Sam Jactel is trying to treat an illness most people are probably uncomfortable talking about publicly. As the founder and CEO of Ayble Health, he wants to help patients better manage their gastrointestinal condition and remove the stigma that surrounds it and other chronic diseases. Hear about his entrepreneurial journey, advice he has on building a brand, why diversity of opinions is important in the startup space, and how he hopes to never be the smartest person in the room.
Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts. And keep up with us on LinkedIn, Twitter, and Medium at @InflectHealth, and on the web at InflectHealth.com.
Sam Jactel is trying to treat an illness most people are probably uncomfortable talking about publicly. As the founder and CEO of Ayble Health, he wants to help patients better manage their gastrointestinal condition and remove the stigma that surrounds it and other chronic diseases. Hear about his entrepreneurial journey, advice he has on building a brand, why diversity of opinions is important in the startup space, and how he hopes to never be the smartest person in the room.
Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts. And keep up with us on LinkedIn, Twitter, and Medium at @InflectHealth, and on the web at InflectHealth.com.
[00:00:00] Lindsay Kriger: Hey everyone. This is Lindsay Krieger, director at Inflect Health, the innovation hub of Vituity, where we strive to be a catalyst for better care. I'm thrilled to be hosting "For Startups, By Physicians" where we share insights and guidance to healthcare startups and technologists looking to create the future of health.
[00:00:18] Lindsay Kriger: As a physician-founded firm, we have connections with clinicians and intimate knowledge of what they need and how they work. We will be interviewing our executives, frontline providers, and industry leaders to help your business be effective and scale. Thanks for joining and let's get going.
[00:00:42] Lindsay Kriger: Today I'm joined by Sam Jactel, the founder of Ayble, a digital gut health platform, personalizing treatment plans based on science. His own diagnosis compelled him to create a solution for all without the typical trial and error process most patients experience. [00:01:00] Ayble has become the first and only GI company to meet the American Nutrition Association and Validation Institute standards, proving clinical efficacy, and gaining customer traction.
[00:01:12] Lindsay Kriger: So Sam, welcome to the podcast. How are you today?
[00:01:15] Sam Jactel: Good. Thank you so much for having me. I like that intro, really hard rock, which I'm a fan of.
[00:01:20] Lindsay Kriger: That's awesome. Good. We like to keep it light and fun around here.
[00:01:24] Lindsay Kriger: You're not a physician, which is great. I love actually having non-physicians on, but one thing you are and is the most important thing, in all of our minds, is a patient and a consumer of health and have had a really interesting journey on how you became a founder and CEO. So why don't you start from that perspective and let us know how you got to where you are today?
[00:01:46] Sam Jactel: Yeah, no, absolutely. I'm Sam, founder, CEO of Ayble Health. I've been a patient of inflammatory bowel disease for about 10 years, and the journey to today has certainly been a very like up and down one.
[00:01:59] Sam Jactel: I [00:02:00] like to tell my story because I'm not alone. I think that the challenge is with managing these chronic gastroenterology conditions that are as stigmatized and sometimes ignored. So my personal experience, I was diagnosed 10 years ago. I went to five different gastroenterologists. I took a cocktail, so to speak, of seven different drugs.
[00:02:20] Sam Jactel: I was adherent to those drugs. I think I was a decent patient and I was able to afford that care, which is not the case for everybody. And I had access to the care, which is not the case for everybody. And despite all of that, I fell out of remission five times in nine to 10 years, and it sucks.
[00:02:39] Sam Jactel: I think where physicians have a tremendous amount of understanding of the biology, I think where there's a gap is the experience, the what it's like to be a patient piece, and that's something that's really exciting to bring to the table — to be able to shout it from the rooftops and to take what is a common thing that [00:03:00] patients do, which is be the CEO of their condition, problem, solve for themselves, be resourceful for themselves, and get answers and get that support in between the office visits.
[00:03:10] Sam Jactel: Ayble came out of me solving my own problem. During a flare, creating a tool that was low code, low tech, really not super great. And it working for me, giving it to other patients and it working for them, and then spiraling that into an academic trial, multiple academic trials — 13 of them — and then a company.
[00:03:30] Lindsay Kriger: So what's your background and were you on that track to being an entrepreneur from a young age, or was the diagnosis really something that propelled you into this career?
[00:03:41] Sam Jactel: I fell into the entrepreneurship side of things. So my background, I was in clinical research, so I did work in the pediatrics space, not a physician, but I was a researcher, published a bunch of papers that had low to medium impact in the space. And I thought that like the way to get good science to people who needed it the most was to go into the business world and align [00:04:00] financial incentives. And I thought that was how markets would change.
