One Doctor's Journey

[oldkevx]

Love this thread, admirable progress....rep+

 

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[Iwokeup]

I feel like this week I put on my big boy pants:

* Partner and I came up with a Master Services Agreement with our developer. Final draft approved today. This was an education for me since I had never done or seen one before. It basically gives our dev ~$125/hr total for 1,000 hours with the vast majority being deferred cash (loan) and economic interest should we ever sell the company. We're not giving away equity at all and at the agreed to rates it works out to a valuation of our enterprise at something like 1.875M, which is totally crazy. We'll have the call off sheet done this week or next, and contract will be effective 1 Sept (when our LLC is officially effective - note that this was done to avoid any whiff of chum to IP sharks).

I've often wondered if we're overpaying...but since we aim to compete in a space dominated by Elephants, I wanted our dev to be Local, Excellent, and Completely trustworthy. I've listened to the INSIDERS call by healthstatus but I just cannot get comfortable (right now) deploying a product like ours via an outsourced dev. At least our initial cash outlay won't be too terrible and the studio has agreed to Net30 terms, which is pretty sweet.

* Business and Financial plans were completed and we had our meeting Friday as I alluded to earlier. Had to work this weekend so little active work was completed. There were a few interesting comments from the docs:

- "Haha, you think that you're going to dominate the world." to
- "Dude, I wish that I had your balls. Don't forget me when you're rich!"

* Set up our basic website. Used a basic (and free) WordPress theme to get started and I'm having to remember how to build web pages. It's been so very long and the landscape has changed dramatically. Inspired by @Gale4rc 's B2B marketing pizzazz and @MJ DeMarco 's popup conversion contest, I'm going to see if I can do similar things with our web page. Would LOVE to harvest a ton of leads. However, I have no clue how to do this so I'm going to have to read in my (minimal) spare time.

* Had a meeting with a specialist physician today and it wasn't so much a sell as a chance to have him tell me how he's keeping a specialty clinic open in this tough (US) healthcare climate. He does procedures so lead generation is huge for him and he's paying an industry player a fair amount of money to do that. It was SO COOL to hear him discuss SEO, conversion rates, lead optimization, etc and EVEN BETTER that I knew what he was talking about. Cool dude. He indirectly also validated our product and our proposed marketing approach in the course of the conversation. He also saw right to the heart of our biggest vulnerability too. I was wonderful to see a physician who's aggressively fighting for independence! I think that when we've got a working product I can approach him for a demo/sale.

**** BIGGEST NEWS ***

We have our first Sales Pitch on Friday at 1030. Scheiße!!!

I've REALLY got to get going this week. I'm scared, nauseous, and super excited all at once!


============================
Strategic Thinking
o Write Business Plan (me) - Goal is one week
o Write financial plan (partner)- Goal is one week
o How many sales do we aim to close by Dec 31? (10)
o What's our plan once we start getting sales?
o How will support be structured?
o When can we afford to hire/outsource sales and basic office staff?

Software development
o Generate accurate requirements
o Select developer
o ********* Get it developed (ongoing) *********
o List of APIs we'll need dev access to (ongoing)
o Get access to those APIs
- Graphic Design
o Sketch out vision for overall design/flow
o Find a great designer
o Design requirements to developer (ongoing now)

- Marketing (thanks to Ultimate Sales Machine)
o What is our stadium pitch/core story/value proposition?
o Develop extensive research to support core story
o Develop 1- page answers to customer frequently voiced objections
o Plan PR campaign (ongoing)
o [Defer for later] Local Charity benefit (especially with us being in health care)
o [Defer for later] Trade magazines? Trade organizations?
o [Defer for later, after first couple of sales] Plan articles/sales pitches that can be made into articles for local/national publications (Texas Monthly, local newspapers)
o What national conferences can we attend and develop kick a$$ national buzz?

- Capital development
o Read through all of zen*******'s Capital Secrets materials
o Get Mockup so I can work on the pitch deck for first round investors
o Develop "Friends/Family" list in order to raise first $250-300K (or more) for development. (Got our 1st "Yes" today!)

