Ever feel like you're standing at the edge of a precipice, about to make a decision that could change everything? That's where Dr. Johann Malawana found himself as he made the audacious leap from the security of medicine to the exhilarating world of startups. On today's show, he bares his soul, revealing the internal battles, self-doubt, and the resilience required to navigate such a life-altering transition. His candid reflections on the pressures of entrepreneurship, juxtaposed with his experiences in obstetrics, make for a compelling narrative that both aspiring and seasoned founders can relate to.
As we weave through Johann's story, the conversation gets into the challenges of leading two mission-driven healthcare organisations, The Healthcare Leadership Academy and Medics Academy. His insights on the importance of focus and the similarities in decision-making between medicine and business leadership are eye-opening.
Johann provides an inspirational roadmap for those contemplating a foray into startups. He encourages aligning one's personal convictions with their career choices, emphasising that the true measure of success is deeply personal and unique to each individual. Embrace the doubt, harness the passion, and carry forward the mission—Dr. Johann Malawana's reflections are a beacon for anyone seeking to leave a mark on the world through their work.
Ever feel like you're standing at the edge of a precipice, about to make a decision that could change everything? That's where Dr. Johann Malawana found himself as he made the audacious leap from the security of medicine to the exhilarating world of startups. On today's show, he bares his soul, revealing the internal battles, self-doubt, and the resilience required to navigate such a life-altering transition. His candid reflections on the pressures of entrepreneurship, juxtaposed with his experiences in obstetrics, make for a compelling narrative that both aspiring and seasoned founders can relate to.
As we weave through Johann's story, the conversation gets into the challenges of leading two mission-driven healthcare organisations, The Healthcare Leadership Academy and Medics Academy. His insights on the importance of focus and the similarities in decision-making between medicine and business leadership are eye-opening.
Johann provides an inspirational roadmap for those contemplating a foray into startups. He encourages aligning one's personal convictions with their career choices, emphasising that the true measure of success is deeply personal and unique to each individual. Embrace the doubt, harness the passion, and carry forward the mission—Dr. Johann Malawana's reflections are a beacon for anyone seeking to leave a mark on the world through their work.
If you're a founder, honestly, the idea that you have no self-doubt about what you're doing I cannot imagine the level of psychopathy you must actually suffer in your head. That's right. The level of crazy you must be is just enormous, right? So if you don't have that self-doubt, then like okay, I don't know what to say to you. But if you do like you've got to live with that self-doubt, then like okay, I don't know what to say to you. But if you do like you've got to live with that self-doubt, if that makes sense.
Speaker 2:Dr Johan Malawana. He is, in addition to being a medical doctor, is also a startup founder.
Speaker 1:And actually it's incredibly exhilarating that once you realize that actually a lot of medicine, a lot of that type of medicine, is pattern recognition, you just have to recognize patterns right and make instinctual decisions that are really, really basic, like do the safest thing, always stay safe, right, always do what you need to do In startup land, it's stress. It's like really stressful. Okay, let me put it this way If everyone tells you to stay and then you decide to leave, you may have made the right decision for you, right, but if people tell you to stay and it makes you stop and think, should I stay? You probably shouldn't leave, right.
Speaker 2:Interesting, just incredible actually listening to you. You really are a real source of inspiration.
Speaker 1:Yeah, I tend to be a kind of all or nothing kind of person, so when I'm working on something I try and just be really focused and get on with it.
Speaker 2:Hey everybody, it's Greg Sheehan. Welcome to my podcast, where you will hear from a range of guests, including those from the startup world and those that have had incredibly interesting lives and some stories to tell. I would really appreciate it if you could hit the follow button and share this amongst your friends, but, as you know, time is limited, so let's get on with it and hear from our next guest. I want to tell you a little bit about desk work. Desk work is your offshoring option. If you want to save around 50% of your total headcount cost for equivalent talent across accounting, marketing, sales, your operations or your admin, then check out desk work. Honestly, if I was looking to start an accounting firm again, it would be a no-brainer for me to use deskwork. I've used offshoring teams before in the past. I got past my skepticism on being able to do it and it was so phenomenally successful. Go have a look at desk-workco backslash, greg, and book yourself a free discovery call to learn more about it. Better still, mention my name and get yourself some discounts. Check it out. Now back to the show.
Speaker 2:My guest today is Dr Johan Malawana. He is, in addition to being a medical doctor, is also a startup founder, and there's some pretty interesting contrasts that we'll pull on there. He's also a bit of a politician in and around medical politics and governance and I understand actually at some point was even the organiser of the junior doctors strikes, or certainly you know massively and behind that. So, johan, welcome to the show. Hi, how are you, greg? It's very, very cool to have you. So you are the Managing Director of the Healthcare Leadership Academy and you're also the founder and CEO of the Medics Academy. But before we get to that, let's sort of start off a little bit about your origin and the kind of kid you were. Were you the sort of kid that was always destined to be a doctor, or were you always destined to be a startup founder?
Speaker 1:Ooh, that's a good one. I don't really know. I think I found my passion for medicine relatively late. I enjoyed the sciences, I enjoyed maths and things like that, and I wasn't too bothered about what I studied because as a kid I was probably a bit lazy in terms of unless I found it interesting, I didn't really apply myself. And so I went into medical school and I think I only really it's interesting because I think a lot of people like describe this deep seated passion for medicine that from when they were like six. I can't pretend that that's what I had.