[00:04:03] Sam Jactel: So I was a consultant for a while as a venture capitalist for a while. Got my M.B.A. I had that infrastructure, the clinical side a little bit, and the business side of it. In trying to solve my own problem as a patient, I was using some of those tools, but very little technical training.
[00:04:19] Sam Jactel: So I'm not an engineer, but I was able to cobble together tools that were in the space to solve a problem. For me, that was identifying and removing the foods that were causing my symptoms, called trigger foods. I did go through what is a very common process, which is taking a low tech, minimum viable product, applying it, iterating, and then getting to something that means something.
[00:04:43] Sam Jactel: And for us, we made the decision at some point of, instead of taking that tool, turning it into a company before getting clinical validation, we did the clinical validation first and then turned it into a company because we thought that was a differentiator and was also [00:05:00] the right ethical thing to do given that we were patients.
[00:05:03] Lindsay Kriger: At Inflect, obviously we see tons and tons of startups coming through. Gut health and this genre of startups is getting more and more popular. I'm wondering how you continue to differentiate yourself in a market where there might be people that are just looking at the total addressable market and saying, "oh, let's go into this. This is gonna be a cash cow." Are you guys building a brand and competing in that space today?
[00:05:29] Sam Jactel: There are a lot of people that do what you just said. They go, "wow, this is a big market. Okay, I'm gonna go and talk to six people and then I understand, okay, what those six people have told me," and they go, "great, I'm gonna now develop a solution." And then that solution goes and seeks a problem. And that's where I think you get the issue of product market fit.
[00:05:46] Sam Jactel: I think the other thing that I think a lot of people miss or actually undervalue in my opinion, is founder market fit, which I think is the other thing. Why do you wanna dedicate your life to solving this particular problem that you [00:06:00] understand better than anyone else? That's where we started, and that patient perspective has been a differentiator.
[00:06:06] Sam Jactel: The other element is we know that patients have had eroded trust in the healthcare and medical ecosystem, and so we thought that there were a couple elements. One is truly having empathy for the patient and what he or she is going through would be a differentiator, both from a business model standpoint, from a brand positioning standpoint, and from building the tooling.
[00:06:26] Sam Jactel: So if you know how I live , that's a differentiator in terms of what you're building. And then being able to emphasize the clinical piece, which makes it attractive to others and builds that trust with your end consumer. So we did all that. I think from a branding standpoint, the easiest thing to point out that we were very thoughtful on was our name.
[00:06:44] Sam Jactel: So our name is Ayble Health. We spent quite a bit of time on doing that because it's a higher order need. So for a patient, it's not just about resolving symptom. It's about being able to eat at restaurants with friends without being afraid of the consequences. It's being [00:07:00] able to travel on a regular basis, being able to be defined by something other than your condition.
[00:07:05] Sam Jactel: And so that's how we positioned ourselves. Our goal is to have that patient feel seen by what we're doing, how we're doing it, how we're explaining it.
[00:07:14] Lindsay Kriger: I love the name and I love the patient-first centered approach to the brand and the consumer. Tell me a little bit about how you foresee a product like this fitting in with someone's journey who's been to 10 different doctors or has a flare up and has to go to the emergency room. How do you see these two worlds interacting?
[00:07:34] Sam Jactel: Yeah, so the interesting thing about the gastroenterology space is that I would consider these conditions as "and" conditions rather than "or" conditions.
[00:07:42] Lindsay Kriger: Okay.
[00:07:42] Sam Jactel: What we're seeing that if you do the medication only or the diet only, or the psychology only, or you know the supplements that may or may not have scientific evidence behind them only, there is a lower likelihood that you'll feel better. If you put all of them together, that's where [00:08:00] you have a collaborative care model, a holistic care model, you're addressing the root cause of your symptoms by doing all of those things together.
[00:08:07] Sam Jactel: And so what we're building is that ecosystem of support outside of the clinic for that patient. So the diet and the psychology in particular, and in doing so, we are able to really treat that whole patient. And in our clinical research, we made sure that the patients that were coming in and using our platform had been on drugs, had not been on drugs, had changed their diet, had not changed their diet, had severe symptoms or medium symptoms. So what we are able to do is show that we can actually improve those outcomes for all of those patients regardless of what they've already been doing, because it's such a multifactorial, multi etiological.
[00:08:40] Lindsay Kriger: Let's switch gears a little bit.
[00:08:42] Lindsay Kriger: Tell me about your journey. This is your first startup, is that right?
