Beyond Academia: Dr. David Lim on Building Healthcare Startups

What happens when an infectious disease specialist decides to step off the academic path and jump headfirst into the startup world? In this episode, I sit down with Dr. David Lim, a physician-scientist turned healthcare entrepreneur, who shares his inspiring journey from UCSF to the boardrooms of Boston Consulting Group, and ultimately, into founding and scaling impactful healthcare startups. His story is proof that physicians can thrive outside the traditional clinical box—and that our unique training gives us a powerful edge in the business of healthcare.

We explore how David made the leap into consulting, the mindset shifts that helped him succeed in business, and how his medical background gave him a clear advantage when building solutions for real-world healthcare problems. From launching a nonprofit with Michael Porter to co-founding mental health startup Quartet, and now building a virtual-first MSK triage company, David shares invaluable insights about creativity, leadership, and staying mission-focused. 

My guest today is Dr. Dave Lim, who has taken many different paths to becoming a startup physician executive. He joined Castlight Health, one of the first cost and quality transparency platforms to enter the market and IPO in 2012. He then joined the Founding Team as employee #1 at Quartet, one of the mental health forerunners expanding access and providing care navigation and support. Today, he is Chief Physician Executive (and also employee #1) at RightMove, a tech-enabled services company providing musculoskeletal care that was spun out of the Hospital for Special Surgery (HSS) - the #1 global, orthopedic institute as ranked by US World & News Report.

Episode Highlights:

[1:15] David’s love for science led him to pursue both an MD and PhD.
[3:45] The moment David paused his academic career and started exploring alternative ways to make an impact.
[5:00] What it was really like transitioning from infectious disease to management consulting at BCG.
[6:35] Learning to make faster, “good enough” decisions in business versus clinical medicine.
[7:50] How physicians bring depth, analytical thinking, and team-based skills into the business world.
[10:47] The mindset shift: being okay with 80% certainty and trusting your gut.
[13:20] Why choosing the right people to work with—who truly value clinical insight—is crucial.
[14:31] How David’s secondment at Harvard Business School sparked his startup passion.
[16:03] Co-developing healthcare tech as a clinician and collaborating with engineers.
[17:45] The overlooked creative potential of doctors—and why startups unleash it.
[18:58] David’s leap into mental health with Quartet Health and the personal story that made it meaningful.
[24:57] From health plans to Medicare Advantage to RightMove: building a virtual-first MSK triage platform.
[27:36] Advice for physicians feeling intimidated by the startup world—yes, you can do this!

Resources:

Dr. David Lim LinkedIn: https://www.linkedin.com/in/drdavelim/ 

Checkout our services at StartupPhysicians.com

If you enjoyed this episode, please subscribe to the podcast, rate, and leave a review. Don’t forget to share this episode with fellow physicians who might be interested in startups. Together, we can shape the future of healthcare! See you next time.

Transcript

Dr. David Lim  00:00

I think the advantages of doctors coming into the business sector is that we can go very deep right on any kind of subject matter. We have the breadth of understanding of human physiology, pathophysiology, many of us have practiced in the clinical setting and understand what those conversations are like when you're actually explaining like a new diagnosis to a patient or the pros and cons of drugs, and so I think that that comprehensive component of being a physician and a scientist really do help immensely in the healthcare sphere and many business processes and decision makings. First and foremost, you should believe that you can do it because it is, it is completely possible to transition from a clinical career as a physician to work in the startup sector. There's immense need for more and more physicians and folks with real good, deep, rooted clinical experience to be in startups.