Speaker 1:I come from a Sri Lankan family and in Asian, especially Sri Lankan, culture medicine is like a thing right, it's like an aspirational goal you aim for, and so I went to medical school, probably with some of the wrong reasons. The interesting thing is actually, after I got to medical school I actually discovered medicine is quite an interesting subject and so I actually really fell in love with the subject of medicine, like the science of it and the aspects of it that were just not also scientific, that were quite artistic. I quite enjoyed that. I loved the kind of communication and the human aspect of it, and then I ended up in obstetrics primarily, and I always said to my students when I was practicing that basically obstetrics is one of the most interesting bits of medicine, simply because it's the only time you go and see a doctor for a happy reason, and so it was again.
Speaker 1:I actually didn't really enjoy obstetrics at medical school, but when I did a placement as a junior doctor in obstetrics I thought it was just amazing like getting to deliver babies and being around that and seeing life come into the world and how vulnerable little babies were, and so I absolutely fell in love with that part of it basically. So I really enjoyed that and so I absolutely fell in love with that part of it basically, so I really enjoyed that, and so that's how I ended up in medicine basically, how long were you a frontline clinician and obstetrician?
Speaker 1:About 10 years. I really enjoyed the obstetrics part of my job. I would say the other thing I kind of talk about whenever anyone asks me about that career and the switch is that essentially, when I made the switch from medicine, the switch is that essentially when I made the switch from medicine, I often find people are often running away from something, whereas I very much running towards something and that was a slightly different reason. So I really loved my job, I loved obstetrics, I loved delivering babies. I found something I was, I thought I was quite good at and I was passionate about. But I was also very aware of other things I really wanted to solve and enjoyed and and genuinely challenges I found that I thought were challenging. I thought that were really interesting and so yeah, like I say, I think I was running towards something as opposed to away from something else.
Speaker 2:It's a massive change, though, to go from delivering babies to delivering companies and, before we get into the startup nature, when you're a clinician and an obstetrician and involved with obstetrics, is that when you got involved with the politics of medicine, if you like, and the governance issues? Is it true that you were involved with the junior doctor's strikes?
Speaker 1:So, no, I was always involved with student politics. I was the president of my medical school at Barton in London, which is one of the five medical schools in London, so I was the sabbatical president. I held leadership roles in medicine and healthcare throughout, pretty much from the middle of my medical school career and then all the way through. So I was always involved in some aspect of governance and leadership and so, yes, it wasn't like a completely different scenario and, yes, I, for there was actually two periods so I was involved with the. So I was the lead for junior doctors at the time when the doctors went balloted and went out on strike in 2015, 2016. So that was the first time that that happened in, I think, 40 years in the UK.
Speaker 1:But prior to that, I'd also negotiated a whole series of aspects of the education space in about seven, eight years before that, when, again, there were lots of difficulties within the British medical system and I was appointed I was elected at the right at the end of that to resolve some of those and negotiate some of those and come up with various policies. So, again, it was quite a long period of life that I'd been involved with that stuff. It wasn't like something where I got involved like very quickly and or I'd spent a short time in it. It was quite something. I'd been basically working alongside or around my medical career for quite a long time.
Speaker 2:And you're still involved with the political aspects of medicine.
Speaker 1:No, not really. I mean I haven't been when. No, not really, I mean I haven't been. When I say not really, not at all. Actually I haven't really been involved in that side of the professional work, probably pretty much since I left the role as the lead for junior doctors in 2016. I did a couple of years kind of supporting the just being around and kind of being involved very much in the background, but I pretty much my work has been so full on, as you can imagine, in a kind of startup, that I always tend to throw myself fully into whatever I'm working on. So, yeah, I tend to be a kind of all or nothing kind of person. So when I'm working on something, I try and just be really focused and get on with it and do that, and so that's basically what I've been doing for the last eight years now.
Speaker 2:I'm really intrigued to dig into that sort of transition from medicine across into startups. Now I can imagine that you know, when you've gone through all of the hard work to get into med school, you become the president of your medical school, you know, president of the student council, if you like of the medical school. You become an obstetrician. You are involved with medical governance and politics. The idea of essentially almost leaving that behind to go into a startup must have had a bit of I'm not even sure what the right word is here some tension there, like there must have been expectations that you were putting on yourself or even others were putting on yourself. How did that go? Take us through that process.
Speaker 1:Yes, I remember when I was early on in the process. I remember a lot of, quite a few people, some very, very prominent people, giving me, yeah, very um, interesting advice about what was I doing, throwing away my career and my life and and going and doing this and given everything I'd done and all the stuff I'd worked on, that I'm throwing away a very well, in some ways, a secure career, so lots of security in that career, but also there was other aspects of it which would have been relatively, I'd achieved certain things and it would have been much easier and to do other things. And so, yeah, it was. It was an interesting transition, I have to say. I again it goes back to this idea of running towards something as opposed to running away from something like I think that the weird thing was that when I was heavily involved, I mean, obviously, in those roles, you pull the curtain back and you see the mechanics of something, you see how health systems work, and you don't just see how health systems work. You know, on the front line scenario.