[00:08:45] Sam Jactel: Yes.
[00:08:46] Lindsay Kriger: Yeah. Okay, cool. So tell me a little bit about the journey that you've been on and where you wanna take this company and how you hope to get there.
[00:08:54] Sam Jactel: The inception of Ayble — I incubated the company in business school at Kellogg, at [00:09:00] Northwestern. It was a phenomenal program called the Zelle Fellowship. So anyone out there looking for a business school program, the entrepreneurship side of Kellogg, we're not just a marketing school. Okay? We do entrepreneurship. We do it very well, and it was a phenomenal opportunity to get a huge amount of hands-on coaching, on business building.
[00:09:17] Sam Jactel: Problem identification was most of what we did. And then we had grant funding to invest in developing the infrastructure of the company and the clinical research, and then spun that out. And so that was the inception.
[00:09:30] Sam Jactel: So we've had phenomenal mentors to be able to build that ecosystem and think about the right things that allowed us to make enough progress to raise some capital and go to.
[00:09:39] Sam Jactel: But yeah, it's an interesting thing. My advice to founders out there is like really, truly understand the problem very deeply and understand that like down the road, if you don't understand the problem as well or if you are not obsessed with your idea or obsessed with the problem that you're trying to solve — don't be obsessed with your solution, by the way, be obsessed with the problem. If you're not there, [00:10:00] try to get there. You're gonna get a lot of obstacles in your way. You're gonna get people saying no. And so really having that conviction and the problem that you're solving is really, important.
[00:10:09] Lindsay Kriger: Tell me about the team that you have assembled and how it's been working both on, I would say the product side, but also just the growth side. Any advice you have to other entrepreneurs and founders on things that you've learned along the way because we all know building teams is challenging.
[00:10:28] Sam Jactel: It's challenging, but it's incredibly rewarding because if you do it right, you're able to exceed your own skillset and expectations. So if you're the smartest person in the room, you're in the wrong room.
[00:10:38] Sam Jactel: What we have done a really good job of obviously, is making sure that I'm the dumbest person in that room, and then supplementing with people around that table who are coming, who are veterans of the startup space, but also who've never done the startup side of things. I value diversity of opinion as much as ethnicity and gender and all that stuff.
[00:10:56] Sam Jactel: The diversity of opinion is a really important piece that I think a lot of people [00:11:00] skip, which is, look, if I come to you with the perspective of a background of research, I'm gonna have an opinion that's different than the perspective and background of, oh, I built and sold a couple companies. Being able to have that really good debate in the room allows us to build a better product, build a better product faster, and be able to commercialize that in a way that is more effective and aligns incentives in the whole space.
[00:11:22] Sam Jactel: But it is very difficult to do that. The biggest piece for us is culture. So I don't really care about the flashy like logo on the resume. If that person isn't able to collaborate and if they don't align, even if they're the smartest person in the room, they're not getting into the room.
[00:11:38] Lindsay Kriger: Yeah. So how big is the team today?
[00:11:40] Sam Jactel: Yeah, so there's nine of us full-time. An ecosystem of contractors and friends and all that stuff building out somewhere around 25-ish. That army's growing. We're very excited.
[00:11:50] Lindsay Kriger: And when you say in the room, I'm gonna just take the assumption it's a virtual room
[00:11:54] Sam Jactel: Yes.
[00:11:54] Lindsay Kriger: Or do you actually get together?
[00:11:56] Sam Jactel: Yeah, the virtual room is great now. There's a lot of value to it. [00:12:00] We do make it a point of coming together every so often, every quarter or so, maybe a little bit more frequently, to all come together and spend some time because it's not a 100% perfect ecosystem in all virtual mode. I think some of the hybrid stuff does add a little bit of value too.
[00:12:15] Lindsay Kriger: Yeah, absolutely. Cool. You sound like you're learning a lot as a founder. We all share a similar attitude at Inflect. If the team that you're with isn't challenging you and creating diversity of thought and opinion, then groupthink is really easy to become stagnant in. That's always the challenging space.
[00:12:34] Lindsay Kriger: So let's go back to where we started. You being a patient, tell me a little bit about the patients in your trials and using the product right now. How are they liking it? What do you hope for them and what do you hope to continue to build as the product continues to mature?
[00:12:48] Sam Jactel: We've had hundreds of patients go through the platform, through our research and our current tool, and it's been very exciting. The way that we got our very early patients was actually through our partnerships with [00:13:00] research organizations, but also patient advocacy groups. So we're part of the American Nutrition Association. We're also partners with the American Gastroenterology Association, the Crohn's and Colitis Foundation. All of that allows us to get access to patients. The interesting thing is not just using our tool, but co-developing it with us.
