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When good ideas make bad business

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Re: When good ideas make bad business

#81

Post by sangnoir »

lonelappde wrote: post #53
jcims wrote: post #37

Earlier quoted context omitted.

I think this is overstated most of the time, otherwise why would we have vaccines? However, I would be on board with saying that when situations get dire, risk management begins to diverge incentives between patients and providers.

Vaccines exist for a tiny fraction of conditions. And in the market consumers revealed preference is for $1000/yr treatment over $20K vaccine, or equivalent multiples. When a new vaccine is invented, people balk at the price and complain it shouldn't have been created. Far more investment is in "managing" conditions.

I don't buy this line of thinking - the list of curable diseases/conditions is longer than the incurable ones. Selection bias means the incurable ones get more attention (because they have to be managed). The health care industry is (mostly) not a coordinated cartel; it's a bunch of self-interested organizations looking to get a leg-up on the competition.

Re: When good ideas make bad business

#83

Post by mritchie712 »

gkoberger wrote: post #38

I'm so confused by the tone of this article. Obviously some of the jokes are parodying startup culture and are meant to be funny, however I think the "fantastic idea" stuff is meant seriously? "So I built something people wanted. Consumers wanted it, doctors wanted it, I wanted it. Where did I go wrong?" As far as I can tell, nobody wanted it except the author. The one doctor he talked to didn't, and no consumer ever…

The funny part is, he might still be wrong about it being worthless. He talked to ten doctors? There are 1M in the US. It's kind of funny to drop all that time and 40k in then give up after ten doctors say no, especially without trying to tweak the product based on feedback.

I, as a consumer, find it worthless and they shouldn't have even started it, but now that you're here, might as well give it a bit more of shot than that. To completely bail on what you have after 10 no's is also the wrong move.

Doesn't seem like he asked the question, "well, what would you pay for?"

Re: When good ideas make bad business

#84

Post by victor106 »

tyri_kai_psomi wrote: post #71
SpicyLemonZest wrote: post #56

Earlier quoted context omitted.

This is why I get so grumpy about startup narratives. If you ask successful unicorns how they got started, they'll usually explain that's exactly what they did. Garrett Camp was just trying to hire a private driver, and realized it was too hard, there's no reason it should be so hard. Jack Dorsey saw a guy who didn't accept credit cards and realized it would be great if he could accept credit cards. If you don't real…

The most realistic founding story so far is Bezos explanation for how he founded Amazon. It was always a business-first mindset in an area of high growth. That one short video filmed in 1997 should be a masterclass by itself.

Anyone has a link to the above video?

Re: When good ideas make bad business

#86

Post by beat »

rjkennedy98 wrote: post #66
leggomylibro wrote: post #9

Oof. The site was practically named after WebMD, and the founder didn't do any market research on that competitor to gauge how viable the business was before quitting their job? This person probably should have known that their main competitor made $0.50/user before they quit their job. Also: >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 patient…

That line stood out to me also. Anyone who feels that the primary goal of healthcare in the US is to improve health outcomes is incredibly naive about how this industry (which is over 20% of the us economy) works. There is only one group in the entire industry which has an incentive to keep people healthy (insurance) and that is the most hated of the bunch!

Perverse incentive structures are the fundamental reason US healthcare is so expensive and stupid. It's not "greed" in a simple sense, and it's not "regulation" in a simple sense. It's a system of interacting problems that needs treated in a systemic way.

Blaming the insurance companies strikes me as the political equivalent of yelling at the cashier.

Re: When good ideas make bad business

#87

Post by mLuby »

SpicyLemonZest wrote: post #56
ageyfman wrote: post #15

At first I thought this was satire. Here's this guy, who uses a pretty straightforward analysis without any prior healthcare domain experience, thinks he's found the holy grail after a few weeks of work, and then spends all of his money (without first talking to actual domain experts) before he gives up, because Healthcare.

This is why I get so grumpy about startup narratives. If you ask successful unicorns how they got started, they'll usually explain that's exactly what they did. Garrett Camp was just trying to hire a private driver, and realized it was too hard, there's no reason it should be so hard. Jack Dorsey saw a guy who didn't accept credit cards and realized it would be great if he could accept credit cards. If you don't real…

Exactly. Founder myths gloss over the starting details heavily (perhaps because then they seem merely lucky and hardworking).

For example, a recent Musk biography spent maybe a page on the part where he became successful, and a Jobs one just a paragraph or two.

I'd like to see a compilation of these details.

Re: When good ideas make bad business

#88

Post by scotty79 »

> 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.

Wow. That's not how any of (especially 'for profit') healthcare works.

I think it's a good heuristic that you definitely shouldn't build a product if you rely on getting money from 'some profession or some institutions or whatever'. This indicates that much more research into your future customers and motivations is needed before you attempt to create business.

Re: When good ideas make bad business

#89

Post by legitster »

I wish he could have invested more in the idea - I think it's an amazing concept but the creator pulled the plug too early. Sales cycles in B2B can take months, and in healthcare they can take years.

Especially the doctor's feedback, she described the possibility of changing her habits slowly as she got used to using the tool.

Unrelated:

"I always have the best interests of my patients in mind, but, you know, it’s not like they’ll pay more if I prescribe Lexapro instead of Zoloft. They won’t come back more often or refer more friends. So I’d sorta just be, like, donating this money if I paid you for this thing, right?”

This line kills me and it's exactly why I hate the healthcare industry. She clearly understands that the software could improve patient outcomes, but describes it as a donation and still wouldn't change how she writes prescriptions (out of laziness, I guess?)

Re: When good ideas make bad business

#90

Post by cortesoft »

cjdupreez wrote: post #51

Unfortunately, I feel like this is a lesson that's best learned the hard way. Everyone can tell you from the get-go to "have a business plan" before committing financially and professionally to a self-concocted venture. It's not until you run through it and witness the brutality of failure first-hand that you realize the importance of doing your homework first and having a plan.

I don't know, I have never witnessed the brutality of this failure first hand and I understand the importance of doing my homework and having a plan.
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