Speaker 1:I was a front line doctor in the most acute of specialties and at the same time, I was learning about the mechanics of health systems at the very top of those systems, right at the governance level, at the financing level, at the political level, and the reality I was struck with was that I was going to probably spend the next 30, 40 years of my career fundamentally becoming very, very frustrated, because I could see many of the challenges and the problems that health systems face, not just in the UK but globally, but very specifically in the UK, some of the challenges that health systems face and I knew that was very little I could do about it, even if, however influential or however political or whatever I did, I could see the limitations of the ability to make any significant change, because there were certain structural problems that I just didn't think anyone was trying to solve, and so part of me realizing that, realized that if there was any way of resolving those tensions and those problems, the only way I could think of doing it was to try something different. I could see lots of people making lots of attempts to do positive change within the health system, but really struggling to make a system adapt and change to what it needs to do, you know, turning the supertanker, as it were, whereas I almost felt it was almost easier, in the same analogy, to head out on a rowboat or a speedboat in a slightly different direction in the hope of finding the right destination, because otherwise I know I would get. I would just become extremely disheartened and demoralized, not again by the job, not the frontline aspect of the role, because that bit was unbelievably incredible, but the inherently given the career path I'd taken. Up till that point I realized I was never going to be just 100% a frontline, frontline clinician. It just wasn't likely to pan out that way because of all these other roles I'd done and I could see myself, even if I there was a period between like 2011 and 2014 2015 actually when I'd actually stopped a lot of my political work. I'd basically I'd done a lot of stuff up till about 2012. And I decided no, I'm going to try and just be a focused frontline doctor and really, really concentrate on that. And I actually really enjoyed it.
Speaker 1:But I got sucked straight back in when there was all this political strife and it was actually not a choice in some ways, because I got asked to come back to do something that was quite complicated and I kind of felt obliged to do it because I'd had like a relatively unique set of experiences that made it appropriate for me to do that role. And I went and did that role because it was a technically difficult role and it was like you know, and it needed to be done. And I guess I kind of thought about it and I thought, well, there's a lot of times when that could happen again and I can't see myself not taking up challenges when I see them in front of me, and I'd rather focus on a challenge that I could genuinely sink my teeth into and drive forward. And then, like you know, just really, really and frankly, the startup life was really, really hard. I mean, I knew and I did it the hardest way you could possibly do it, like I threw myself fully in, I didn't hedge my bets, I didn't, you know, do a bit of this and a bit of that. I I kind of realized that if I was going to do this, I wanted to be as I said I'm.
Speaker 1:When I do something, I really focus and try and double down and really make it happen like really do the best I can. And so I kind of I realized that if I was going to do this, I'd do it that way anyway, and if I fail, I fail, but if I succeed great, and and I guess it's that that I can't remember who actually says this, because there's lots of attributions of this statement. But you don't want to be on your deathbed and look back when you're 80 and regret the choices you've made. I think they attribute it to Jeff Bezos, but I think lots of other people have said this as effectively, and so I kind of I had that mentality or that thought process going through my head of like what is the decision here? I would regret the least, or regret the most, or et cetera, et cetera.
Speaker 2:And so did you literally go from one day you're wearing the white coat, essentially to you know that you finish on a Friday as a doctor, and then, on a Monday, you're at a co-working space and you're a startup founder. Or was it a bit more nuanced than that?
Speaker 1:It was slightly more nuanced, but not that different. Actually, I kind of it was a very rapid transition. I realized if I was going to do it I would do it full on. And so there's a lot of particularly medics who do startups. They do tend to have like a transitional period where they might work a bit. But I was very clear that I knew that if you're going to do something you've just got to get on with it. So I kind of did, and I also was a lot. I was probably a lot older than most people starting a startup. I would have been 37, maybe I think at the time 36, 37. And I had two kids. I had a baby that was under two months, like literally very new, very new baby.
Speaker 1:And I always say that my wife is just ridiculously supportive and she's very tolerant of my crazy ideas. And she she just basically said to she was like I talked about it with her, I'd I'd always been interested in the kind of startup space and the ideas and you know I'd read a lot about it and I was really like interested in technology. I was always interested in in technology. I was always interested in technology. I was always interested in that space. But she kind of encouraged me and I again I, I mean I asked her and she was encouraging and she said you should just go for whatever you think you want to do. She actually said to me once you know that I've watched you make some really crazy decisions over the years and stuff that I'd be scared to do, but you find a way of it and I think you shouldn't back down from your instinct basically. So I kind of went with it.
Speaker 2:I love that and I'd be remiss if I didn't ask you the question that I think probably are on the lips of those sort of people listening Did you deliver your own children? No, god, no, are you allowed?
Speaker 1:to in the UK. I don't think you are, unless it's like you're literally in the middle of a field and it's like yeah it's you or nobody else, yeah. I don't think anyone would ever encourage you to do that. No, yeah, that's right.
Speaker 2:Had to ask that question. So then you get started. Now did you start the two businesses at the same time, and actually it might be quite good to talk a little bit about what both the Healthcare Leadership Academy and Medics Academy are all about. You know what are they and when did these two get started?