Alison Curfman  00:54

Welcome to StartUp physicians. Please like and follow our show to join our community of physicians who are re imagining healthcare delivery. Hi everyone, and welcome back to startup physicians. I'm your host. Dr Allison kirchman, and I am excited to introduce you to my guest today. Dr David LEM he is traditionally trained as an infectious disease physician, but his career has taken a number of different turns that led to so many interesting opportunities and chances to make really great impact on health care. And so thanks a lot for coming on the show. David, Yeah, my pleasure. Real, real pleased to be here. Allison, awesome. Well, I would love if you could start by just telling us a little bit about your journey and how you started, and then what, what actually got you into this field? Yeah, no, I would say it's it stems all the way back from really a love of science and medicine, and I was really a biochemist at heart. Couldn't decide between whether just to go to med school or go to grad school. So decided to do both an MD and a PhD degree. And very well, very well, down that traditional pathway of an academic career. I was working as an infectious disease specialist at UCSF, working in the in the wet lab, and I, I kind of hit the pause button in, you know, 2010 you know, well over 14, now, almost 15 years ago, and took a moment to really ask myself, like, is Is this the path I really want to continue? And, you know, while very meaningful and, you know, very fulfilling, it just made I just kind of forced myself to ask, are there different ways I could drive impact in the healthcare sector? Are there different aspects of healthcare, beyond academics, that I could leverage a lot of my skills and knowledge? And I kept coming to the notion that the business side of healthcare, where you can drive a lot of your impact in a very scalable fashion. You know, unlike other physicians, traditionally in academia, I decided that I would just take a leap and get, really, essentially, essentially my business exposure by becoming a management consultant and joined the Boston Consulting Group, BCG, initially, first and foremost, to get some exposure to pharmaceutical How did you even find out about that opportunity? What I did was I really just spoke to a number of my friends who were physicians, who were not in academics, and really asked, like, how did you decide to become a private practice physician? I did have a handful of friends who did try consulting as a route. Some folks went straight into pharmaceutical industry. And so it's really gathering all those data points and striking out to see what might be a good path to get involved with. And consulting was one of the pathways that just seemed to fit very well. That's amazing. Did you have to move for that job? Where was which office were you in for Boston consultant? Yeah. So I was, I was located in San Francisco, and I had the opportunity to actually stay in San Francisco, but I'm an east coaster, and my wife is also an east coaster, and our our parents were like, You got to get back to the East Coast. We want to see the grandkids, and so it's just a nice fit to move in in back in the New York City metro area, and I was in the New York New Jersey, Boston Consulting office. Very cool. So I'm assuming that your experience there may have felt a little bit like my experience when I first moved into a private equity firm that all of a sudden everything is totally different. Yes, I think the world is somewhat turned upside down, if you one way to describe it, because in academia and especially infectious disease, it's a very deductive process. You gather as much information as you can possibly can, then you know a.

Dr. David Lim  05:00

Rise to a conclusion or an answer, where, in the business world, I had to rapidly turn around that process and start with an answer and just get enough data to get myself comfortable right with an answer that's 6070, 80% sure. And in the business world, I think that you get very accustomed to doing that because it's much faster, it's much more iterative. And I think BCG was a wonderful place where I could just learn how to do that again and again and again. That's great. And I'm assuming you were working on healthcare concepts at BCG, where I'm assuming it also spanned the whole breadth of healthcare and wasn't just focused on infectious disease, is that right? Absolutely. I mean, I think what was wonderful is that a lot of the case exposure, the clients are really designed to be 236, month engagements. Had a really wonderful broad experience in the pharmaceutical world. I'm doing a lot of strategy work, new product launch, consumer insight studies, reorganization work, even in the big, large pharma companies. It really got me immersed into understanding the business process, what it takes to set up the business and maintain it, and just like a lot of the hard decisions that have to be made when businesses are running but I also had great exposure. Did a wonderful work with the Gates Foundation, which leveraged a lot of my infectious disease training to do some innovative, groundbreaking scientific work on HIV prevention strategies. The real kind of turning point for me was I did a one year secondment with Professor Michael Porter at Harvard Business School, and we launched a nonprofit organization, really that zero to one phase where we had this concept around value based healthcare and harnessing doctors and scientists together to really align outcome measurement together. And we launched this organization, and that's kind of how I caught the bug for startups,

Alison Curfman  07:03

so that that's awesome. I feel like, when you get some visibility into how businesses are built and how they approach problems and questions, and then have the experience of actually building one yourself, then it, it is an iterative and replicable process. It's, it's like you could build a infectious disease company, or you could build a value based care company, or you could build, you know, some what I know, you've gone on to build other companies too. Were you continuing to practice medicine at that point I

Dr. David Lim  07:34

had, I had decided not to. I was pretty focused on just building my business skills and network and just being fully immersed in all things Consulting at that point. So yeah, I had not, I had not continued. Do

Alison Curfman  07:47

you feel like you were using your like scientific background as a PhD in a lot of the work that you were doing?

