Startup Physicians

Turning Physician Pain Points into Business Opportunities with Dr. David Canes

• Alison Curfman, M.D. • Season 1 • Episode 11

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In this episode, I sit down with the brilliant and down-to-earth Dr. David Canes—a practicing urologist who found himself burned out, uninspired, and stuck in the repetitive rhythm of clinic visits. But instead of staying stuck, he did something a lot of us dream about—he turned a real-life clinical inefficiency into a business. And get this—he didn’t start with a formal pitch deck or MBA, just a Loom video and a whole lot of curiosity.

We dive deep into David’s transition from full-time clinician to founder of WellPrept, a patient education platform built to enhance physician-patient conversations and reduce redundancy in clinic. We talk risk aversion in medicine, developing an MVP on zero budget, the underestimated value of physician creativity, and how to know when it’s time to pursue an idea that just won’t leave you alone. If you’ve ever wondered how to spot a startup-worthy problem in your own practice or what it really takes to build software from scratch—this one’s for you.

Dr. Canes was born in South Africa, and spent most of his life growing up in New England. He attended Yale University as an undergraduate, followed by medical school at Cornell, then Urology residency at Lahey Hospital in Burlington, MA. After a 1 year laparoscopy and robotics fellowship at Cleveland Clinic he returned to the Boston area where he has stayed ever since. He is Associate Professor at Tufts University, and his clinical work mostly centers on minimally invasive oncology. After a personal burnout struggle, now he deeply enjoys talking about strategies and tactics that help doctors work more efficiently. This passion led to founding WellPrept, a health technology company aimed at helping doctors work smarter. He is a father of 5 boys, and enjoys playing guitar if he has a spare minute. 

 

Episode Highlights:

[1:00] Getting to know Dr. David Canes—his journey from South Africa to urology and how safety shaped his early career path.
 [3:15] Why physicians are wired to be risk-averse and how that impacts our startup mindset.
 [6:55] The moment David realized repeating the same patient education daily was an opportunity—not just a frustration.
 [9:40] Creating his first MVP with a Loom video + a PDF—no budget, just brainpower.
 [12:46] How WellPrept was born out of necessity, and the surprising validation from colleagues.
 [17:06] The power of looking for problems with the intention to solve them—David’s advice for mindset shifts.
 [22:07] Starting without an MBA or tech background—how curiosity and passion fueled the process.
 [28:20] Why co-developing software became one of his favorite parts of the startup journey.
 [34:01] From prototype to paying customer—how he validated the idea before fully building.
 [38:56] Balancing clinical practice and startup life—and when it starts to tip.
 [42:16] David’s final words of encouragement for physicians who are on the edge of taking the leap.

 

Resources:

 

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Dr. David Canes:

That's the other thing I should mention. It is so much fun along the way to have a startup. I mean, imagine the contrast of being an employed physician in a very large health system, where nothing happens quickly, everything happens by committee, which is okay, that's how safe institutions move forward, but the pure joy of having your own startup, you have a vision for what you want to do, the team decides to do something, and you just do it. And even if you don't know how the attitude is, I'll figure it out. That's why people love working in startups. Like assembling a plane in mid air while you're falling out of the sky. It's incredibly enjoyable, so long as the problem you've identified gets you super excited.

Alison Curfman:

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 am your host, Dr Allison kerfman, and I'm really excited to have Dr David Kane's on the show today. He is a colleague of mine who has a very interesting story and has really identified a problem in his practice that turned into a business. And he'll have a lot to share with us about his pathway and his background and how he got from practicing full time clinical medicine to actually building and starting a company and still practicing medicine. So David, thank you so much for coming on today. Thanks for having me. Allison, this is great. I really appreciate it. Yeah, no, we're gonna have a great conversation. And if you could just go ahead and start by telling us a little bit about your background, how you went through your training in med school, and did you ever think you were going to start a business and All right, so, I am an only child. I was born in South Africa to non physician parents. I lived in Canada for a while. When we immigrated, we went to Canada, and then I grew up mostly in New York. I went to undergraduate at Yale, and then I went to med school in New York City at Cornell. You know, the decision to become a doctor was something that I thought about since I was a kid, going to see my own pediatrician, and it was always in the back of my mind is something that I wanted to do, but really reflecting back, it was also a choice based on safety. In other words, I remember thinking, I will always have a job. I'll get paid decently well.