Speaker 1:So they kind of started at similar times. But the Healthcare Leadership Academy, the HLA, is a social enterprise, a not-for-profit. In the UK we kind of call them CICs. They're basically a community interest company, so they're not-for-profits and et cetera. That was basically my passion project. So that was what I really really kind of.
Speaker 1:I'd spent a lot of my career mentoring but first of all, learning about leadership, like the ideas and the concepts and stuff like that. And I just I'm interested in philosophy and I read lots and lots of books and and like reading kind of philosophy books and non-fiction literature and so biographies and history and things like that. I like that area of literature and so I'd always read a lot about the ideas behind various things. And so and the HLA was all about kind of helping individuals that were a bit like me, that wanted, that were early in their career, developing leadership journeys in healthcare thinking and reflecting on who they were, what they were trying to do, essentially trying to help them be better and more effective leaders, and not just at the latter stages of their career but actually quite early on thinking about what they potentially wanted to get out of that aspect of their career. And so it was just very much a course based on my experience that I did with a couple of other people, kind of co-founded it with me and supported me delivering the first few programs, and that was definitely not developed in the kind of startup mentality. And medics academy was the startup. That is the kind of the quintessential. It's a technology based education company, so we build education programs and obviously my whole career was in healthcare education. So healthcare and education and that, those and workforce and that's basically what that company does is build education, workforce development, education concepts, that kind of thing.
Speaker 1:And so the two kind of started at the same time with the idea that the HLA was really a passion project. I didn't really expect it to go anywhere. I thought it was just going to be this thing I did for a couple of years and it was on the weekends and I ran it on my own time and I would do all this stuff. And then Medics Academy was this kind of commercial technology company and I thought the focus would be on the technology. And you know you see all these things about scaled technology companies and the rapidity of their growth and their making. You know they raise millions and all of this kind of stuff. So I thought, okay, well, maybe that's what I want to do, that's how you do this. And actually over the years, that's definitely not what happened.
Speaker 1:And the reality was that all the stuff that we were learning about within building the technology company really helped in the not-for-profit space, because there's loads and loads of help and support actually for commercial technology startup companies. It's surprising actually just how much support there is. There are incubators there, accelerators, there's books on it, there are podcasts like this on it. There's loads of stuff right and it's exciting and people want to do it, and there are billionaires flying around in planes and taking instagrams of their whatever it is. There is a huge amount about it.
Speaker 1:But actually building a not-for-profit, a social enterprise, anything in that space and certainly at the time when I did this was there wasn't very much around to support someone doing that, and the weird thing was I was riding these two horses, where essentially one was just this. You know, was all in that startup space and we ended up being a Founders Factory company. You know, in the Europe, founders Factory is quite big and we ended up being a founder's factory company. You know, in the europe founder's factory is quite big and we ended up doing like a whole range of accelerators. We got some awards and all of this and so we're getting loads of support and we were in the health space. We got some investors, all of this stuff and the not-for-profit no one really like. Everyone was just like, okay, what the hell is that about? No one, you know that's not. This is, and the weird thing was because I was building the two organizations at the same time and and one was definitely not meant to be an organization, one was just this kind of passion project I did on the side.
Speaker 1:I learned just so much about building organizations, right, and so, um, what was interesting was that I learned I took a lot of what I learned from the technology company, from the commercial company, and applied it into the not-for-profit and, as a result, the HLA, like we professionalized a lot of things that we normally wouldn't professionalize. And subsequently, actually about four years in, three years in, I realized actually that is something like no one helps people do, and I was helping all these young clinicians coming through who wanted to like do have an impact on the world, and some of them were starting to think about social enterprises, not-for-profits, charities as as vehicles to have that impact, and I realized that I'm actually I've learned so much about both the commercial side and the the actual, just the growing an organization side that we built an incubator. I say I actually didn't. So it was a colleague of mine, ali Jawad, who's now running his own startup actually, who the two of us sat down and said all this stuff going on with social enterprise and not-for-profits, they're just not getting any support. So why don't we just completely like with a blank sheet of paper, really think about what kind of support we would have wanted I would have wanted back when I started the HLA in 2016.
Speaker 1:And we came up with a model, an incubator model, which, honestly speaking, was nothing like any of the other things that we couldn't find an incubator for not-for-profits in Europe. Actually, I think there was one in the US, but there wasn't really anything like this in Europe at all, and certainly not in healthcare sorry, not in the healthcare space. And so we basically started this thing and again built that within the HLA, within the actual organisation, we built the small incubator programme and again it showed just how much there was space for this, and so we built both organisations at the same time. Now, actually over the years the commercial company Medics Academy has provided an enormous amount of resource to help the social enterprise build up and I think it's well over a million pounds of resource has been we've kind of invested in building out the hla infrastructure and that's through the technology we've built and various other things that we've done and and actually and actually directly supporting how we do it.
Speaker 1:And so I think again, I don't think I would have been able to do both, I wouldn't have done either of them particularly well without the other one kind of almost helping and supporting, because they each had some aspect of you know, they each were kind of slightly different, but I mean, both of them are mission driven. I guess that's the other important thing that we both in both organizations they are incredibly mission-driven organizations about trying to resolve slightly different problems in healthcare, or probably the same problem in healthcare when it comes to workforce and leadership and the ideas about health systems, but coming at it from slightly different perspectives from the perspective in the HLA of supporting an individual to become a better leader and manage a health system, an individual to become a better leader and manage a health system. And from the Medics Academy, the commercial company, building education programs, workforce to support the infrastructure of healthcare just get better basically, how did you manage your time across these two things?