Dr. David Lim  07:54

I would say yes and no. I would say certainly, for the Gates Foundation work, there was a lot of heavy science involved there. But I would say like, but I think what you can really apply from your kind of the academic and medical knowledge is that the ability to really think thoroughly, think more comprehensively with a clinical hat on about a specific problem, really think deeply about I think the advantages of doctors coming into the business sector is that they can go we can go very deep, right on any kind of subject matter. We have the breadth of understanding of human physiology, pathophysiology, many of us have practiced in the clinical setting and understand what those conversations are like when you're actually explaining, like a new diagnosis to a patient, or the pros and cons of drugs. And so I think that that comprehensive component of being a physician and a scientist really, really do help immensely in the healthcare sphere and many business processes and decision makings.

Alison Curfman  08:57

I feel like sometimes doctors don't realize how much they actually know we are used to, like, working our way up this academic ladder to become more of an expert, along all against, like, all of the along, all the training and and then, like you said, going out into the business world like you're never going to be like the top, top expert, who knows? You know the answers aren't 100% clear all the time, and but at the same time, we do have this very broad skill set, including analytical thinking and how to measure. Anyone who's done any research knows how to create metrics and measurement and understanding the value of creating an evidence base for something. So I think that sometimes doctors don't recognize how many skill sets they actually have trained into them that could be very applicable to this field. Yeah,

Dr. David Lim  09:49

I couldn't agree more. And I think that the degree of rigor, the degree of critical thinking, problem solving, is inherently very unique to doctors. And I would in. Then right underneath that, I would really apply that, the whole notion of team based work, right? And especially when, if you're very accustomed to inpatient hospital work, that the need to drive decision making, to make very, very critical, sometimes life saving decisions under extenuating or pressure situations. And so I think the ability to think clearly and to apply a framework and to work with other team members is like is those skill sets are very, very valuable in the business setting, and I don't think doctors realize that all the time.

Alison Curfman  10:35

Do you think there are tendencies that physicians have that that could hold us back in this area, like things about the way we've been trained, that make it harder to operate in this area, I

Dr. David Lim  10:47

would say the the one thing I had to do to get comfortable is, you know, I think in the hospital setting or in the laboratory setting, if you're 5% unsure about your Answer, you go and drive and try to find that last 5% data right to get to 100% confidence on what you're doing. And I think doctors have to get comfortable. And I had to learn how to do this. I think I mentioned this really, but just being comfortable, like if 10% of my answer is not correct or might be wrong, or even 20% right, but it's good enough to keep things moving forward. I think in the business sector, we're more more often than not, most often than not, we're not making life or death situation, life or death decisions, right, especially when it comes to setting a strategy or creating an implementation process or even hiring individuals like so it's, it's the the pressure is not quite the same as like you might be accustomed to dealing with in the patient situation.

Alison Curfman  11:51

Yeah. And I think about building some of our initial business models and how, you know, there's, like, hundreds, if not 1000s of assumptions that are going into these very complicated Excel sheets that kind of map out all the revenue streams and costs and everything. And some of those lines were things that came directly out of my brain. It's like, oh, well, what percentage can we affect this? And it's like, you don't actually know. You're going from a gut feeling, and you're making a best guess, and you're probably going to change it later, but you're bringing these like hundreds of variables together to come up with an answer to try and determine, like, what is the ROI of this, or is this going to be a meaningful business that will be able to sustain itself? But there's no like, peer reviewed journal, you know, evidence based on like, every single piece of information that we have to bring to to an assessment like that. Yes,

Dr. David Lim  12:44

that's, that's right. And so we're not, we're the degree of scrutiny is not the same. You know, they're not even comparable, honestly, academics versus business, right? I think we're inculcated into the belief as physicians that you will be asked like, you know, if there are 100 questions to ask about what happened to the patient last night, you're expected to answer all 100 questions right? And that's not the same in the business setting. And so having that comfortability and the confidence to know that your your gut is right, is something I've had to learn over the years,

Alison Curfman  13:17

and also working with individuals in industry and in business who who respect and value the clinical perspective, because I've been very fortunate to work with a lot of companies that very deeply respected the clinical perspective, but I also have encountered some that that don't care as much about that. And so I think choosing who you work with and who values your viewpoint is also really important, yes,

Dr. David Lim  13:47

and I think when I when I do think about the companies that I've built up from the ground up, and the people I've worked with, it is very much the that element of healthcare has not changed for me, and that that is very much the commitment to great clinical quality, the commitment to patient first, right, and, and, and doing things that don't really go counter to the mission of helping patients right, achieve better health and and doing it in a way, at least for my my mission is to do it in a way where we're not endlessly driving up costs, right? Yeah, medical care system. So, so

Alison Curfman  14:24

you started this nonprofit focused on value based transformation. What was next after that? Yeah.