Dr. David Canes:

It's very unlikely that I'll get fired and I'll have a, you know, nice, steady career doing something meaningful. All that is true, but I had friends, you know, I graduated from college in the late 90s, and the internet was just coming into four I had friends who ended up working with startups and going to work for incredible companies, some of which are now household names, and some of which crashed and burned, but even the ones that crashed and burned, those people had very successful careers, and I was afraid of that, that path, yeah, I remember that distinctly,

Alison Curfman:

and honestly, I never thought of that before. But there's a chance that most of us as physicians may lean more on the like risk averse side of things. That is sometimes a challenge to overcome when you're working with startups.

Dr. David Canes:

Yes. I mean, I think, by our nature, I think medicine does attract risk averse people, and that's a good thing. You know, we're constantly making decisions for on behalf of our patients, to mitigate risk. That's all we do all day long, on on behalf of other people that we care about, right and who are trusting us. So maybe it's a necessity that it attracts that kind of personality. But I also think I wouldn't be good at that, like I am good at biology, so I should do this. Like, What business do I have, starting a company? That's not my thing,

Alison Curfman:

yeah. And honestly, it's like, What business did your friends have, starting a company either? Yeah,

Dr. David Canes:

right. I mean, they're, they're no no smarter than I am, you know. And, but, you know, with medicine, there's a path to follow, and the path is like, it's the same path. I'm a urologist, and to become a urologist, every generation has got to basically go down the same path. It's all laid out for you if you want to start a business. And it's an original idea, the path is not laid out. I mean, yes, the path of starting a business is somewhat laid out, but it can be intimidating to think that you're doing something Uncharted. So anyway, you're setting the stage. But I will tell you, I distinctly remember thinking that's not for me, that that entrepreneurial pathway is not for me. I'm going to become a doctor. And to a great degree it was, it was the right choice for me. I strongly think that there isn't only one career for each of us. There's probably parallel lives we could have each LED that would have led to happiness, but and surgery is one of them. I really enjoy being a surgeon. Being in the operating room is a magical thing and doing really obviously meaningful work, but I got fairly burnt out about eight years into practice. After fellowship, I was feeling disconnected. You know, all the classic sides still enjoyed and was very engaged in the operating room clinic days for me, started to become something that I would dread. You know, when you're interviewing for medical school and the person asks you why you want to become a doctor, and then the 19th time somebody asks you that you tell the same story, but you have to sort of, maybe change it a little bit to make yourself remain interested. And you have to give it with the same enthusiasm that you gave the answer to the first person who asks you, well in urology, and really, frankly, any medical specialty, all these basic facts that I was teaching my patients I had now at this point, explained 1000s of times. You know, what is? What does the prostate do? How do you get kidney stones? And I'm sitting there thinking, God, like, this is getting really old, very

Alison Curfman:

repetitive, and you're recognizing a pattern, right? So part of this is pattern recognition and identifying a problem or an inefficiency.

Dr. David Canes:

Yes, it's an inefficiency. It's a problem. It sounds like a selfish problem when you first hear about it like, Who's this self centered Doctor Who doesn't want to explain how kidney stones form again? But if you think about it like, Where is it written that I have to explain that from scratch every single time well,

Alison Curfman:

and are you as good at saying it in a way that's really, you know, understanding to the patient when you're doing it for the 20th time in a day. And you know, is the quality of your presentation, of discussion and education the same every time. So, right? I mean,

Dr. David Canes:

here's the realization that I came to I really enjoy talking to patients, but what I most enjoy is having a real human, human interaction. And when you have a real interaction with somebody, you can't really predict what's going to happen next, and that's what makes it feel spontaneous, and you feel alive, and you feel like you're you're in the moment with somebody that's And if somebody waited a few months to see me, what I think the patient wants is a discussion about what's happening to them specifically, and if it could be possible for the patient to bring themselves up to speed on the basics before they show up. Then guess what? That 15 minutes that they have with me is going to be so much more meaningful for them, and then also meaningful for me, because, you know, I do have to have a 35 year career. Or, you know, we want doctors to stay in medicine and not leave, or, God forbid, something worse like commit suicide, you know, so how the doctor feels about their workflow is is important, and I don't think it's selfish. I think it's important to think about, how can you get through your days in a way that you're going to be able to be sustainable

Alison Curfman:

brings you joy? Yeah, like having those richer interactions? That's right.

