
elseif(this) { do that }
elseif(this) { do that }
elseif(this) { do that }
else { do that }

You can branch from there and program an entire site...

The one thing, however, that I would spend the time and be intimately involved from the get go, is the data side of things. I spend huge amounts of time figuring out my database before I lay my first line of code. I don't know what your project is, but I'm willing to bet your data is going to be complicated and the relations will be very important. Having a schema that models your data in the best most flexible yet efficient way will serve you very well, or a bad schema will cause you HUGE headaches.

I learned this lesson the hard way, on one of my early projects. I basically modeled my data-set in the easiest way possible, but this really was a huge limiter and was very hard to fix later.

An example that would make sense you but probably not a programmer. Say that you are making a database for patients, the inclination would be to put the MRN in the database for the patient, but maybe your application is going to be used across multiple sites and you know that a patient will have multiple MRN's. One (or sometimes more than one by accident) at each site. So for MRN you MAY choose to create a completely a separate data table for the MRN that is then linked back to the patient, this way you can associate as many MRN's with the patient as you want. Or course the MRN table would also need to reference the facility that the MRN was issued to, but you get the point. Now if you will NEVER have a situation conceivable where data will be linked to one patient from multiple sites then it makes sense to just drop the MRN into the patient table.
 
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Excellent points. Thanks!

Where would you suggest that I start? I'm currently running through the Java script tutorial on code academy, but then what?

I have little idea of where to next..

Let me guess... Neurosurgery? If so, mad respect. I nearly went down that road myself.
 

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My personal view is that in the beginning I would work on the database architecture and focus on learning front end technologies. HTML, CSS, JQuery/Javascript (Jquery will save you tons of time, it is just a javascript framework with a bunch of pre-built helpers that make your life tons of code easier).

Once you have a decent handle on HTML and CSS, I would find a CSS framework that works for you, many of them are built with Jquery built in to give you dynamic stuff. Probably the 2 biggest CSS frameworks are Bootstrap and then Zurb Foundation, not sure which is bigger. But...there are tons of CSS frameworks that all do certain things different or better depending on what you are looking for.

Here is the rational for why this is my advice. First, the back end stuff may be more abstract to begin with, it's all basically data handling and logic, and ALL text that does everything in the abstract without any visual output to tell what your doing. The front end on the other hand, you can make a tiny code change and SEE what it did visually in the browser. In fact you can code front end views in plain HTML, CSS, and Javascript without even tying it into a back end in the beginning.

Second, you can take a crappy back-end (I'm talking UGLY code not buggy code here) and make a pretty darn good if not kick-A product by making the front end exceptional, this is what the user sees and interacts with directly and is the largest thing your product will be judged on. On the other hand, the most beautifully coded back end CANNOT make up for a crap front-end, it's absolutely impossible.

Also, and more importantly, as a physician (end user) you know what and how you want to interact with the system, you know the flows and layout that can be the most efficient. This gives you a HUGE advantage over any product that doesn't have this type of input into the design.

If you are interested, this is my technology stack I use.

-- OSX (mac) or Linux Machine (Mac is BSD Based which is really similar to linux), my development workstation is Mac because I like it better than linux for a workstation.
-- Apache for Web Server
-- MySQL for most of my databases, but I always write my code database agnostic so anything can be dropped in for the database server. But you have to have a huge data set to out grow MySQL, honestly few probably ever will.
-- PHP for my server side scripting language
-- Phalcon PHP which is a PHP MVC framework, which is coded in C instead of scripted in PHP so it's lightning fast in comparison...this is what I do all my back end coding in
---- VOLT template engine, which is part of Phalcon and allows me to keep all the HTML free from the backend, this makes later maintenance so much easier, and also allows you to split work with others a lot easier since you don't have to know ANYTHING about the back end, only what is being handed to the front end.
-- Bootstrap for CSS framework
-- JQuery/Javascript for front side scripting
-- A bunch of Bootstrap and JQuery extensions to give added functionality.

If you are planning to do onsite installs, where you install equipment onsite, then I would 100% use windows, .net, MSSQL, etc because you want it to be familiar to the people you are selling it to...otherwise IMHO I would go the linux/APACHE/MYSQL route because no one cares what technology you use in the cloud, it is much much cheaper to aquire the hardware because you don't have the multi-thousand $ server licences, and my personal bias is that it is just overall better anyway.
 
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Oh, and to answer your other question. I was in Plastic Surgery, I left 1/2 through into Radiology because I realized that even though I loved plastics, like really really loved it, there was no way I could run a successful practice without dedicating nearly 100% of my time to it, and that just wasn't the life I envisioned for myself.

After I wrote my software during residency, I realized I wanted a split career that I could scale my work up or down as I wanted and have free time to pursue my business interests. As it is now I work 7 on 7 off and so I do medicine every other week. As some of my other projects come online, I expect I will scale my medical practice back even more, I have a pretty good Locums deal that I can do as much or as little as I want.
 

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