- Legal/Accounting
o Are we vulnerable to any IP issues?
o Draft partnership agreement
o Form company
o Retain CPA

- Board of Advisors/Mentors
o Got the first one, looking for others.
o Reach out to Sales mentor (partner) - if we're successful in out local markets, then we'll need to ramp up rapidly for a national outreach (thanks to JackEdwards for this tip).
o Reach out to local/national business startup guy for advice (friend of partner, ongoing)

 

[Iwokeup]

Also, on a side note, I've been doing something a lot of folks advocate, which is to start one new habit at a time, rather than multiple at once. So I started doing push-ups six days a week, rain or shine, working or not. My staff often cracks up at me but persistence pays. Started out barely being able to finish 50 per day and now I'm up to 125 per day and feeling stronger, and looking better. Feel like it clears the mind for action, whether in the ER or working on this project...

 

[Iwokeup]

Thank GOD for the Small Business Development Center! Had a wonderful meeting with a local SBDC rep who has experience in tech/software startups. She validated a lot of what we've done so far, gave us a fantastic insight into how we should approach our meeting on Friday ("Don't think of it as a sales call!"), and kindly kicked our butts on getting a product and sales done in 3 months.

I'll definitely post more after I've processed things.

 

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[Iwokeup]

I find myself getting overwhelmed a lot. Realizing that there is so much to learn and so much to do. It's mentally exhausting and I feel like I'm never going to get it all done. I want to get to a point where I can hire someone to just offload some of the minutiae, but I also understand that I need to learn the minutiae first in order to direct an employee. It seems like the damned mountain is so damned steep and high and I wonder if we'll ever get there. :\

Of course I know that it's just one foot in front of the other, but still. It's damn daunting.

 

[JEdwards]

Wow. Great for you. It's a great idea.

 

[throttleforward]

I find myself getting overwhelmed a lot. Realizing that there is so much to learn and so much to do. It's mentally exhausting and I feel like I'm never going to get it all done.

How many times in medical school did you think this? You've already proven you can do the hard work, and you also know that the only way to succeed, just like the only way to become an MD, is by one day (class, assignment, exam, rotation, etc) at a time.

Keep pushing, and keep venting. The venting helps - do it here, do it with people you physically interact with who are like-minded.

 

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[Iwokeup]

Wow. Great for you. It's a great idea.

Thanks, Jack!

 

[Iwokeup]

How many times in medical school did you think this? You've already proven you can do the hard work, and you also know that the only way to succeed, just like the only way to become an MD, is by one day (class, assignment, exam, rotation, etc) at a time.

Keep pushing, and keep venting. The venting helps - do it here, do it with people you physically interact with who are like-minded.

Thank you. This is awesome advice.

Because I'm so used to being Mr. Positive, Can-Do!, Never Let Them See You Sweat guy, actually opening up can be tough. So I decided to be more open about the ups and downs.

 

[Iwokeup]

Immensely productive day today.

So tomorrow is our big "sales" call with the CEO of a medium sized company. After the conversation with the SBDC rep noted above, we've crafted an approach that let's us validate our idea, see if we can get this company to come on board in an advisory role ("What features would you like to see? Can we run the beta by you? Interested in a Beta test/pilot when it's ready?") and hopefully:

o Get an even better handle on their needs (and thereby other customers)
o provide them as much value as humanly possible.
o have them be a beta tester, who we hope turns into an ongoing customer
o will be willing to be serve as a reference as we go out into the world.

With that in mind, I started the Miracle Morning process and got up three hours before the rest of the family. I was able to workout AND get the pitch deck 90% complete. I just have to make some tweaks this afternoon and we'll be good to go.

Partner and I plan to meet for coffee in the morning in order to walk through the talk so that we're more polished (but not "sales-y").

!!! Best of all? I had a conversation with a very old friend (18+ years) that turned out to be spectacular. We've been very close for a long time, but other than knowing that he travels for business, we haven't really talked in detail (more likely that I was pretty clueless) about what he does....

Turns out that he's been a top-selling sales rep/manager for a Fortune 1000 company who just got poached away from his home company to their biggest competitor. I explained about tomorrow and he totally validated our plan...I LOVE this guy and would trust him with my life and my money. He's my bro from way back and we both got out of the Marine Corps at the same time and met our first day of college.