Dr. David Canes:

So by the way, I'm telling you what's happening when I'm burnt out and I'm identifying this problem, I am nowhere near thinking I'm going to start a company. At this point, I'm only thinking, this is a problem, and I need to fix it for myself, not for anyone else. So I do a lot of oncology, and I see a lot of prostate cancer. You know, I'm explaining, what is cancer grade? What is cancer stage? What's a Gleason score? What is the prostate? Here's the anatomy, and I, instead, I recorded a video. And I don't know, you know those loom videos where your your pictures in the circle while you're getting your screen? Yeah, so I said, All right, enough is enough. I'm gonna record a loom video of a really good explanation of Gleason score for

Alison Curfman:

people who are following along, this is an MVP. I talk about minimum viable product. You needed nothing. You needed a free loom account and your brain. And you're like, I'm gonna solve this problem, right? Exactly?

Dr. David Canes:

And then, you know, the National Comprehensive Cancer Network prints these beauty. Beautiful PDFs, a patient guide for every cancer you can think of. Whether those guides actually end up in front of patients is a totally separate problem that that can be identified. But I started asking my administrative assistant listen if someone's seeing me for prostate cancer second opinion, send them this PDF and send them a link to this video. And what I noticed was, you know, doesn't apply for every patient, but most patients watched the video and read the whole PDF, and they came in, and first of all, they started by saying, Thank you. I walk in the room, and almost universally, thank you so much for sending me that information. Nobody's ever done that for me before, and that was really helpful. I have some questions, and we got right into answering their questions. Now, the previous workflow for me was the patient would surface their list of questions in the last minute of the visit, to the point where I would, I would probably visibly sort of sigh like, oh God, here's the list of questions. There's no time for that, which is totally and

Alison Curfman:

these are patients that are dealing with, you know, oncology issues, or you really need to talk to someone about their questions. Exactly.

Dr. David Canes:

So instead of resenting this list of questions that now I had no time to cover. We spent the whole visit talking about their questions and their particular cancer, and let's review your MRI and, and it was, it was personalized medicine the way I think it should be. And I was enjoying it, like really enjoying being a doctor again. And you know, I have this thing that I say sometimes now, as I recount this story, that if we could get back to our medical student self, or even our undergrad self, thinking about why we decided to do this in the first place, something about patient care and patient interactions was really lit our fire, right? So what this was for me was getting back to that, how can I make most of my day one enjoyable patient interaction after another, and one way is to try and pre educate the patients to the extent possible. So I solved the problem for myself. And by the way, Link tree and companies like that had just come out. And for listeners who don't know when you have an Instagram profile or a Twitter profile or X, they only let you put one link in your bio. So there's a whole bunch of companies that will let you make that one link go to a landing page with a stack of buttons so you can put,

Alison Curfman:

so you can, like, put a bunch of links in one link,

Dr. David Canes:

