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.
I wasted $40k on a fantastic startup idea (2020)
191–200 of 336 posts
Re: I wasted $40k on a fantastic startup idea (2020)
#192"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.
Re: I wasted $40k on a fantastic startup idea (2020)
#193The 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-…
The main reason it didn’t work was because the idea was bad. See salient comments from previous posts: https://news.ycombinator.com/item?id=25827610 https://news.ycombinator.com/item?id=25829290
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.
Re: I wasted $40k on a fantastic startup idea (2020)
#194The 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…
> 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?
Re: I wasted $40k on a fantastic startup idea (2020)
#195The 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-…
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
Re: I wasted $40k on a fantastic startup idea (2020)
#196I 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 review…
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…
Mining proprietary data is indeed a value proposition.
Re: I wasted $40k on a fantastic startup idea (2020)
#197The 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-…
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
What are some possible ways to invest a few hundred bucks, for getting interviews with intended customers? I'm truly curious.
Or do you mean he should have invested into a designer to create mockups?
Re: I wasted $40k on a fantastic startup idea (2020)
#198“Over the next nine months I would quit my job, write over 200,000 lines of code”
That stretches credulity. It’s, like, 750 lines of code per day, working every day.
Re: I wasted $40k on a fantastic startup idea (2020)
#199I’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 “Doct…
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.
Re: I wasted $40k on a fantastic startup idea (2020)
#200I'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 compan…
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.