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I wasted $40k on a fantastic startup idea

tjcx.me

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Re: I wasted $40k on a fantastic startup idea

#261

Post by wpietri »

eightysixfour wrote: post #30

I remember reading this the last time and it was posted and I still think the core failure is that the author didn't actually recognize the issue he was solving. He thought the problem was choosing the most effective medicine when the real problem was decision fatigue looking at endless shelves of things that all seem to do the same thing. Those two problems sort of look the same, but the latter cannot be resolved by…

I'd be skeptical that would work.

A friend did a ton of user testing of improvements to a price-comparison site back when those were the rage. With some frequency the engineers would come up with a way to help people make a better buying decision. E.g., picking a TV is a problem, so they'd make a wizard that would ask you questions and then give you a recommendation. Problem solved, right?

Alas, no. Turns out most of these user guidance things wouldn't help, because people had no reason to trust the thing. They might go through the process, but their behavior didn't change. I'd expect to see the same effect with a kiosk. Most wouldn't engage, and those who did wouldn't weight the recommendation very highly.

A website would have an even deeper trust problem, and would add an SEO problem on top. Imagine a referral is worth $1 on average and you spend $0.50 on coming up with good answers, $0.49 on making sure you're on the first page of Google results, and take $0.01 in profit. You'll very quickly have a competitor with that spends $0 on research and $0.99 on being ahead of you on Google. Sure, their data will be garbage, but the page will be just as convincing to somebody who doesn't know anything, which is your target market.

I suspect the real outcome, as with many would-be startups, is that this is a feature, not a business. Somebody like Wirecutter or Consumer Reports could turn this into solid content that would be a nice addition to what they have already. They've already built a trust relationship with their users, and they don't have to specifically find people in the (very rare) moment of choosing a new medication.

Re: I wasted $40k on a fantastic startup idea

#263

Post by cko »

nickjj wrote: post #9

That was a fun read. I wish the author mentioned how much he was trying to sell the service for. It could have been $59 a month or $599 a month and with doctors you could potentially expect the same answer. I'm not a psychologist but some of the author's quoted text came off extremely demeaning in written form. If the author happens to read this, did you really say those things directly to them? For example, Susan (p…

It was indeed a fun read. As a pharmacist I had a similar 'idea' years ago and got two other pharmacists excited. We were sick of seeing prescribers not follow 'Evidence based medicine' and thought maybe something that took Cochrane Meta Analyses and UpToDate info in a nice interface would be amazing.

> I started babbling about network meta-analyses, statistical power, and p-values, but he cut me off.

> "Yeah okay that's great but nobody cares about this math crap. You need doctors."

So true. As an insider in healthcare I would probably have disregarded this for idealism.

Re: I wasted $40k on a fantastic startup idea

#264

Post by a-dub »

> "Hmmmm," she said, picking at her fingernails. "Not directly. Of course 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 is the problem. the incentives in healthcare are messed up. doctors are paid for their time, not for their outcomes. if a patient comes in and is prescribed a therapy, and they don't have to come back, the doctor should receive more than if the patient returns because the therapy had an issue.

Re: I wasted $40k on a fantastic startup idea

#265

Post by concreteblock »

MacsHeadroom wrote: post #234
ketamine__ wrote: post #231

Earlier quoted context omitted.

Far more effective? Source?

For a user named ketamine_ are you really questioning the well known efficacy of few-shot therapies for treatment resistant depression and PTSD? Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041963/ Reviewing the Potential of Psychedelics for the Treatment of PTSD: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311646/ etc.

> For a user named ketamine_ are you really questioning the well known efficacy of few-shot therapies for treatment resistant depression and PTSD?

Maybe they want to convince their friends?

Re: I wasted $40k on a fantastic startup idea

#266

Post by Aeolun »

nickjj wrote: post #9

That was a fun read. I wish the author mentioned how much he was trying to sell the service for. It could have been $59 a month or $599 a month and with doctors you could potentially expect the same answer. I'm not a psychologist but some of the author's quoted text came off extremely demeaning in written form. If the author happens to read this, did you really say those things directly to them? For example, Susan (p…

Just because someone spends 30 years learning something does not mean they learned the right thing.

Re: I wasted $40k on a fantastic startup idea

#267

Post by rawoke083600 »

stevewodil wrote: post #25
nickjj wrote: post #9

That was a fun read. I wish the author mentioned how much he was trying to sell the service for. It could have been $59 a month or $599 a month and with doctors you could potentially expect the same answer. I'm not a psychologist but some of the author's quoted text came off extremely demeaning in written form. If the author happens to read this, did you really say those things directly to them? For example, Susan (p…

It's actually a very good sales question, I don't find it demeaning at all. If you're on a sales call selling a product that increases user retention and someone says "no we don't need that", you would often reply with "So you have perfect user retention then?" to probe them and re-open the conversation. It could come off as standoffish but when used correctly it's very effective because it gets the person on the oth…

Arg I HATE that angle ! It's like that sales calls.. "Do you like money ?".. if you say no thank you I"m busy... they like... oh so you don't like free money ?

Re: I wasted $40k on a fantastic startup idea

#268

Post by kangaroozach »

Resonates with me big time. I also bootstrapped a digital health startup called AnywhereMD with a team of physicians. At first it was a triage app that evolved into a messaging platform. The triage had a similar value proposition; get people to the optimal point of care and they will avoid unnecessary and costly ER visits. Self insured employers and accountable care organizations would reap the savings and therefore pay per employee or insured per month and drive people to use AnywhereMD before deciding where to seek care. We were bootstrapped and had a hard time convincing large companies that we were legitimate since we were so small. The biggest parallel I can see is that in healthcare, cost savings and better outcomes are obscured, hard to see, delayed etc.... So it’s not easy to prove value and then capture some of the value for your self.

Re: I wasted $40k on a fantastic startup idea

#269

Post by vasco »

a-dub wrote: post #264

> "Hmmmm," she said, picking at her fingernails. "Not directly. Of course 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 is the problem. the incentives in healthcare are messed…

Maybe we should also pay programmers based on outcome then, and you get less if your % of bugs is higher than the team average, sounds like a great idea, eh? Maybe a day without pay if you bring down the live service? I'm pretty sure this wouldn't work. The first place to put it in place, be it a hospital or a tech company, would just have most people quit. Sometimes things are hard and people need to know the business has got their backs as long as they try their best. Reducing pay on bad outcomes is institutional blame culture on overdrive.

Re: I wasted $40k on a fantastic startup idea

#270

Post by inopinatus »

a-dub wrote: post #264

> "Hmmmm," she said, picking at her fingernails. "Not directly. Of course 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 is the problem. the incentives in healthcare are messed…

If you paid doctors by individual outcome then the incentives would be even more messed up, since no-one would want the tough or ambiguous cases.

This is opposite of the desired outcome, which is that the best doctors see the hardest cases.

Always pay professionals for their time. Patients are not widgets.

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