my podcast, my website, my whatever you want. So I saw those companies start to come out, and I thought, boy, that would be a great way to organize patient education materials. And so the idea for what eventually became well prepped was born, and my MVP was hijacking one of those video, yeah, loom video and a link tree site, essentially. And I had a bunch of my friends, I called up some colleagues, and I said, Hey, I've been doing this thing where I'm sending links to patients beforehand, and it's totally amazing, but just to make sure I'm not crazy, would you mind trying it out? So that's like, beta testing. This is beta testing, but I didn't think of it that way at the time. I was just like, all right, the logical thing to do is to just make sure I'm not crazy. So I have a couple of friends try out this new workflow, and they were doubling down on it. They were taking the QR code of this landing page and reprinting their business cards with it. Oh, wow, yeah. So at that moment to say I knew I should start a company, it was more like it became such a passion that the idea would not leave me alone. I know that feeling, yeah, and you know, let me just backtrack for one. One other important aspect to this that shaped my thinking was I had a mentor who invented a few surgical devices, and they were successful devices that were widely used in the urology market. And he I really looked up to him. His name is Dr Roth, and it was because of him that I always thought I was going to invent a surgical device. And his advice to me was, listen, problems, don't just that need solving. Don't just hit you over the head. You have to be looking for them. Most people just go through their day to get to the end of the day. And if they encounter frustrations, they just plow through them. Complain about it. Complain about it. Yeah, you have to have the mind. Mindset of looking for problems that need solving, and if you do that, you increase the chance that you'll you'll come up with a good idea. Now I for at least 10 years, I was doing that in the medical surgical device realm, and I got to be honest, no idea occurred to me. I wish that I also thought about software as another sort of Avenue. And doctors deal with software all the time, frustrating electronic health records, prescription systems that don't work properly. You know, we still use fax machines for God's sakes and

Alison Curfman:

then all the softwares we build in options to effects things, because we just can't get the medical system right.

Dr. David Canes:

So what I will say is thank you to Dr Roth, I did have a mindset of looking for problems that needed to be solved. So my advice, if at this stage of of telling you the story for listeners, is, you sort of have to be primed to be looking for for problems, and if you are, they will occur to you, because most other people are just going through their day with blinders on,

Alison Curfman:

yeah, and that's actually a question that when I'm doing speaking engagements, a lot of times, I start with with an audience of physicians to say, like, can you think of a problem in healthcare that affects your patients? I've yet to find anyone who can't think of a problem. But if you're going through your day with that that lens, or that perspective, and instead of feeling so beaten down and like despondent that like all these things don't work, and feeling like, you know, the system's so broken, looking for problems in a in a positive aspect of like, well, I wonder if there's anything I can do about that. I wonder if I could fix that, you know. And I, a lot of us don't have the capacity to feel that way because we're drowning in, you know, tasks and patients and but I think it's really great, the way you took a problem that you saw and and actually just did a little thing.

Dr. David Canes:

Yeah, I mean, we, we are in, I mean, physicians are in the best position doing the daily work to know what's needed to solve it, not somebody else. You know, I've also heard people say and so I'll repeat it, because I it resonates with me. People aren't circling around physicians figuring out ways of saving them. That just doesn't happen unless it's an obvious, lucrative opportunity. And those are few and far between. We're the ones in the best position to identify what problems need to be solved. I mean, you know, the concept of pre education is is only going to potentially occur to people doing the job. Yes,

Alison Curfman:

that that's such an important point. Because I sometimes feel like physicians come to me and they say, like, I don't know what I possibly know, that these, like, very smart investment bankers or AI people like, want to know, and I'm like, they don't know anything about what you know. And you hold the answer to the problem, you hold the perspective on it. They may have data, they may have software, they may have ideas, but they need that physician input, and I think that we actually are very well equipped to do deep analytic thinking on things and assessments and understanding like whether something may work or not, and people just aren't used to that type of work, And they think this. And maybe it's the risk burst thing, maybe it's the, you know, wanting a very clear path thing. But for the most part, almost every doctor I talk to says like, I don't, I don't know what I would have to contribute to that space.