The sales part (or, how do we grow the company well and rapidly) has been really bothering me..as in, how could we afford someone who could grow our business rapidly and well? I may have our answer. Sales Friend is very interested and there's definitely potential there.

It was cool, because I was able to talk to him in his sales language for the first time ever, and I gained a big insight into someone that I've known for so long. He's the real deal and I think that he was pleased that I realized and recognized that fact. You know, six months ago it was so abstract but now it's totally understandable.

Chance favors the prepared mind. Thank goodness that I haven't been slacking on my sales reading and absorption of all the gold in this forum!

Feeling really excited (and not nearly as nervous) about tomorrow's meeting. This finally got fun again.

Edit to add: if there is one thing that has become crystal clear to me, it is the WHY. Why am I doing this all?
.
.
.
Freedom, yes. But freedom for not only my family and my partner's, but also FREEDOM for those that I love and care about. IF they have the moxie, the hustle, and the DRIVE to succeed, I want to give 'em the chance.

 

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[Iwokeup]

Big day today. I'm up early, caffeinated, and excited. Gonna deliver some value with an @IceCreamKid attitude. No matter what happens, I'm going to learn something valuable. Cannot wait!

 

[Iwokeup]

Success! More later...

 

[Iwokeup]

Okay, short update: Meeting went extremely well. Met with the CEO of a medium sized company and he was VERY enthusiastic about our product. Our proposed software solution fills a glaring need that nothing is doing very well at the moment. Again he identified our known weakness and also recognized our strengths. He had a few insights that we hadn't thought of but they wouldn't require major work to implement. IF we had a product ready to go today we'd probably be talking about a pilot program in less than a month! Of course, we don't yet but now I'm REALLY going to press our developer to get 'er done....CEO gave me his personal contact information and asked us to keep him updated as we go along.

Partner and I present very well together, and we do have complimentary skills. It's time to take this show on the road and visit a couple of other companies of various sizes and get some more validation and buy in done. It also paid to have done deep research on the company, its founder(s), and the CEO, and I was able to drop personal history nuggets along the way that seemed to really smooth our interaction.

Okay: Lunch, then nap, and then to write up the meeting notes.

 

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[Iwokeup]

Followed up on Monday with the CEO, and I mentioned that we're going to look into implementing his suggestions into the MVP. Got a very enthusiastic response back and he's definitely emotionally involved. He even made a point to re-emphasize how much he loved our presentation and obvious competence.

Partner's skill in corralling the Devs is showing. He drafted the MSA with call-offs on Sunday, we reviewed them, and then he sat down with our Dev yesterday. Minor quibbles to be hashed out but I think that we'll be ready to roll soon.

One potential hazard is that our dev is looking to use secure hosting as another income stream and he's been really trying to set that up as his eventual best income stream (we would be his first customer). However, as @mikekob had suggested earlier to me, with HIPAA compliance an issue, Amazon Web Services might be the way to go, especially as the host is just as liable for any Protected Health Information breaches as well. And since those penalties are pretty stiff, our Dev may back off of this for us. We'll see.

Just finished two of my final night shifts at the job that I'm leaving. I cannot WAIT to be done but I'm suffering from Third Shift Brain (TM). It sucks. So in the meantime, I've downloaded the Agile WordPress theme and started to flesh out our web site.

Waiting on the mockup revisions from our Graphic artist. Should be looking better soon.

Had my birthday this weekend so little work got done. Feeling a bit guilty about that and the effect that Third Shift Brain is having on me today. I hate the effect that working these shifts has on my energy, cortisol levels, etc. Cannot wait until I never have to work a night shift ever again.

Ah well, tomorrow should be better.

Going to do some Social Marketing/Cold calling/Validation stuff tomorrow.

