Breaking the Mold: How Physicians Can Thrive in Startups

Welcome to the very first episode of Startup Physicians! I’m Alison Curfman, and I’m so thrilled you’re here. This podcast is for physicians who are curious about diving into the dynamic world of startups—whether you’re considering launching your own company, consulting for innovative health-tech initiatives, or just exploring new opportunities. In this episode, I share my personal journey, from practicing pediatric emergency medicine to co-founding Imagine Pediatrics, a company that’s revolutionizing care for high-risk children on Medicaid. We’ll also discuss why physicians are uniquely equipped to lead healthcare innovation and how you can get started in this exciting space.

Join me as I recount the moments that shaped my career, from spearheading telemedicine projects to navigating the challenges of scaling a startup. If you’ve ever wondered how to turn your clinical expertise into meaningful change, this episode will inspire and empower you. Plus, I’ll give you a sneak peek into what’s coming up in future episodes as we build this community of mission-driven, startup-savvy physicians. Let’s dive in and reimagine healthcare together!

Episode Highlights:

[0:00] - Introduction to the podcast and my journey from pediatric emergency medicine to the startup world.
[3:38] - The case that inspired my passion for telemedicine and innovation in pediatrics.
[4:49] - Building Imagine Pediatrics from an idea to a scalable, impactful company.
[9:06] - The pivotal role of private equity in turning our vision into reality.
[11:48] - Launching a startup during a whirlwind year: the challenges and triumphs of our early days.
[17:31] - Why now is the time for physicians to step into the startup space and how to get involved.

Resources:

Checkout our services at StartupPhysicians.com

If you enjoyed this episode, please follow the podcast, rate, and leave a review. Remember to share this episode with fellow physicians who might be interested in startups. Together, we can shape the future of healthcare! 

Transcript

Alison Curfman 00:01

Hey, Welcome to StartUp physicians. I'm Allison Kirkman, and I am thrilled to have you join me

on this journey. This podcast is all about helping physicians explore the exciting opportunities

through waiting for us in the startup world. So whether you've been curious about launching

your own company, consulting for innovative health tech startups, or simply exploring what's

out there. You're in the right place. I like to start by sharing a little about myself and why this

work means so much to me. I'm a practicing pediatric emergency physician, but a few years

ago, my path took a pretty dramatic turn. I co founded a company called Imagine pediatrics,

which focuses on delivering care to high risk children on Medicaid. Over the course of just a

couple of years, we scaled to over 300 employees, served more than 25,000 children and

reached a nine figure evaluation. That journey really changed everything for me. It showed me

what's possible when physicians and entrepreneurs come together to re imagine healthcare. It

also opened my eyes to how much potential we as physicians have to drive innovation and

make a meaningful impact far beyond the walls of a hospital or clinic. But here's the thing, I

had no idea how to get started when I began this journey. I actually didn't know anything about

startups, private equity or even how to pitch an idea, and that's why I'm so passionate about

this podcast. I really want to share what I've learned along the way to give you a roadmap to

navigate this world. So what can you expect from startup positions in future episodes, we'll dive

into topics like design thinking, private equity, product development and how to position

yourself in the startup world. We will hear from inspiring guests, including physicians who've

made the leap and startup leaders who understand the value of clinical expertise. Today,

though, I want to focus on my own journey, how I went from a full time practicing emergency

physician to launching a startup, and why I believe this is such an important time for physicians

to step into this space. So let's start with a question, why startups? Why should physicians even

care about this world? The truth is, healthcare is changing faster than ever before, from AI and

digital health tools to new population health models. We are in the middle of a transformation,

but a lot of these changes are happening without meaningful input from the people who know

patients best physicians. That's a problem without us at the table, these solutions risk being

impractical, inefficient or even harmful. Startups are very different from traditional healthcare

systems. They're agile, mission driven, and willing to take risks. They're not bogged down bythe bureaucracy that can make changes in hospitals feel impossible, but here's the catch,

speed doesn't always equal quality. That's where we come in. Physicians have the ability to

bring an invaluable perspective. We know what works and what doesn't, and we know what's

safe for patients. We understand patient care in a way that no one else does, and startups need

that expertise. I wanted to share a story that really shaped my journey into the startup world.

When I was working in a academic pediatric emergency department, we'd often get calls from

rural hospitals asking for help with critically ill children. One night, I got a call from a doctor in a

rural emergency department who said, I have a very sick little boy, and I don't know what's

wrong with him, but I need to get him to pediatric care as fast as possible, and we're putting

him on a helicopter. At that point, we had almost no information about him, no real history, no

vital signs and no ability to assess his physical exam. Tragically, he had an unrecognized head

injury and he didn't survive the flight. I was so devastated about this case, and I couldn't stop

thinking that something as simple as video technology to connect with other departments could

have made all the difference, and that really sparked my interest in telemedicine and

telehealth. This was back in 2014 when, at the time, telehealth was not common in healthcare,

but it was starting to gain traction in stroke care for TPA. A administration, but it really wasn't