Speaker 2:Were you finding that you were just literally different emails on the different organisations throughout the day? Or did you time box and go look, I'm going to work on medics academy in the mornings and the HLA, you know, in the afternoons and the evenings. Like how did how did you kind of divide the time we?
Speaker 1:had two. We have two separate email systems and I mean, uh, quite distinct organizational structures. We've got two separate boards of directors, but I guess everyone that knew me knows me kind of. There's a common mission in a lot of the work, I guess. And so whenever you talk about startups, people fixate on the individual, like the founder and it. Honestly, there are bits of both organizations. I don't really understand how certain things happen, because it's not my response, like it's no, it wasn't my, it isn't my responsibility, because people have done, they've taken on their own functions within it, and so the reality is that just there's lots of, lots of other people involved and those people are absolutely yeah, I mean, I, I come and do these podcasts and various other things, but on shami who and and shami was the person who introduced us together said watch it, because johan will not take credit for anything and he will deflect questions about being a founder because he'll credit the team.
Speaker 2:That you're very humble, and there you go, you are crediting the team, which is fantastic. So when you got started, how did you find that transition, going from you know this storied career as an obstetrician to now being the startup founder? What was the experience like for you? Was it what you thought it would be when you got started? Was it harder?
Speaker 1:Was it easier. Obstetrics is an incredible specialty, right, because you're made to make decisions rapidly, right, there's a problem in front of you and your training kicks in, it's not? You don't have time to think. It's not having time to think in the same way that when you're driving a car, you shouldn't be thinking right. If you sit there thinking about what your left hand is doing, your right hand is doing, your left foot is doing, your right foot is doing, you're probably like the worst drive in the world ever, right? You kind of naturally know how to drive the car right, and obstetrics is very, very much like that at the acute end. So when you're in an emergency situation, you kind of your training kicks in and you kind of just do things instinctually because you've repeated the task so many times. Right, you've it's repetitive emergency management, and so that was an interesting one. To go from that to a very different type of stress, because the stress of that particular scenario is one where you know that the biggest outcome, the biggest implication of your actions actually does not have anything to do with you, right? So this is the other thing that you've got to think about if you're an obstetrician, is that, even if you have the worst day ever. If something goes horrendously wrong for you and you think about it and it's traumatizing for you, the chances are the impact on someone else, or in this case, a family is going to be 20 times well, not even 20, just 100 times bigger and worse. Right, because they have to live with the consequences of that for the rest of, not just, say, a baby's life, but the parents and everyone else right, and so it's a very stressful situation. But it's a very different type of stress and and actually it's incredibly exhilarating. But once you realize that actually a lot of medicine, a lot of that type of medicine, is pattern recognition. You just have to recognize patterns right and make instinctual decisions that are really, really basic, like do the safest thing, always stay safe right, always do what you need to do.
Speaker 1:In startup land, it's stress, it's like really stressful, and there are elements of pattern recognition right. So, dealing with staff and other people, there's often quite a lot of pattern recognition should, or how someone interacts, or or what will work within the team and what won't work within the team, and you develop a set of pattern recognition that works. You kind of get an idea of this kind of deal may work, this may not. This is what like good looks like and and people you know they often talk about product market fit, where you've got like a product and you adapt it to the market and it fits and all of that stuff. And I think that product market fit applies in lots of different contexts, not just to the product of the company, but lots of other elements like do you have the right HR structure, do you have the right finance team, do you know whatever it is? And I guess those were very, very different patterns or different problems that I transitioned from one to the other to solve.
Speaker 1:But then there are other elements which are very, very similar which really helped right, and one was rapid decision making right and understanding that sometimes it is better to just make a decision and do the best you can with the information you have and then correct when you get it wrong or if you think it's going wrong, or if you think you've made the wrong decision.
Speaker 1:Right, and that is very much something that you do in obstetrics right, you get the information you've got.
Speaker 1:And if you don't make a decision and just do something and get on with it, or the decision is not to do something, whatever it is, but you make a decision and then you take more data, more information, and then you change your direction of travel slightly and you tweak, and you, you know all of that, but you know that not effectively just getting completely paralyzed is a really bad idea.
Speaker 1:Right, by decision making and the same is true in startups. Right, the ability to make a decision is really important, like it's so important and that's probably the only main function of a founder is that ability to make those decisions early on and then later on, understanding that other people should be allowed to make decisions too, and it's that that in in startup world, that transition is also quite difficult, because you're so used to being the sole decision maker for some time and then it's all the power sits with you and then suddenly you're transitioning organizations into where you have to allow the organization to evolve and it's no longer really your baby on your own. It's like all the people who were there at the beginning, and there's groups of people in both organizations who very much are part of the absolute DNA of the two organizations and without them the organizations just wouldn't be what they are. So it's not just who I am anymore, right, and it's that transition which is also quite difficult, I'd say.