 

[Iwokeup]

So we had our second meeting with the SBDC and it was again quite productive, in that areas of strength and weakness were identified and a very clear action plan for the next two weeks was identified. I can see that my partner and I are pretty new at this game because when the SBDC rep pointed out certain things, he and I collectively smacked our foreheads. :/

Last week was a tough one emotionally for me. Finished up my final shifts at the old job while learning what a bunch of mean spirited and nasty folks half of them were (the doctors). Half the docs were extremely supportive and excited for the new direction in life (including the company) and the other half (the ones not actively looking for another job) were vitriolic, hateful, and cold. Crazy. It wasn't as if I was saying "F-you guys, I'm out!"

but rather choosing to move on....

Probably even more angst-inducing was the slowness of getting our dev to get cracking (more on that later) plus the fact that I really hadn't gotten anything done last week. Been feeling really guilty and if I'm being honest, somehow really afraid of picking up the damn phone and calling people (we want to meet potential customers for better validation). Why!??? I'm such an idiot. Anyway, got called out by my "Mastermind" group of partner and SBDC rep (LOL) and today and tomorrow I am making calls. No more excuses.

On a postive note, I finally have an answer to the question, "What should I make our site's blog about?" This has been a problem for me in that I've wondered how I could make an interesting, content-rich blog for our company and the Rep's answer (and I believe her b/c she has tons of experience in this space) is that I should blog about what I know (medicine, emergency medicine) and fill it with that content while also weaving in what we're trying to achieve as a company (generally speaking). Very liberating. Should have the first post done today.

Well, I found out today why you should always be wary of a first time developer: we thought we had a good one when we initially met but now he's proposing radical changes to the MSA, and now he's really hitting hard to make the professionally managed cloud solutions (PCMS) portion of the deal his real gravy train. Plus, he actually told my partner that any time spent talking with us as opposed to building the product was billable time, and (!) demanded payment for the mockup that he did (of his own volition) to demonstrate his chops to us. Ridiculous! Partner and I decided yesterday that we're done with this clown and now we are on to finding the next dev. As if to op off the Sundae of Silliness, the dev sent us an email this morning stating that "I want to revisit the MSA that we agreed to last week." Buh bye!

I go to work at my Independent Contractor job on Thursday so I gotta "Get 'Er Done."

 

[Iwokeup]

Other notes: It's apparently a bit of a deal when planning to use Amazon Web Services versus the Google Compute Environment.

Our (former) dev wanted to use GCE and use his own PCMS solution to host our SaaS product. I on the other hand, while not a dev, have a real issue with a local dev with limited resources handling HIPAA data. I dunno..I *think* that I'd rather have the peace of mind that comes from 24/7 professionally managed cloud services.

 

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[throttleforward]

the other half (the ones not actively looking for another job) were vitriolic, hateful, and cold. Crazy. It wasn't as if I was saying "F-you guys, I'm out!"

It's likely they were so angry because they married the job a long time ago, and the only way they justify that to themselves is if they tell themselves that there is literally nothing else worth doing in life than being in medicine (something they were likely told by others, including their parents, at a very young age). When someone takes the "red pill" they get angry because you are shattering that little world that so many build for themselves - things that seem critically important within the medical field are suddenly exposed as not all that important in the rest of the world, and when you show that there is another path, you cause them to question their own decisions. Many people would prefer to stay within the microculture that they have carefully navigated at great personal cost.

I see the same thing in the military, especially the officer world. People who have spent all their adult lives in the military, worrying about promotions, command billets, impressing their superious, getting a good OER, etc. literally can't understand that no one outside of their work-life culture cares about these things. Almost no one cares outside of the military whether you were an LTC or a COL, or a BG vs a MG, or an E8 vs E7. The vast majority of the population couldn't tell you the difference between a battalion or a brigade, or what a field grade officer is...to tell these things to people who have spent their lives caring about these things is an affront to who they are. When you tap them on the shoulder and say "hey guess what - all those hours spent at the office on those slide decks, all that time you spent away from your family, all that effort you put into getting promoted...your kids don't care, your wife probably doesn't care, and the civilian world you will eventually live in definately doesn't care beyond "thank you for your service" (in fact in their mind, your service is the same as the corporal's)" they look at you with bewilderment.