being used at all in pediatrics, so I started working on projects to change that, but the barriers

were immense. So there was no payment model for telehealth, and there was no policy or best

practices around it, and there was truly no evidence base about how to use technology in this

way in our clinical practice. So I connected with a group of like minded leaders, and we

launched a national telehealth Research Network for pediatrics. And the goal with that was

really to try to start establishing best practices and create an really good collaborative network

where we could help build an evidence base for something that hadn't been done before. So it

was called Sprout, and it eventually became part of the American Academy of Pediatrics. That

was my first taste of building something from the ground up. And it really showed me the

power of identifying a need, designing a solution and then pushing through barriers to make it

happen. Fast forward a few years, and I found myself leading virtual care programs for

pediatrics for a large hospital system. Our flagship program focused on children with complex

medical needs. It was a population health program that used virtual care to provide an extra

layer of support for these families who often felt truly abandoned by the healthcare system

they struggled to coordinate their care, navigate appointments and manage crises in their

households, and all of this is just they're trying to keep their child alive. So we built a program

to support these families, and it really worked. Over two years, we reduced their

hospitalizations by 35% and cut their ER visits in half, just by providing more support for these

families virtually, which was really meaningful work and really significant results. But there was

a catch. The program didn't work financially in a fee for service system. So it was really based

on value based care, principles of really investing in a population to help keep them healthy

and out of the hospital, but we were operating in a fee for service system, so there was really

no billing code for the services we were providing. We were operating a pilot to prove that the

concept could work, but really hoped to get into value based contracts. But when budgets

tighten during the pandemic, the program was very unfortunately shut down. I was really

devastated about the loss of this program, because I felt like we were doing incredibly

meaningful work, and it was the middle of the pandemic. I was still working in the ER and I felt

like every shift that I was working, these children were coming in to the emergency department

in the middle of COVID, and they were kids we had previously kept out of the hospital for two

years. So that was really a turning point for me. I knew we had something valuable. We had a

model that was really working clinically, but it needed the right financial structure to succeed,

and that's when my colleague Megan, suggested that we just start our own company. And at

first I thought she was crazy. I said, I have no idea how to do that, and I don't know how to

launch a business, but eventually her confidence and vision really convinced me to move

forward with her. So our first step was to pitch our idea to a local startup accelerator, which Ihad no idea what a startup accelerator is. It's basically an organization that can help really

early stage concepts and ideas have an environment to try to get some traction, and they

provide resources, and they, for us, provided some coaching, so we pitched to them, and they

accepted us into their coaching program. And I was still debating if I really felt committed

enough to this to, like, quit my job and actually not take an income and try and build something

where the stakes were really high. After that, things started to move faster than I ever

imagined. I came to Megan one day and told her that I was willing to quit my job. I was willing

to put it all on the line to build this with her. And that same night, I received a message on

LinkedIn from private equity firm in Nashville that had come across our research. They were

specifically looking to invest in pediatric complex care, and they reached out because they

wanted to learn more about what we had built. Within a matter of days, Megan and I had a

video call with them, and had an incredible synergy. And then a few days later. We were on a

plane to Nashville to meet with the team. That firm was called Rubicon founders, and it's led by

one of the most well known entrepreneurs and healthcare leaders in the country, Adam bowler,

and their interest in our idea was both humbling and energizing. I was actually pretty shocked

that someone was so interested in investing in pediatrics, because my entire career, I have felt

that pediatrics is very overlooked when it comes to funding and innovation. But in Adam's

experience, he had previously built one of the first home based medical groups for chronically

ill seniors called landmark health. And while he was building that, he was often asked, Could

you include children in your model? And he thought about it, and said, Yeah, I think you could

build a model like this for children, but not in this company. It would need to be something

totally separate. So when he started Rubicon founders. This was one of the first concepts that

they wanted to do discovery on and and that's when they came across our paper. So the first

meeting was really intense and also exciting. We were surrounded by experts in finance,

healthcare, economics and operations, and they immediately saw the potential of this concept.

By the end of our visit to Nashville, we knew this was the right partnership, and Rubicon

founders offered to incubate, imagine pediatrics within their firm, which would give us the

resources, connections and mentorship we needed to turn this idea into a full fledged company.

It was a once in a lifetime opportunity, but also a leap of faith. I had an established life in St

Louis, Missouri, and we lived close to family, and my husband is also a physician and has an

outpatient practice, but within a few weeks, we made the leap and quit our jobs, we sold our

home, bought a new house site, unseen in Nashville. I thought we were going to be homeless

for a while because the housing market was crazy, and I really dove head first into this new

world, along with Megan and a couple other co founders that came on board, we started

incubating the company in 2022 and that year was nothing short of a crash course in startups. I

joke that as soon as Megan and I started this opportunity, I went to the library and checked out

a bunch of books, like startups for Dummies, because I was like, I don't know what any of these

words even mean. I don't know how these things work, and I've never done this before, but the

year that we were incubating the company was such a growth experience for me. I thought my

clinical and academic experience had prepared me for anything, but this was a whole new ball

game at the firm, we worked side by side with experts to build the foundation of imagine

pediatrics. We collaborated with healthcare economists to create a patient selection algorithm,

ensuring that we could identify the children who would really benefit most from our care model.