Dr. David Lim  14:31

So I, um, like, again, I think all things, whenever you're in these inflection points, you start talking to people and saying, Hey, like, I've had these experiences over the last few years, either the skills I've gained, right? And that was like all my consulting skills, and then just again, starting to talk to your network, to say, hey, what what ideas, or what other people have you, you know, known with similarities to me, and what have they done? And and I'm very interested in this startup space, and so I was. Able to network into some of the discussions with some of the venture firms from my work, after launching this nonprofit and a number of the Venture Partners. Well, you know, what you've done has a very nice fit with Castlight health. And Castlight was one of the very first companies that created a platform that really cast light on on healthcare costs and quality. And it was a platform that was really sold into the employer space to enable employees to really look at healthcare costs and quality information in a very organized, really almost a consumer like interface to help them shop, you know, shop effectively for healthcare services. And they were seeking somebody with a clinical background who had a lot of experience in the value based healthcare world, and and they were building out a clinical team to help really design the clinical components to the platform. And so I joined up, and it was my first experience in a startup, and it's wonderful.

Alison Curfman  16:03

I find that CO developing technology as like the clinical mind that's working directly with a team that's more of a tech team is one of the more fun things that I've ever been able to do. Yes,

Dr. David Lim  16:15

absolutely. And I think that it's such a great creative environment where you're able to take a lot of that clinical backbone and the clinical experience and the perspective and understanding of the persona the patient, and then blend it with someone who understands how to make information readily organized and relevant, and A really beautiful user interface that really helps that individual get to the right place, you know, in in the most wonderful experience possible. And so it's, it's always been a lot of fun to work with the product teams and the engineers to help, not only to help them understand the world of healthcare better, but then to help, well, to have them help you understand how to deliver healthcare services better?

Alison Curfman  17:02

Yeah, absolutely. It's definitely a bi directional learning. And I feel like one of the things that really resonates when with physicians, when I talk to them about doing this sort of work in startups, is that in traditional healthcare, it is creativity is not encouraged. It's just not part of you don't want to be creative with, like how you're going to treat septic shock. Like we have protocols. We have very clear ways of doing things, and we operate in environments that are structured for a reason, but it's not a very creative environment. And I think that that's one of the things that has been most fulfilling for me, and it sounds like you really emphasize that too. Yeah,

Dr. David Lim  17:45

it's very easy as physician in your day to day work to just accept the the the process, accept the status quo. But I agree. I think a lot of the when when it comes to medications or procedures or clinical guidelines like that. That makes sense, but there are, there's so many different things about healthcare that do have room for creativity and or improvement. Ideally both, you know, the ability to take technological solutions to really impart better data analytics, to impart a better decision making process, to eliminate many of these manual things that still happen all over the country today. And so I think that there's so there's this incredible area of robust creativity that can come to bring efficiencies and just a better experience overall for all from provider to patient to family members, you know, and I think that that's why we see so much hope and promise in these tech companies to just continually improve our healthcare system.

Alison Curfman  18:51

Absolutely. So after cast light, what was the next venture for you? Yeah,

Dr. David Lim  18:58

so I am. I had the fortune of getting introduced to the founder of quartet health, and this was even before there was any any fundraising whatsoever. It was just, again, kind of similar, harkening back to my experience with Harvard Business School and Michael Porter. But this was just a concept at the time, and I think I was so driven by this notion, this was back in 2014 of improving access to mental health care and as well as really just shepherding and giving a patient, really that compassionate guidance and navigation and support into mental health care, I would say that it was something that I saw very lacking as as a practicing physician, you know, on my own patients, when it was clear they had mental health care issues, but I just had no know where to turn to help them. And I think even when we started quartet, it was very clear that the stigma of mental health was just. So immense, and so I think personally, this was like a very important mission for me to start something in this space. Took again, took another leap of faith, and joined the company. Even before there was any fundraising, we went out and was were able to land a Series A and really just begin to begin building that company.