If you tap them on the shoulder again and say "see that guy over there? He's in his thirties just like you, but he's a multimillionaire, went to West Point but got out after his service obligation, started a business, and is thinking about which tropical island to visit next while you're worried about whether dropping your kid off for his first day of school in the morning instead of getting to the office by 0530 (and staying till 1900) is going to make you look bad to your boss and impact your promotion to major" their heads explode. You can literally see the wheels turning - wait, there are people who go to West Point but get out before retirement?! They don't care about making general?! They don't want to take special assignments, wake up at 0400 and miss their family's life because they could care less about advancement? Should I be caring about these things? Then they get angry.

 

[Iwokeup]

It's likely they were so angry because they married the job a long time ago, and the only way they justify that to themselves is if they tell themselves that there is literally nothing else worth doing in life than being in medicine (something they were likely told by others, including their parents, at a very young age). When someone takes the "red pill" they get angry because you are shattering that little world that so many build for themselves - things that seem critically important within the medical field are suddenly exposed as not all that important in the rest of the world, and when you show that there is another path, you cause them to question their own decisions. Many people would prefer to stay within the microculture that they have carefully navigated at great personal cost.

I see the same thing in the military, especially the officer world. People who have spent all their adult lives in the military, worrying about promotions, command billets, impressing their superious, getting a good OER, etc. literally can't understand that no one outside of their work-life culture cares about these things. Almost no one cares outside of the military whether you were an LTC or a COL, or a BG vs a MG, or an E8 vs E7. The vast majority of the population couldn't tell you the difference between a battalion or a brigade, or what a field grade officer is...to tell these things to people who have spent their lives caring about these things is an affront to who they are. When you tap them on the shoulder and say "hey guess what - all those hours spent at the office on those slide decks, all that time you spent away from your family, all that effort you put into getting promoted...your kids don't care, your wife probably doesn't care, and the civilian world you will eventually live in definately doesn't care beyond "thank you for your service" (in fact in their mind, your service is the same as the corporal's)" they look at you with bewilderment.

If you tap them on the shoulder again and say "see that guy over there? He's in his thirties just like you, but he's a multimillionaire, went to West Point but got out after his service obligation, started a business, and is thinking about which tropical island to visit next while you're worried about whether dropping your kid off for his first day of school in the morning instead of getting to the office by 0530 (and staying till 1900) is going to make you look bad to your boss and impact your promotion to major" their heads explode. You can literally see the wheels turning - wait, there are people who go to West Point but get out before retirement?! They don't care about making general?! They don't want to take special assignments, wake up at 0400 and miss their family's life because they could care less about advancement? Should I be caring about these things? Then they get angry.

Yep! Very well said. Having been in the military myself I can totally see your point and how it applies to my situation. Thank you.

I will also add that I've learned to let my wife be an integral (& unofficial) part of the company. She has a very sharp mind and excellent vision and has helped tremendously. So after yesterday's meeting she was very helpful in getting me to see where/how to move forward.

 

[Iwokeup]

Quick update:

Been action faking (and working <weak excuse>) for the past two weeks because I was afraid for some reason to call prospects. Told my wife, who lovingly

me. She was right, so today I got back onto the horse:


* Set up a meet with the COO of a medium sized practice on Monday.

* Straight cold-called the CFO of a large practice (comparable to the practice CEO we met with a few weeks ago);
- got his assistant but instead of letting of myself get blocked, acted like I have a 10 pound sack and told her that "Since the CEO of the other practice met with us, it's probably in his interest to meet with us too." She's going to call back with a couple of options to meet.

* Called a smaller practice and managed to turn a "Well, you wouldn't be right for us" into a coffee meeting next Tuesday which looks likely to generate a TON of useful data for us. Best part of the call was that she straight out said, "If your product can do what you say it will do it would be awesome!"

* Set up a Meetup group. We're going to become the experts in our space/niche.

* Fired our developer. Too amateurish and not the guy we want for our project.

* Set up a meeting with a savvy entrepreneur for tomorrow and hopefully he become a mentor. Fingers crossed....

