When good ideas make bad business • Hacker News Board

Re: When good ideas make bad business

#251

Post by Toenex » Fri, Jan 03, 2020, 8:54 PM UTC

amitmathew wrote: post #166

I think people are being a little too hard on the author. Startups in healthcare are hard . Been there, done that, have the t-shirt (literally, that's all that left). I even made the same fatal mistake - not identifying who the buyer really is. And when I say identifying the buyer, I don't mean it in that hand-wavey, vague way like "doctors" or "insurance companies". The starting point has to be something like "ophth…

This. Been through two medical device companies that pivoted from clinical trials to product and the major hardships came from not fully understanding the money trail. In the UK the 'Cathedral' of the NHS means that the benefits may not be felt by the your customer.

Re: When good ideas make bad business

#252

Post by pilingual » Fri, Jan 03, 2020, 8:59 PM UTC

The foremost problem is lack of domain expertise as others have noted. If you lack domain knowledge but love your idea, the best course of action is to keep your day job and gain as much knowledge as you can before quitting.

But another problem is lacking the conviction and traversing the idea maze[0]. Several comments here have provided good paths for possible methods of execution like offering a free API and seeing who is using it.

[0] Summary of Balaji's concept here: https://cdixon.org/2013/08/04/the-idea-maze

Re: When good ideas make bad business

#253

Post by JamesBarney » Fri, Jan 03, 2020, 9:06 PM UTC

cosmic_shame wrote: post #138

StavrosK wrote: post #126

The author says that they fired the contractors and closed the site. I can never relate to this. You built something that is at least somewhat useful to at least some people. Why not just keep it online forever? It can't cost more than $5/mo to host this, I have a server where I host around ten of my projects for less than $20/mo. Why do people shut things down instead of just leaving them there, unmaintained? Even t…

Well in the case of this particular product that offers medical advice, the info may become outdated fairly quickly. I suspect there is some amount of liability associated with offering potentially out of date medical advice that isn't worth the tiny revenue stream.

It's just a programatic meta analysis. And no one's get sued for having an out of date meta analysis.

Re: When good ideas make bad business

#254

Post by danieltillett » Fri, Jan 03, 2020, 9:11 PM UTC

reggieband wrote: post #151

> I had literally nothing to say to that. I think this is literally why salesmen exist. One of my good friends is a real estate agent and he is helping me find a house. My job is to complain about every place we see. Every single time he finds a way to spin my complaint into a positive or something constructive. Roof leaky? You can get it fixed for $X dollars and we can work that into an agreement. For a great salesm…

A lack of money from the customer can’t be overcome. In your case if you can’t afford any of the houses there is nothing the great salesman can do. Of course a great salesman qualifies their prospects before attempting to sell.

Re: When good ideas make bad business

#255

Post by danieltillett » Fri, Jan 03, 2020, 9:16 PM UTC

DJBunnies wrote: post #7

I feel like one can just review the symptom relief for each product. Are there people that don't know acetaminophen is for headaches and ibprofin is for muscle aches?

Yes those of us that know ibuprofen is better for headache than acetaminophen.

Actually taking both together is more effective. Take one tablet of ibuprofen and one of acetaminophen.

Re: When good ideas make bad business

#256

Post by ljm » Fri, Jan 03, 2020, 9:16 PM UTC

amitmathew wrote: post #166

I think people are being a little too hard on the author. Startups in healthcare are hard . Been there, done that, have the t-shirt (literally, that's all that left). I even made the same fatal mistake - not identifying who the buyer really is. And when I say identifying the buyer, I don't mean it in that hand-wavey, vague way like "doctors" or "insurance companies". The starting point has to be something like "ophth…

At risk of identifying myself, I work in this industry (or should I say, I work in the medical field) and yes... it's insane. And of course, you get that privileged peak behind the veil, you get to see how the sausage is made as it were.