Dr. David Canes:

Yeah, you know, it seems almost trite for me to bring up Steve Jobs, because he comes up a little bit too often when people talk about entrepreneurship and ideas, but I'm going to at the risk of being tried. I'm going to bring up one interview that I saw with him that matches up with what you just pointed out in this interview. He says, when you look around at the world, I'm paraphrasing, but if you look around at the world, at all the things that you've just considered to be part of the world, the phone you're holding the plastic water bottle that holds your your your water and the computer you use were all created deliberately by people who are no smarter than you are. And then he was the best at this, one of the best imagining the future before other people can can see it. And so it got to the point where it seems so obvious to me that most doctors should be pulling this lever of pre educating their patients in order to improve efficiency. Seems obvious. It's not rocket science, but it's facilitated by other technologies that exist in 2025 Like SMS texting and QR codes and and all those things that now make it possible. But you know, can you believe, if you walk into any doctor's office now and you say, Bring or even the ER, bring me to the place where you keep your handouts, there will be a place a file cabinet, usually with curled up manila folders with photo copied and one of them and highlighter says, save the last copy. You know, like, how could that? How could it be that we're still doing that

Alison Curfman:

in the ers that I work in, you can attach different like licensed content to the discharge instructions. But are those ending up like, under the floor, under the seat of their van, like, is it in the moment? Like accessible to them when they are ready to absorb it. And so it sounds like you found some really simple solutions to solve a pervasive issue for your personal clinic. And it not only helped your patients and brought them a new solution, helped the interaction, but it brought you more joy as a clinician, and then you had friends who realized it worked really well too. So at that point, what made you decide to actually pursue this into a business, and did you feel equipped to start your own business? Yeah,

Dr. David Canes:

so that's a wonderful question. So listen, I told you I was primed to look for problems. I should mention. I've thought of a lot of terrible ideas over the years that never amounted to anything and too, yeah, there you go. I mean, a good sign, I mentioned it before, but I'll just repeat it again. They a good sign that you have a good idea is that it doesn't fade. You think about it a few days later and weeks later, and it just will not leave you alone. So, you know, I know from talking to a lot of doctors, as you have, the next step is usually where people just absolutely stop with thoughts like, what right do I have to start a company? I do. I need an MBA. I don't have an MBA. I've never done this before. Am I allowed to do this?

Alison Curfman:

Yeah, how? How do I actually thought of that when you were talking about this? I was like, well, you're an you're an employed physician. Are you a private practice employed? Yeah, it's like you said this when we were talking before, like, physicians really want to ask permission for everything. And it actually crossed mine out. It's like, oh, did you have to, like, ask someone if you were allowed to, like, send your patients info, or, I guess you're probably doing it through their portal, or some way that you already were communicating. If you've

Dr. David Canes:

ever read Crossing the Chasm, have you read Crossing the Chasm? So it's I have not. It's a classic book about technology. Adopt the technology adoption curve. Any new innovation goes through a repeatable curve where the first people to try stuff are early adopter personalities who tend to not ask for permission. As it turns out, I'm one of those personalities. Yeah. Me too, yeah. I mean, I sort of, I sort of reasoned it that I'm doing it for patient care. If I didn't send them the link to the NCCN guideline, I would have said, go to the website, click on patient resources, find the cancer that you have. And that's just cumbersome. So I'm just doing the same thing in a different way. But yes, I don't have an MBA. I didn't even take econ 101, in college. I I have no business background at all, but I was very, very passionate about this idea because it helped me so much. It became almost a mission to try and put it in the hands of as many colleagues as I could. I mean, doctors are in trouble right now, yeah.

Alison Curfman:

And when you start with a problem that becomes So, and you then find a solution that you're so mission driven about like that. That's what creates that drive and that growth exactly

Dr. David Canes:

so. Because I am an employee doctor, I did the first thing I did before I started an LLC before I bought a domain name, before I did anything I did go through the intellectual property committee to because I didn't want, above all, for there to be any issues related to that.

Alison Curfman:

This is a really important point, and I emphasize this to everyone who goes through my trainings or who wants to start something is so important to look at your contract. I tell people there's generally, like, three type flavors of contracts. One, there are a few that say, basically, you have, you are not allowed to do external like consulting. And if that's the case, then if you're about to sign a contract and it says that, I would highly recommend you ask them to take that out, that's rare. On that other at that same extreme end is that if you develop anything, no matter what it is, even if it's like a kitchen appliance, while you're employed by them, even if you. It in your time off, that there is some amount of ownership that that institution has over your intellectual property. And that is a clause that I've seen and some people's I mean, I actually know some physicians who have come to me, and they've been like, I have this idea. I want to, want to build it, but I'm not going to, while I'm employed by this institution, because they didn't want them to have ownership. They wanted to keep their ownership of their idea other contracts, the most common is to say, you need to disclose to us what you're working on, and it can't be like, competitive. You can't be like, Oh, I'm working on building a private urology practice. So it can't be competitive. But you do need to disclose it, but they don't have ownership over it, and they don't get a say in whether you do it or not. And so that would be, what I would say is the most common. But I always want doctors to check their contracts before they get into this sort of thing. And I'm sure you also probably consulted with your own lawyer. Yes,