 

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[throttleforward]

because I was afraid for some reason to call prospects

Maybe it's just me - but I feel like this never goes away, no matter how easy it was in the past. I could cold call 5 people, get all 5 to sign up, be happy with myself and confident, and wake up the next morning finding every excuse possible not to call people. I don't really understand it, but all I know is that it just takes some massive mental energy on a daily basis to make it happen. Glad you got back on it.

 

[Iwokeup]

Maybe it's just me - but I feel like this never goes away, no matter how easy it was in the past. I could cold call 5 people, get all 5 to sign up, be happy with myself and confident, and wake up the next morning finding every excuse possible not to call people. I don't really understand it, but all I know is that it just takes some massive mental energy on a daily basis to make it happen. Glad you got back on it.

Thanks. Yeah, it really is weird how each day is like that. But it is addictive when you get "yes" especially.

 

[LuckyPup]

So as I alluded to in my introduction thread, I'm making the transition from SL with high intrinsic value (Physician) but no control to the FL. I have read quite a few of these progress threads and they are often full of good advice.

I am strongly considering a SaaS solution approach a la' Dane Maxwell versus some sort of distribution model.

I'm planning on using this as an external journal which might (if I am so lucky) garner some external murder-board type of feedback.

Bottom line, please feel free to ignore this but I would welcome any advice or commentary, negative OR positive.

=)

=============

[5.10-5.28]

[x] Decided that I need to get out of the SL
[x] Read TMFL with notes and highlights.
[x] Came up with about 10 potential ideas for FL pathways, some easier to execute than others. Easier ones look to make less per month and less overall potential.
[x] Discussed with The Wife the feeling that we need to get out of the SL. (She is now onboard!)
[x] Read through my employment contract and agreements to ensure that I wouldn't be violating NDA/Non-compete clauses (none found).

[x] Decided that I would like to launch in 8 weeks with "easy project," or 6 months with more ambitious one.
[x] Start reading Scientific Advertising

*** Realized that, as @IceCreamKid says, it's about Loving Others and Helping Them with Their Problems (paraphrase) first, money later.

[5.29 - Friday, 6.3]

[ ] Meet with friends in target industries for lunch, idea extraction, pain point identification.
[ ] Are there actionable targets there?
[ ] If so, could I pre-sell target solution in order to finance the initial development?
[ ] Watch an episode of "Shark Tank" for ideas, understanding, motivation.
[ ] Re-read TMFL in order to reinforce fundamental principles.
[x] Arrange and [ ] Attend meeting with Tax advisor in order to set up LLC vs. S-Corp.
[ ] Decide on a company name
[ ] Finish Scientific Advertising
[ ] Have a plan: 8 week launch versus 6 month, & what financial resources will be needed.

=================

Funny doctor story: Pt comes in complaining of an infection "on (her) stomach." Says that it's been there for a couple of days. She is VERY LARGE (think small moon of Jupiter large) and points to regions below. Oh, and by the way she's about 2 weeks pregnant but has yet to see her OB. So I go to examine her and I have to have two nurses in the room to help lift this woman's HUGE pannus. It turns out that the underside of the pannus is extremely red, swollen, and clearly infected. The kicker is that the underside has several (about 5-) wooden splinters which seem to be the infection sources. I asked her how they got there...


Well, her husband's friends had used a piece of wood to lift up the pannus so that her husband could "do her right" and get her pregnant.

Yeah, that actually happened.

Hey doc! Great posts and I wanted to reach you to a) encourage you and thank you for sharing, and b) let you know that my wife is a doc - ten years in private practice and burning out on the hamster wheel. Wracking my brain to find ways to help her escape!

 

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[Iwokeup]

Thanks man.

Hey doc! Great posts and I wanted to reach you to a) encourage you and thank you for sharing, and b) let you know that my wife is a doc - ten years in private practice and burning out on the hamster wheel. Wracking my brain to find ways to help her escape!

Good luck to you guys!

 

[Iwokeup]

* Set up a meeting with a savvy entrepreneur for tomorrow and hopefully he become a mentor. Fingers crossed....