Speaker 2:Hey, just let me pause you there for a second and tell you about some help that's available for startup founders. One of the biggest reasons startups fail is that the founders give up. They just burn out through struggling with aligning all of their people to what it is they're trying to do. It doesn't have to be like that, though. Jess Dahlberg is an expert in startup performance and she works to align your team to the performance you need so that you, as founders, can get on and scale with confidence. Simply head to jessdahlbergcom. Backslash, scale up. That's jessdahlberg D-A-H-L-B-E-R-Gcom. Backslash Scalab. Use promo code Scalab2024 and start removing those headaches.
Speaker 2:Let's get back to the show. See, for all founders that are listening, or even those who are considering being a founder, startups are really hard. The decision making, the stress. It's incredibly hard, but nobody dies. If you get the decision making, the stress. It's incredibly hard, but nobody dies. If you get the decision wrong, you're like you could really screw something up, but nobody dies. So did you find? Therefore, even though startups are stressful and there would have been days it was stressful you must have kind of had some relief. Well, I've done stress before, you know, and I've done it where it's literally life and death and I'm making decisions that are really tricky and are going to impact a family, a child, etc. Did you enjoy that in a sense, or was it actually? It was just as stressful.
Speaker 1:Yeah, that's an interesting question. I mean, the interesting thing is that modern obstetrics people do die, but they don't like maternal death and fetal death is like quite very low yeah.
Speaker 1:And I mean fetal death, but certainly maternal death is something that you don't, and so you've got life and death decisions that have big impacts and, yes, definitely not belittling that, because it's like scary as hell. I mean, I remember there were lots of times where the only thing going through my head is do not let my face say what the hell is going Like. Do not like. You can't, like, I cannot transmit how stressed I am right now, because that is not a good idea. It's all good.
Speaker 2:It's all good, it's fine.
Speaker 1:I'm happy, I'm smiling, it's fine, right? So yeah, I guess that is true. In terms of the startup space, it is really stressful because the complexity grows and it doesn't get simpler if that makes sense. And it doesn't get simpler if that makes sense. In a sense, as the years went on, it felt like the job got actually quite a lot easier, in that I'd seen it so many times that the times when I hadn't seen something, it was so obvious I'd never seen this before and therefore I was like freaking out and I'm like quickly on, you know they had phones, right. So I'm quickly on my phone, like what the hell is this situation? Or or I'm phoning someone, or I get help from someone, quickly on, you know they had phones right, so I'm quickly on my phone, like what the hell is this situation? Or I'm phoning someone, or I get help from someone, or I call you know you send up the flag, and I was like I need help now.
Speaker 1:Right, in startup land, the interesting things is there's just like a low level, permanent what the hell is going on? Like genuinely what is going on here, right? And the other thing is in obstetrics, the weird thing was that I mean I was on a labor ward where you had a big degree of control within a labor ward setting, because you you had to have a really good overview of what's going on on this labor ward, right as in that was in my job, right. So you'd have to. You'd basically just need to know what was happening with each room. You'd need to know what was happening with each room. You'd need to know what's happening with each, what's going on in each scenario, and not knowing was like the worst thing ever, right? I mean, like you just couldn't, you weren't allowed to do that, you weren't allowed to not know what was going on, right, it was just not good.
Speaker 1:Whereas in startup land, in the company, oh my God, the amount of stuff I don't know that is going on in the company is like enormous right, and if I worry about it, I just would not sleep at all, right, and so, and to be fair, I don't I literally go on and on and on at people about sleep and how important it is, and yet I am terrible at it, right, and so you know you stress about it and you know there are lots of times you're like waking up and just thinking, oh god, I've got like my task list is ridiculous and I need to do so. It's just. Yeah, it's a very different type of stress. I mean I don't think there is a better or worse version. I don't think it was. I mean, having experienced both, I can honestly say both are awesome, that's the weird thing, right like I honestly say, being an obstetrician is like just simply the best career.
Speaker 1:I wouldn't recommend people do my current job, but I would definitely recommend people do my old job. Right. My old job was by far the best job that you can possibly have on the planet ever. Right, being an obstetric doctor was genuinely unbelievably cool. Right, it was just something, and so I cannot in any way say anything negative about that job because, honestly speaking, I still live off the buzz of a lot of what I got to do before. So yeah, Very cool.
Speaker 2:Now with Medics Academy, did you take that traditional path of I want to be the Instagrammable guy, you know, taking venture capital and this is how we're going to go and we're going to raise multiple rounds and et cetera, et cetera? Or did you take that sort of more bootstrapped approach to building the company?
Speaker 1:So I am terrible. I've worked out, I'm good at raising money because, in order to raise money, you basically what you're doing is you're painting a picture of something with absolute certainty that has like a 2% chance of success and like, okay, in obstetrics I had to be very, very confident in what I did, like there was no chance. I could just be, oh, I don't know what shall I do? I can't do that, right. But at the same time, I felt like I knew what I was saying and I knew where it was going In startup world. I guess we did actually raise money. So we raised money. We did two rounds in 2017 and 2019. And I was very good at the raising money part, right.