And we designed and built a technology platform from scratch to support our clinical teams and

families. And in future episodes, we'll talk about clinical product development and how that's

different than what we're used to as physicians in traditional practice settings. We also met

with a lot of potential partners and payers, and had to continually refine our model and our

pitch and build credibility in the market. The biggest turning point came when in August of

2022 we landed a major contract in Texas, so we really needed to secure a value based

contract for at least 1000 patients to be able to launch. And in August of 2022 when we had

three co founders at the company and I was the only clinician, we landed a contract with twodifferent payers in Texas, Medicaid, managed care plans to launch with almost 20,000 pediatric

patients, and that would be value based care agreement to provide these wraparound services

to these very sick and needy children and their families. So that was interesting and definitely a

whirlwind, and we very quickly had to stand up the team. We recruited some of the most

amazing people I have ever met, and with just a few months to prepare, we really went into

overdrive, assembling the team, finalizing our operational workflows and scaling our technology

to be able to handle the. Flux of patients. So we launched on January 1 of 2023, and it was

really exciting, very mission driven and super chaotic. I will never forget our first few weeks. We

had so many different tasks needed to do to launch our program, and somehow all of us co

founders had overlooked the fact that we needed to order furniture, and so we actually had no

furniture when we launched, and we were all sitting on the floor or using folding tables. So it

was very startupy In the beginning, but I have such fond memories of those days and the

relationships and the work that we were doing. Everyone was working long hours and juggling

countless tasks. Everyone wears a lot of hats in the early stages of a company, but the energy

was just electric. We were also driven by the mission to provide exceptional care for these

children and their families. And these kids have had so many challenges navigating this very

fragmented and broken system. And when we design our model, we we really sat down with a

blank piece of paper and said, if we were to design this from the ground up. What do these

families need? As opposed to when you're working in a traditional healthcare system, the

ability to pivot or to redesign something is is quite minimal, and often we will just take

something that we've been doing for a very, very long time and maybe modify it slightly, as

opposed to completely rebuilding it from scratch, and so that that experience was one of the

most exciting things to do, because I felt like we were able to create a product that would really

provide exceptional care for these children and their families. Despite the challenges, there

was a sense of camaraderie and purpose that made every obstacle worth it, and watching this

model that we had designed come to life was one of the most rewarding experiences of my

career. You've heard the joke that when you have a child, it's like a part of your heart running

around outside of your body, and I definitely agree with that. I for little kids myself, but with

imagine, I felt like it was almost like my another kid, you know, that was off operating on its

own. And so it was so amazing to see something that really started as a seed of a thought in

my mind, that started from your true patient experiences and stories of these families and their

children. And it became something that hundreds of people were now having jobs at this very

mission driven organization because of that idea. And they all had things to do and things to

operate within the model, and they were carrying forward the torch that mission, and it was

operating without me, and I, like all of these other people, were able to start infusing their

mission into our model. And I found that to be really inspiring. So why am I sharing the story

with you, my journey was pretty extreme. Most people will not want to quit their job or start a

company or move across the country or work at a private equity fund, but there are so many

ways for physicians to get involved in startups, whether as founders, consultants, advisors or

even clinical team members, and the skills you already have are actually exactly what startups

need. I have had many physicians come to me and say, Should I get my MBA? Should I go get a

clinical informatics degree? And I think you guys are educated enough. I think you have a lot of

degrees and a lot of experience, and I would love to walk you through some of the different

things that I see physicians working on in the startup world, and things that you can get paid

for, and things that can really make a meaningful impact. So I want to help build these

pathways for other doctors, because as I moved into a more advisory role with Imagine

pediatrics, over the past year, I've built my own consulting and advising company, and with

that, I have the opportunity to work with many startups, and I find it to be really exciting to

work with founders and other people who are really mission driven and excited and have an

energy about them to to get something done that hasn't been done before. I think it's creative.

I think it's fun. I love the flexibility it's provided me. Me, and I think there's so much need forphysicians, and as I've been doing this, I've had a flood of physicians approach me and say, I

really want to learn how to work with startups, and so I want to create practical resources for

you all. I want to help you to hear inspiring stories that really help get the wheels turning in

your own head, but also create some really clear pathways for how you could do some of this

yourself. So if this story resonates with you, I hope you'll stick with me on this podcast. In future

episodes, we'll explore how you can position yourself in the startup world and build your

personal brand and and find roles that really align with your goals and your mission. So thank

you for tuning in to the first episode of startup physicians. If you're ready to dive deeper, please

check out the resources at startup physicians.com we also have a link to our Facebook group

and subscribe so you don't miss what's next? Let's shape the future of healthcare together.