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When good ideas make bad business

tjcx.me

181–190 of 361 posts

Re: When good ideas make bad business

#181
Hey, I prototyped something similar to this a while back. It used NLP and Elsavier search API to do entity detection and sentiment analysis on drug/effect pairs.

So you would search like "Mirtazapine", and then it would create a word-graph where the drug was in the middle, and it would be connected by things like:

    Mirtazapine --> Reduces --> Anxiety/Depression

    Mirtazapine --> Increases --> Hunger
The words were colored either green/red based on whether it was considered a positive or negative effect, and the size was based on the size of the effect and numbers of mentions.

It was meant to be a tool for clinicians and prescribers to be able to enter a medication and get an easy overview of its effect.

Do you have any interest in pursuing this further?

I know a few investors who I think might still be interested in this.

Re: When good ideas make bad business

#182

Just FYI: "Doppelganger" exists in Russia and makes tons of money from government contracts.

This was my reaction ... it's presented in the article as a fun idea without a market, but seems like a plausible play to build a saleable corpus of facial recognition data.

Re: When good ideas make bad business

#183
Here's how I see it, and the quote at the end kinda fits into this:

What problem are you trying to solve? Googling "what is the best pain killer" is a very "average user" question. It's also 99% useless.

Pain killer for what? Headache? Muscular pain? Nerve pain? You have a partially severed limb that's bleeding profusely? Oh you mean an OTC pain killer?

Ok do you have stomach problems? Liver problems? Kidney problems? Diabetes? "Oh I don't know" oh well...

"But I'm just trying to get the best drug for your situation" yeah, that doesn't exist. And there are personal preferences (doctor), personal preferences (patient), limitations, marketing pushes, etc.

Finding out drug X is more efficient than drug Y in 5% is just background noise. Hence why the doctor didn't see much value in this.

What would be valuable is finding which drug X to try if drug Y didn't work or can't be used (though doctors usually have that in their heads).

Re: When good ideas make bad business

#184

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 no…

That anecdotal interaction is extremely damning for the entire US healthcare system. Physician admits she prioritizes practice revenues over patient outcomes. Other physicians express similar preference. Inventor of useful tool tosses it into the mothballs. That tool isn't just a physician aid. If that's what doctors are really doing, it's more like a physician replacement. If they won't do evidence-based medicine, a…

I don't know how old you are, but at a certain point, the input of a general practice doctor becomes very valuable. Remember, the doctor doesn't even do the little tests you mentioned, like taking measurements and blood tests - they just order them, and nurses or technicians do the work. The doctor's job is to make decisions and give advice.

About a dozen years ago, my doctor caught my blood pressure shooting up in my annual exam and started treating me for high blood pressure. High blood pressure is a "silent killer" that leads to premature deaths for millions. You don't feel sick, while your heart struggles and your brain risks explosions. And treating it, once diagnosed, isn't straightforward. It took six months of experimenting with various medications to find the combination that worked for me. That's a doctor's judgment and expertise, not something for some technician with a community college associate's degree. And this summer, when a critical potassium depletion drove me to a scary ER visit, she noted that one of my BP meds could affect potassium and adjusted my dosages.

And it's not just an expert-system thing that could be replaced by a robot, either. She's not just dealing with my measurements - she's dealing with my fears, and helping me decide on best approaches. That requires a human touch.

Re: When good ideas make bad business

#185
post #86

Earlier quoted context omitted.

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.

I mostly agree, but...

Insurance is one of the oldest industries in the US, which means they have accumulated many (probably well meaning, but ultimately stupid) regulations over the years.

For example, to be taxed as an insurance company (e.g. avoid paying tax on premiums that will partially be paid out in the future), most states assign a maximum profit margin.

That means, in order to make more money as an insurance company, it's perversely in their best interests to increase the cost of medical care as much as possible. Medical care is not like cat bonds that might wipe out your risk pool, so it's just a cashflow game.

That's not to say there isn't any downward pressure. On a day to day basis, individual claimants eat more into that margin than was budgeted, so a company might have to raise rates higher than their competitors (essentially they have some pressure to deny claims), but there is very little systematic pressure to reduce overall costs. Also, marketing budget does not count towards profit, which is why insurance companies are in this rat race of brand advertising to steal customers from each other. With auto insurance, for example, upwards of 40% of your premium is just going out the door as ad spend.

Anyway, I would assign a lot of blame in this perverse incentive scheme to poor regulations.

Re: When good ideas make bad business

#186
post #179

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 no…

I'd like to imagine "laziness" isn't the reason doctors write the prescriptions they do.

"Laziness" is probably unfair - but there is a lot of evidence that everyone, doctors not included, will get stuck in their ways unless forced out of them.

Re: When good ideas make bad business

#187

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…

From a business standpoint, saving lives can actually be expensive. The longer someone lives, the more healthcare they consume. Health insurance companies are very aware of this, which is why they so frequently deny coverage for various life-saving cancer treatments. If you die while waiting for treatment, not only do they save the cost of the treatment, but also the entire cost of ongoing screening / care during rem…

This is precisely why we need universal healthcare. The incentive structure of private markets don't properly value human life.

Re: When good ideas make bad business

#188

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…

I feel like the best play would have been to spend 100% of his effort to get WebMD as the first Angel Investor. If WebMD owned 20% of his product, for say $300k in Seed Money, he could have used that Runway to build something really cool. And WebMD would have an incentive to promote his site and help bring free users.

Does anyone know Bob Brisco the C.E.O. of Web MD?

I'm going to try and get this in front of them using my contacts, but it is a long shot.

Re: When good ideas make bad business

#189
I think we mistake these ideas as being bad business because of our expectations. Some ideas take longer to produce returns.

I'm currently working on an idea that has no business plan in the near future. It's a cryptocurrency. I hope to make money from in the future by either selling my stash or providing software and services. But in the meantime, I'm running it as a fun/side-project. The project is picking up steam. I've seen interest growing, some coin trading on an exchange.

I don't expect to make money soon. So I do everything myself. I spend little money on the project, 3-5k per year. I enjoy working on it and learning. It helps me learn not only about my project but also about other cryptocurrency. I think that I will make some money, eventually.

Re: When good ideas make bad business

#190
For anyone else who, like me, is prone to the excitement of new company ideas and has a tendency to gloss over questions like "is it even possible to monetize this?" I'd recommend reading Disciplined Entrepreneurship. It's not the One True Way but the steps they recommend cover a lot of questions that you should think about during the process.
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