Speaker 1:So the weird thing was the people who really, really, really knew me and often who had worked with me for a very long time, or people that knew them and so had seen me doing lots of stuff in my career they were very quick to invest in the company, right, I could not. I did not seem to have the same magic effect on people that were just like who had big, and the problem was that lots of my friends were not stupidly rich, right, or lots of my family were not, so I didn't have the ability to just magic up money from people that I didn't know if that makes sense, and so so I did raise money, we raised money. Actually, we raised money quite successfully for the first, like we did two rounds. And then, in 2019, and I get, I got told this like in no uncertain terms by one person that I did something which I kind of took a look at the pattern of the company that I was building, because it was in healthcare and it was in education, and it was the confluence of the two, or the interface of the company that I was building, because it was in healthcare and it was in education, and it was the the confluence of the two, or the interface of the two areas, both of which are very traditional in that they're very conservative. Once you build something that really sticks in both industries, it's really hard to dislodge it, right. That's the cool thing about healthcare and education.
Speaker 1:However, to build something that really sticks also is not like an instant issue, right. It's not like you can just go in and you know, even if you're sitting on a pile of like a billion dollars, it doesn't mean you're going to somehow build a healthcare organization or an education organization. I'll be frank, right, because there are so many reputational factors and there are so many other factors that go into a confidence issue to do with what you're doing right, and I think I guess the the best example is probably something like haven, right, which is the what the big, most invested, the biggest startup, ever invested in, or something. I think they raised a billion dollars or something from like the three big you know, know, amazon and JP Morgan and whatever, and yet they only lasted 18 months or something I think it was. That was like that, the lifetime of that entire organization. And so the reality is it's not. This is not the space I don't think you can just froth your way through. I mean, theranos is another example, right. I mean like one example of like just complete and utter BS ruling right, and you just can't do that, right. You just it just doesn't work, right.
Speaker 1:And so in 2019, I realized, after raising that round, actually, to be fair, it didn't. It wasn't in 2019, it was, but it was a few. It was about a year or two later when I realized that what I was getting pressured to do, in terms of the decisions I was making, would not meet the expectations of the people necessarily, and I had that conversation. I mean, I said you know, the reality is that this is probably not going to be the thing that just blows up. Right, that is going to. I cannot.
Speaker 1:And then the problem was that in 2020, 2021, 20 like that was frothy as hell, right, startup land was just these massive valuations and at the time, I was like trying to work out how to get the company to be profitable and how to make it last and be self-sufficient, in the idea that if we are self-sufficient, then I'm not constantly trying to catch up, I'm not constant, I can focus on what we're doing and building the thing we're doing, rather than doing like just constantly out there trying to grab more money and not like focus on on building a, a genuinely sustainable company. And I guess that was a decision that, in hindsight, I honestly still don't know is the right answer, because I know that, for where we are right now, it's definitely the right answer. Like we are definitely, you know, we're self-sustaining, we're doing like we're doing, but we're also relatively quite small and there are lots of companies that in this interim who, like you're where the founders were just fixated on raising money and they just made these enormous numbers right work in that period during this pandemic, and I can't tell you. I mean, yeah, some of them don't exist anymore. But I mean, you know, the question is, I don't know, you know, what is the right thing to do. I don't honestly know, is the answer I don't know. I can't, because I most people there's.
Speaker 1:The motivations of startup founders are very different. Right, my motivation is I want to build an organization that's still here in 50 years time. Right, or in a hundred years. I mean I'd like to build an organization that, when I'm dead, is not dead with me, if that makes sense. Right, and so knowing that as a motivation I think makes it a slightly better like in my mind. It makes it more obvious what I need to do and for the whole team, what we have to do, and also it means how you build the startup matters. Ie that it's not about I mean, you know, you say this, but it's really can't be about me, because it's building like in my mind. We're building institutions. We're building two institutions and they are hopefully going to be institutions, and an institution can't be dependent on one, two, five, 15 people. It's got to have solid foundations, if that makes sense.
Speaker 2:What's the hardest thing that you've experienced in this startup journey with you know either organization that you wouldn't have anticipated kicking off your startup journey? Something that has really not so much floored you maybe it has, but it's something that it was way tougher than you thought. Was it the capital raising? Was it hiring? Was it finding product market fit? What was that?
Speaker 1:I mean the most stressful thing by far by, like a country. The most stressful thing by far was there was a period about 18 months into the company where we were genuinely teetering on the edge. Right, this is the commercial company and my wife very, very, very, very, very supportively, basically agreed that we would sell our family home in order to recapitalize the company. Wow, okay, I mean remember we've got two young kids here, right, and so like I honestly have to say no one should ever do this. This is why, like, this is not a good idea. No, and basically we did it and we were in rental accommodation for like five years, six years, something like that, and it was difficult and she made like she was so supportive and like never questioned that this decision, like she never held it against me, like now she works in the company. I mean, she's worked in the company for a few years. Right, for not, not since then, but she a few years later she was like, oh well, you know she actually came and helped with the company in lots of ways. Um, and so that level of support is what do you say to that? Right, because you're on the journey, but like everyone and you know it's everyone else around, it's not just like Sarah, it's not just my wife, but everyone around me was like hyper supportive, like friends of mine and family members and people like you know. There were just so many people that have just helped me over the years and like that is like crazy.
Speaker 1:Right, it's like really crazy and I think part of it is because I hope part of it is because we're kind of really mission driven. We are, we've got a mission that we're on. We want to do it. We want to help people in doing it. We've just spent the last four years working on gender in healthcare and leadership and we've done a whole series of projects in Africa and Ethiopia.