Met with the guy. Seems to be exactly the kind of guy that we need to help guide us through the rocky shores. In talking with him it came out that he has a lot of subject matter expertise and (I hadn't truly realized) quite the successful (retired) entrepreneur in my space. Sweet! Anyway, he was very interested in our product/vision and (I think) will be an ongoing mentor for us. Been a nearly life long friend & mentor to my wife (in a different space) so I know that we can trust him. Biggest take away from the meeting was that we apparently weren't thinking big enough. Thanks to the Wife for the intro! What a woman.

This weekend: more blog posts, try and get the Meetup group going, prep for my presentation/meetings on Monday and Tuesday, and generate a bigger call list for Monday.

 

[throttleforward]

I can't wait for your guys to blow up. We need more doctors to think outside the box and serve the healthcare industry from the outside in. Doctors - not politicians - will lead our healthcare revolution.

 

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[Iwokeup]

I can't wait for your guys to blow up. We need more doctors to think outside the box and serve the healthcare industry from the outside in. Doctors - not politicians - will lead our healthcare revolution.

Much appreciated. We'll get there or we won't but it's going to be an informative journey one way or the other.

Of course, I've got a burning desire to win so failure isn't really an option.

The big thing that your post highlights is that, because physicians are so averse to "getting involved," they cede control of healthcare delivery to everyone ELSE. And for sure everyone else has other agendas other than delivering the best care to patients (1,2). We as a country need to get physicians out of the "I'll tend to my garden and you tend to yours" mentality that just isn't viable in the connected economy that is 21st century America.

(1) of course, physicians are human too and there are legions of examples of bad behavior by doctors. The only saving grace is that there are ethical and moral boundaries in place that serve to put us on notice about what is and isn't acceptable.
(2) There's a nice discussion about human tendencies to do right/wrong and ideals of service to others in Robert Heinlein's, Starship Troopers.

Once were successful and rolling with this first app, I've had in mind developing my own Electronic Medical Record that is designed by/for physicians, with the relevant information useful to US and all of the non-essential crap hidden. It's amazing how much important stuff gets lost on the mass. A prime example of a class of products being built by people who don't actually use it in the trenches daily. And as I read about Lean product development, the founding of Apple v. Microsoft, I've come to realize that the Apple approach (design based on human beings and for human beings) is the one to be emulated in the EMR world, whereas everything to this point has essentially followed the MS route (we (engineers) build the product and tell you about our cool features).

 

[LuckyPup]

Much appreciated. We'll get there or we won't but it's going to be an informative journey one way or the other.

Of course, I've got a burning desire to win so failure isn't really an option.

The big thing that your post highlights is that, because physicians are so averse to "getting involved," they cede control of healthcare delivery to everyone ELSE. And for sure everyone else has other agendas other than delivering the best care to patients (1,2). We as a country need to get physicians out of the "I'll tend to my garden and you tend to yours" mentality that just isn't viable in the connected economy that is 21st century America.

(1) of course, physicians are human too and there are legions of examples of bad behavior by doctors. The only saving grace is that there are ethical and moral boundaries in place that serve to put us on notice about what is and isn't acceptable.
(2) There's a nice discussion about human tendencies to do right/wrong and ideals of service to others in Robert Heinlein's, Starship Troopers.

Once were successful and rolling with this first app, I've had in mind developing my own Electronic Medical Record that is designed by/for physicians, with the relevant information useful to US and all of the non-essential crap hidden. It's amazing how much important stuff gets lost on the mass. A prime example of a class of products being built by people who don't actually use it in the trenches daily. And as I read about Lean product development, the founding of Apple v. Microsoft, I've come to realize that the Apple approach (design based on human beings and for human beings) is the one to be emulated in the EMR world, whereas everything to this point has essentially followed the MS route (we (engineers) build the product and tell you about our cool features).

Doc, I love this thread, and bravo on your reference to Heinlein! As I mentioned, my wife is in private practice. She and I have been together since before she started med school, so I'm pretty familiar with the myriad dysfunctions of the system. In addition, I've been on the biz side of healthcare for many years (most recently working for an academic med system). Seems to me that there are three reasons physicians' tend to mind their own gardens: First, as you mentioned, they are risk averse; second, they have a time energy deficit, which impedes them thinking and acting beyond the narrow confines of their roles, and third, our current model is rife with misaligned incentives, ie, most docs are not incentivized to improve the system, most are incentivized to maximize patient volume. Not sure how to realign things, but hope your baby helps achieve that end.