[00:13:17] Sam Jactel: So we have a phenomenal advisor, Dr. Kate Wallen, who's an expert on behavioral change and is a behavioral epidemiologist, which is a really cool subspecialty, but one of the things that she always has coached me on is not to do "me" search, but to do research because I, as a privileged white male, I have one perspective on what the problem is, but others that don't look like me, talk like me, experience things differently.
[00:13:42] Sam Jactel: And so we've made some real investments on making sure that there's diversity of population. One of the ways that we've done that is I think we're one of the only companies out there that has a patient advisory board, not just a scientific advisory board. And oftentimes that's a really good debate.
[00:13:56] Lindsay Kriger: That is interesting, especially in the [00:14:00] world of Dr. Google and now ChatGPT and all of the self-exploration that patients can do. I think inviting patient panels and patient advocates to be at the table in the founder groups and in this technology groups is so critical because, right, consumers, patients are going to seek out information, whether you as the doctor or you as the company want them to or not. That's just how we're all built and bringing those things together is really an important step and not to be missed because you're gonna miss out on their opinions and behaviors one way or the other.
[00:14:36] Sam Jactel: Yeah. I'll get on a soapbox for two seconds here. I go to so many medical conferences, digital health conferences, all of these kinds of things, and the panels are chock full of investors of startup, founders, of policy makers of physicians. There's never a patient on a panel. And it's flabbergasting to me sometimes that, we as a healthcare ecosystem, make [00:15:00] decisions on behalf of other people that we don't know. And that those patients don't have that voice on panels. A panel is an example, but be in that room I think is really important.
[00:15:08] Sam Jactel: And so we don't wanna perpetuate those biases either in our company. Yeah.
[00:15:12] Lindsay Kriger: I love that. I'm like, my wheels are spinning. We should co-write an application for speaking and we should bring all of our patients because we obviously... we deeply believe that the patient experience, the customer experience, the consumer experience is what matters. And we don't wanna just pay lip service to that. We really wanna build something that people are gonna use. Otherwise, you're just in this ecosystem of trying to raise money and sell, which is fun, but can be unimpactful in the long run if you're not really focused.
[00:15:45] Sam Jactel: Yeah, and this is where I think there's a difference between patient-centered innovation or care and patient-driven innovation.
[00:15:52] Sam Jactel: Maybe it's a semantic thing, but I actually think that there's a difference. Patient-driven things are the, I'm the one who's expensive, I'm the one who's sick, [00:16:00] and a lot of what we want me to do is change my behavior. And so if you're not, I am proposing a solution that I am solving of my own problem or being resourceful in doing so, I think that's incredibly valuable rather than other people building a solution saying, "don't you want this thing?" and then you go, "no, not really. It doesn't solve my problem." That's a big shift that I am hoping gets a little bit more popular than it is now.
[00:16:24] Lindsay Kriger: I love it. Any last thoughts or comments? This was a really interesting discussion and I'm so grateful that you've taken your own personal experience and been so vulnerable and vocal. I know there's so many friends, family members, everyone knows someone that's suffering so much and can really benefit from innovative solutions here.
[00:16:42] Sam Jactel: First of all, thank you guys. You guys have been phenomenal partners to us as we've grown. Our mission at Ayble is to smash the stigma that's related to these conditions, and only when we smash the stigma will we really understand the burden. Once we understand the burden, the solutions will flow.
[00:16:57] Sam Jactel: We're very excited about not just creating a [00:17:00] tool that solves the problem and helps people get better and stay better longer, but also be a force for community-driven evolution in the gastroenterology space because I think it's a huge unmet need with very large potential impact. And doing so without the community, I think is probably the wrong way to do it. So we're very excited.
[00:17:19] Sam Jactel: Feel free to join us@Ayblehealth.com. Shoot us a note and we're excited to have anyone on the platform that wants to join us.
[00:17:26] Lindsay Kriger: I love it. Thank you so much, Sam.
[00:17:28] Sam Jactel: Thanks Lindsay.
[00:17:29] Lindsay Kriger: Thanks for joining us and again, I'm Lindsay Krieger, director at Inflect Health. Here at Inflect, the future of medicine care and health delivery is not just right for disruption; it's increasingly personalized, accessible, and human. Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts. And keep up with us on LinkedIn, Twitter, and Medium at @InflectHealth, and on the web at InflectHealth.com.