Alison Curfman  20:23

It's so interesting to me how as you progress through your career and different experiences and opportunities to work on different healthcare concepts, you continue to expand your reach. And I bet when you left San Francisco. You never thought you'd be like, starting a mental health company as an ID doctor? Absolutely

Dr. David Lim  20:46

not. But, you know, it's, it's interesting, because I think going back to the physician experience, right? It's, it's very clear. Like, it like, Yes, I'm, I'm formally trained in infectious disease. But why did mental health mean so much? I mean, and I think the story is very much that, like I had a patient who was newly diagnosed with HIV, and very easy for this patient to start an HIV anti retroviral regimen, but it was clear that, you know, every time they were not taking the medicine, they would come up with some excuse that they forgot to get the prescription, or they were confused. You know, we would try to simplify the regimen, but it took me, literally, like, a couple months until this person really told me that they felt so ashamed about their HIV diagnosis and they still lived with their mother and hiding the pills. And so it was, it was clear that I had missed the boat completely on, you know, their anxiety and their depression, and I felt like I didn't, I didn't serve this patient well enough, right? Because I missed something entirely. And so I think these like relatable experiences as physicians, when you see that actually you are, you are, and have been at the front line of many of these issues that really just come to the forefront. And again, we talked about process improvement, or just, you know, it would have been great if I had been, like, prompted on, like, hey, HIV and depression anxiety are very common. You should be screening for this. Like, you know, whether it was through an EMR or whether it was just training, or both, right? And then, then have a solution at hand, like quartet, like, hey, you know, I have someone who specializes in newly diagnosed in HIV, and they can help you, like, tomorrow, right? And so, you know, understanding the problem where things are breaking down, and a vision of a solution is just like, I think physicians can see that, that, you know, that that arc very easily. And

Alison Curfman  22:50

some of these problems in healthcare are so pervasive across specialties. They affect everything they affect. You know, even if you're not, like we said a mental health care physician or provider, you see it every day, day in and day out, and you also have the added perspective of having had 1000s of patient encounters, and you will have had so many conversations, and we see patterns. I don't think doctors always recognize how valuable that is to know pattern recognition and what sorts of things cause people to have trouble in the healthcare system, they feel really obvious to us. But it's not always obvious when all you have to go off of is you know, claims data or some other source that you know, bunch of investment bankers or tech you know, developers are looking at. And I think that this perspective of this very human perspective of things that we carry with us as we practice medicine is something that carries over into this world as well.

Dr. David Lim  23:59

Yeah, absolutely. And I think, you know, tech can always help anything in the world, really, but, but it's when, when you have those moments of real kind of intimate connection with a patient and and real empathy of understanding what they're going through and what the struggles and, and I think too much of medicine gets, we get so focused on our little silo of what we're doing, you know, and I need to just write my antiretroviral prescription and call it a day, and I got 10 minutes, and we got to go to the next patient, and we and we get too focused on like a singular problem versus thinking comprehensively. And I think that that's why physicians have this ability to enter startups, to add immense value, because they can, they've been at those really intimate moments with patients, and can empathize and understand that comprehensive kind of journey that the patient's going through. So

Alison Curfman  24:54

what was after a quartet for you? Yeah,

Dr. David Lim  24:57

so I, I did work for. The insurance company for a little bit, took a little break from startups, led a mental health care division for a few months, and then we transitioned that it was actually the health plan was sold to anthem, and then we transitioned into the Medicare Advantage space. And I did that for two years, building a Medicare Advantage provider line, but the startup world called me back, and I was I was had outreach from the Hospital for Special Surgery an orthopedic Institute here in New York City. And during the pandemic, they had this epiphany that a lot of the musculoskeletal triage and treatment that they performed very well in person and during the pandemic, they realized that they could do it with equal quality, virtually. And rather than licenses technology or the clinical assets and algorithms out, they decided to create a company, and that company's name is right move, and they asked if I wanted to be one of the building team members. And the more I looked into this, the more I saw that there was real value creation in having a very highly accessible, virtual first musculoskeletal triage for any kind of joint or muscle or pain that one might be experiencing. And it's such an incredibly important first step to somebody's musculoskeletal journey, because as the problem as it is today, patients and even primary care doctors don't know where to start. You know, and it may start with an MRI or may start with a CT scan or a pain specialist or a joint injection or an orthopedic surgeon who might unfortunately put you on the operating table unnecessarily, and so you can see this confusing, you know, web of how to enter the musculoskeletal health care space could be really simplified with a very readily accessible tech. First triage, and then, if it's treatment through virtual you can also get that done very well. And so I joined up as again, another employee, number one, and started this company about two and a half years ago.