I'm intrigued about your product - you've been on a tear!

 

[Iwokeup]

Doc, I love this thread, and bravo on your reference to Heinlein! As I mentioned, my wife is in private practice. She and I have been together since before she started med school, so I'm pretty familiar with the myriad dysfunctions of the system. In addition, I've been on the biz side of healthcare for many years (most recently working for an academic med system). Seems to me that there are three reasons physicians' tend to mind their own gardens: 3

First, as you mentioned, they are risk averse;

second, they have a time energy deficit, which impedes them thinking and acting beyond the narrow confines of their roles, and

third, our current model is rife with misaligned incentives, ie, most docs are not incentivized to improve the system, most are incentivized to maximize patient volume.

Not sure how to realign things, but hope your baby helps achieve that end.

I'm intrigued about your product - you've been on a tear!

Quoted for excellent insight! Thank you for your support, and I hope that you and your spouse find a way out of the grind.

As far as misaligned incentives...I *think* that this is the most difficult nut to crack. I'm not sure how to fix it, unless you did a totally socialist thing where all doctors make X, and certain specialties (Neurosurgery) make more...

As for the tear....I dunno, I guess that I'll feel better once I have my first sale. Like Vick ...when does it become real? To me, when that first customer payment hits the bank account. And then I want to be like Vigilante: being a legendary company while being addicted to passive income deposits while living part time in HI.

 

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[Iwokeup]

Today the Partner and I met with the COO/CIO of a medium sized practice and got tons of useful feedback. He's really invested in seeing us succeed but we're going to have to meet several integration and performance metrics in order for him to use our product. He definitely validated our idea and concept though so it was a very useful exercise. We've definitely got another advocate.

As we go through the product validation process, we're discovering that different sized customers will require different solutions, which is kind of obvious. What hadn't been obvious was that certain types of customers will require more features than others. So another potential market has opened for us - smaller practices with simpler needs.

We're going to have to try and pursue tight integration with EHRs and this is definitely going to present a significant challenge for us since there's so much Balkanization of the EMR field. However, our CIO/COO suggested that we consider being affiliated with an EMR in order to use them as a distribution channel. Potentially very valuable since we would get access to their customers, but also challenging since it does expose us to the wider world of competitors early in the game.

I've got a validation meeting with a small practice tomorrow, and the Partner and I are meeting with developers today, tomorrow, and Thursday.

Initial product validation could theoretically be finished in two weeks.

I've got 50 sales calls to make this week. 10 down, 40 to go.

Damn. The barrier to entry in this space is really high.

 

[LuckyPup]

Maybe align with some practice management companies, score some quick victories, scale a bit, then develop a relationship with one of the bigger fish in this fragmented market, say Epic or Allscpripts. Exit strategy to sell to one of them?

Today the Partner and I met with the COO/CIO of a medium sized practice and got tons of useful feedback. He's really invested in seeing us succeed but we're going to have to meet several integration and performance metrics in order for him to use our product. He definitely validated our idea and concept though so it was a very useful exercise. We've definitely got another advocate.

As we go through the product validation process, we're discovering that different sized customers will require different solutions, which is kind of obvious. What hadn't been obvious was that certain types of customers will require more features than others. So another potential market has opened for us - smaller practices with simpler needs.

We're going to have to try and pursue tight integration with EHRs and this is definitely going to present a significant challenge for us since there's so much Balkanization of the EMR field. However, our CIO/COO suggested that we consider being affiliated with an EMR in order to use them as a distribution channel. Potentially very valuable since we would get access to their customers, but also challenging since it does expose us to the wider world of competitors early in the game.

I've got a validation meeting with a small practice tomorrow, and the Partner and I are meeting with developers today, tomorrow, and Thursday.

Initial product validation could theoretically be finished in two weeks.

I've got 50 sales calls to make this week. 10 down, 40 to go.

Damn. The barrier to entry in this space is really high.