Speaker 1:Clearly, some of those decisions are you're taking a very long-termist view of the world. To work in a war zone in the middle of Ethiopia on gender empowerment and gender-based violence and doing that from within a commercial entity. To do that and justifying that to my board of directors was always an interesting one, right, but they were so supportive, right, because they were just like okay, I see what you're, what you're doing here. I can, I explained it, I, you know, I kind of justified it and it fulfills the kind of mission that we've set ourselves on, without being hypocritical about it, we're not just saying it for the sake of doing it, we're actually going and doing this stuff and so I think you know, in lots of ways, that is our. That's like what I want. Like I left a very rewarding role in order to do what I consider just as rewarding a role in a very different way.
Speaker 2:Just incredible actually listening to you. You really are a real source of inspiration. My final question, I suppose, is you know, is there something you would want to leave others to consider, a piece of advice for startup founders? Maybe for people who are in a profession currently not doing a startup they might be in medicine, or they might be in law or whatever, and they're not happy. Yet there's a lot of pressure to stay within that profession, to maintain the status, if you like, of being in that profession, or maybe something for startup founders A piece of advice you'd want to leave people that are listening to this Stay, stay in the profession.
Speaker 1:That's not what I thought you'd say I would say that, like the, the, you know security is something that is you have to really. Okay, let me put it this way if everyone tells you to stay and then you decide to leave, you may may have made the right decision for you, right? But if people tell you to stay and it makes you stop and think, should I stay? You probably shouldn't leave, right? Interesting. So, and the other thing I've worked out is that there is absolutely no pattern to this one right? What makes a good founder? Right? I honestly, I've met so many different people from so many different backgrounds. I honestly cannot say that there is a pattern for what makes a good founder, because often founders are contrarian, so they are contrarian. But the other thing is that founders are very, very different in what motivates them, right. So there is. Some of them are just like, literally just want to make the money. I mean, they only care about the money, and that is perfectly fine. I do not. You know I'm not like some. You know I'm not going to be some kumbaya kind of crazy, like hippie on this stuff, right, like, if that's what motivates you, that's fine, go for it. Like, go and do that what you want to do Right. And then there are others that are like mission driven and want to do, and then there's people in the middle that kind of are mission driven but they're really like not you know. There's this kind of weird kind of interface between the two. The one thing I'd say is just really really know yourself. Like you don't have to admit it in public, you don't have to admit it on a podcast, you don't have to tell everyone what you want to do, you know. You just have to admit it to yourself. What is it it? Why are you doing this like? Why are you putting yourself? If you're slightly older, your family, everyone, you know why are you putting people through this crazy decision?
Speaker 1:The thing is, you can be around startups without necessarily being the founder. You can be an early employee, you can be in venture, you can be in finance, you can be. You know there's lots of ways you can be around the excitement without necessarily doing the founder job right. And the reality is that I think in the first five years, the majority of the companies I've either seen I've actually invested in a few invested in or I've kind of like done Like the reason why it fails is usually because of the founders, right, like that's the only reason I mean we can work up a percentage, but really it's something to do with the founder or founding team, right? It's like that problem.
Speaker 1:And so the question is just be really, really sure that you're making, especially if you come from a professional background, because there's two elements to coming from a professional background which both play in your favor and don't play in your favor, right, the play in your favor bit is that you have history, context, expertise, et cetera, et cetera, and it gives you a safety net right. Expertise, etc, etc. And it gives you a safety net, right. So it gives you this safety net you can go back to or you may use at the same time as being a founder, etc, etc. But that's also a negative right, because you have a safety net. You're not walking the tightrope without the safety net, right. And that means there's other kind of considerations that you always play in your head.
Speaker 1:Because if you're a founder, honestly the idea that you have no self-doubt about what you're doing I cannot imagine the level of psychopathy you must actually suffer in your head, that's right.
Speaker 1:The level of crazy you must be is just enormous, right. So if you don't have that self-doubt, then like, okay, I don't know what to say to you, but if you do like you've got to live with that self-doubt. If that makes sense, right, and that can be stressful. So if, after all of hearing that, and everyone tells you not to do it, and your parents tell you not to do it, and your spouse and your partner tells you not to do it, and everyone tells you not to do it and they don't divorce you and they don't throw you out on your ear and all of that stuff, you still decide to go and do it, great, maybe it's the right job for you johan, this has been an absolute masterclass and I I kind of I I really regret that you live in the uk and I live here in new zealand, because I just think you'd be the kind of guy I would love just hanging out talking over a glass of wine.
Speaker 2:You're talking about history and great nonfiction books and things. This has been, as I say, a true masterclass. You are an inspiration, because I think you are very much driven by mission. You're going to have a massive impact. The 80-year-old version of yourself, I think, is going to be very happy with the way that you've lived your life. So I want to thank you for the time you've given today. I will make sure there's ways for people to connect with you on LinkedIn and through your two organizations as well and to learn more about both. Really, really appreciate the time you've given today, johan. Thank you so much. Thanks, lord.
Speaker 1:Craig.
Speaker 2:Johan, thank you so much. Thanks so great. Hey, don't forget to check out desk work, the team behind you being able to build high-performing offshore teams for your startups and Smee's. It's desk work, co. Backslash, greg, and go and save yourself some hard-earned money.