Alison Curfman  27:10

That's amazing. You seem like you've gotten experiences to kind of try a lot of different things over the past few years. I think it might be easy for doctors who are listening to this podcast to say, Oh, I'm nothing like him. He worked at Boston Consulting Group. What would you say to people who are actually interested in this work but find themselves thinking like, oh, there's no way I could ever do that.

Dr. David Lim  27:36

Yeah. Well, I think the first and foremost belief is that you have to believe. I mean, you should believe that you can do it, because it is, it is completely possible to transition from a clinical career as a physician to work into the startup sector. There's immense need for more and more physicians and folks with real, good, deep, rooted clinical experience to be in startups, I would say second to that, speak to me, speak to Allison, speak, speak to folks who have done it and and we're here to help. We're always, I think most you know, as I've gone through again, through all these transition points and inflection points throughout my career, just speaking to folks and discussing ideas and then and being able to, you know, adapt your ideas to different scenarios, being opportunistic for kind of openings, I think, just speaking to people to understand, like, what's out there, like, what company needs a physician, what, what type of advice or potential clinical expertise that they are seeking. I've seen physicians come in, even just as contract basis, into startups to provide some advisory role and just to get, you know, a flavor of what it's like to be in the startup environment. Yeah. So I mean, and then at some point you will have to decide if you want to just, you know, fully jump into the deep end of the pool. But there's so many different things you can do, and there's so many different ways to go. You just got to start by trying,

Alison Curfman  29:07

yeah, and I think there's so many different levels of involvement that people can have. And you know, you could do something as simple as an advisory role, like be on an advisory board, or be more of a consultant, or, like you said, a contractor. You could take a role as a clinical physician within a startup if you want a different flavor or a leadership role. Or you could do what you and I apparently keep doing over and over again, which is just go ahead and start new companies over and over. Because once you do it, once, there's a lot of translatable skills. But you know, you don't have to quit your job to go into startups. And I think that part of the appeal is that as an advisor, you can you can learn a lot about a lot of different companies. And I think that our opinions are so needed, and people are eager to have them. And sometimes, if you don't. Spend a lot of time in this space. It's hard to know what it is they're looking for and to really believe that you have that skill. No matter how much you and I, David will tell them like, No, you're a great analytical thinker. You have all these patient care experiences. You understand how patients move through the system. But the truth is, an early stage startup only has so much internal expertise, there's usually only a couple of co founders. Maybe it's being incubated within a firm or an incubator or an accelerator, but even they are reaching out to their networks to bring the expertise for a particular concept. So when you're doing discovery, you really deeply rely on advisors, and so I think there's so many ways for physicians to get involved, even if they don't have an MBA, even if they haven't worked at Boston Consulting Group, and definitely recommend what you said, which is reaching out to people like you and I who have done this and continue to help other physicians kind of move this direction. So if people wanted to reach you, what is the best way to is the best way to get in touch with you on LinkedIn or something else

Dr. David Lim  31:07

LinkedIn and or email? My, I think my email should be my LinkedIn, but it's just Dr, Dave lim@gmail.com, dr, dr, but one word. Dr, Dave Lim, okay,

Alison Curfman  31:17

great, and we can put that in the show notes as well, absolutely. Well, I really appreciate your perspective and you coming on the show today. I think that your journey is incredibly unique, and it just shows how broad your skill set can be if you if you start trying this path, and how much impact you can have, even outside of your specialty. So thank you again for joining me today.

Dr. David Lim  31:42

Yeah, no, a real pleasure. Allison, anytime and any way I can help, and I think solely committed to helping other physicians as they think about this awesome well,

Alison Curfman  31:52

thank you everyone for listening, and we'll see you next time. Thank you for listening to startup physicians. Don't forget to like, follow and share.