It is truly humbling because there is no easy solution, there are no unified APIs; you couldn't use them even if there were, because your medical records are highly sensitive. So forget about poking around production to solve a bug, you've got to do it through observability.

You can't move fast and break things because your downtime will get the regulators involved, because peoples livelihoods are at stake. You will get official complaints through various official bodies who can and will sanction the business.

In short, it's not a fucking joke and it takes a lot more time and a lot more money to do something serious here, and for good reason.

Note that I'm not talking about low-key wearables like Fitbits that monitor your pulse, I'm talking about doctors, triage, etc.

Re: When good ideas make bad business

#257

Post by sweeneyrod » Fri, Jan 03, 2020, 9:16 PM UTC

wayoutthere wrote: post #241

sweeneyrod wrote: post #240

Earlier quoted context omitted.

Your second link has a pie chart that claims that pharma companies spend around 200x as much on advertising as clinical trials. Do you believe that is true?

This has been known for a very long time in pharma circles. Marketing budgets are several orders of magnitude higher than R&D budgets. An extra dollar spent on marketing has much higher returns than an extra dollar spent on R&D. Most of the real "hard science" R&D is paid for with NIH grants.

> Marketing budgets are several orders of magnitude higher than R&D budgets.

This is a lie. Marketing budgets are approximately equal to R&D (https://www.bbc.co.uk/news/business-28212223) so you're off by several orders of magnitude.

> Most of the real "hard science" R&D is paid for with NIH grants.

Also not true. NIH grants are ~$40 billion/year whereas industry R&D are around $80 billion (https://www.statista.com/statistics/265085/research-and-deve...).

There are definitely lots of problems with the pharmaceutical industry, several of which are mentioned in that BBC article. But making hyperbolic claims that they essentially don't do any R&D isn't helpful.

Re: When good ideas make bad business

#258

Post by acvny » Fri, Jan 03, 2020, 9:21 PM UTC

Wow, what a nice and funny story!

Why GlacierMD? You know glaciers tend to melt these days.

You'd be surprised that the dumb and not so noble idea of your buddy with Doppelganger could gain much more traction and make much much more money than your idealistic thing... this is usually the thing.

People are attracted more to fun than to pragmatic usefulness.

You feel almost like a martyr who wanted to save the world, but nobody understood you. I am very sorry and I see great value in your idea, but looks like people don't want to consume that.

Indeed, why would a medical practice want to completely cure the patient and never see them again?

Really fun read and with lots of useful references.

Re: When good ideas make bad business

#259

Post by nikita2206 » Fri, Jan 03, 2020, 9:23 PM UTC

catchmeifyoucan wrote: post #136

I still think this idea is powerful. Not because I believe it transforms healthcare, but because it informs consumers a bit more. That’s what seemed to get you excited in the first place. There are a few paths I see still: a. Assuming you own a database, expose your dataset as an API. Consider possible consumers. Open source it, and monitor the usage. Who’s using that data. b. Cold message a few folks on Linkedin fro…

Maybe you could open source it, and with the help of people from the community get sort of grant from Google or Amazon or say digital ocean so that this could work without you having to pay for servers? All the work that contractors were doing, people could do that for free. The only thing is I’d license this thing so that it can’t be used commercially (except for research)

Re: When good ideas make bad business

#260

Post by sombremesa » Fri, Jan 03, 2020, 9:24 PM UTC

bobosha wrote: post #11

Perhaps you gave up too soon, your startup journey is shared by most (all?) startups i.e. where they end up finding PMF is often very different from where they started. It's a matter of sticking with it and if it's worth the opp. cost. Admittedly, this is Survivorship Bias, since the overwhelming majority of startups fail. As PG said: "startups don't fail, founders give up"

Sure, but that's not the whole story -- the OP would also need to be okay with changing the idea drastically where and when required. As other people have noted in this thread, not much effort was made when talking to the doctors to find out what problem they do have, and no mention is made of ever even showing this product to consumers.

The fatal flaw here was building a product "in secret" and not launching soon enough.