Dr. David Canes:

I did consult with the lawyer. And you know, first of all, I love the way you encapsulated that is no wonder why doctors want to come to you for this kind of advice. It was exactly what the situation is at most employed hospitals or private practices or what have you. So, yeah, I mean, that was the first thing to to square away. And it took a while to come to some sort of agreement, and it involved my doing this on my own time, and a few other stipulations after that, I didn't have the language of an MVP and all that stuff this. This is all in retrospect that I I had created an MVP, as you said, I learned that later, but so I decided I need to develop this software. Unfortunately, that's not one of my skill sets. So at this point, I did what I completely self motivated, what I, in retrospect, consider to have been sort of an honorary MBA. I just started devouring books. A lot of the most common startup books things like zero to one. There's another book by April Dunford, which is called obviously awesome, which I highly it's the most number one recommended book that I tell people. It shaped the way I thought about well prepped in the early days. It essentially talks about product positioning. That doesn't matter how good your idea is, if it's framed in the wrong way to the general public, it will fail miserably. And there's lots of idea like this, like the Segway motorized scooter is a classic example of something that could have been much more pervasive had it been positioned properly, and instead, now it's mostly just for city tours and mall cops. So anyway, I started devouring books and devouring podcasts. I as like a crazy person, I listened to podcasts at 3x speed, but with my fairly long commute, I could consume about three hours of podcasts in one hour. So I went into the software development realm, and it was so enjoyable. And this is one of the things I want to emphasize. Doctors love learning Yes,

Alison Curfman:

and I agree with you that CO developing software has been one of my most favorite things to do in the startup space.

Dr. David Canes:

It's so much fun. There's some there's nothing quite like coming up with an idea and then seeing that idea actually come to fruition, and then shaping it and keeping on iterating it and seeing it used in in real life. It is. It's something else. Now,

Alison Curfman:

one thing that people don't realize is that even though you might have an app on your phone or something that's like seems pretty simple, software development is extremely expensive, because you have to pay developers and like every single little feature, every single little click, every button, every everything that connects somewhere is developed and then has to be maintained, you can't it's not like you're building one thing that is then good to go forever. So how did you navigate that? Were you self funding it? Or did you fundraise?

Dr. David Canes:

Yeah, so the first I started by self funding, and I made a lot of mistakes. And you know, it's okay to make mistakes, and people who have MBAs and know what they're doing make mistakes. It's like a series of experiments, and that's fine. Things always look clearer when you recount the story. But the first mistake I made, and I'm sorry if people end up listening to this podcast. Who, who I hired, but I hired an agency, a development agency, in the US, and they did a great job developing version one of the product, but it was the most expensive way for me to do it, and I just and I just didn't know what I didn't know.

Alison Curfman:

And a lot of people. Will take the tack of actually hiring overseas development teams to build something because of the cost.

Dr. David Canes:

Yes. Now that's a double edged sword too, because what you really want is a team. It's very rare that you can actually in software. You can tell people exactly what to build, and then they build it. That's not really how it works. You want a team who will help you shape your idea, because guaranteed your first idea of what it should look like is not how it's going to end up being. And you actually want a team that's going to say, no, that idea is not right. Let's try this. And as you said, it's a constant, ever changing iteration, and if you leave it alone, it starts to get buggy and it breaks. So,

Alison Curfman:

yeah, and what you're describing is the role of clinical product and product managers. And I'm sure, since it was just you, you probably didn't have necessarily a product manager, but I'm going to be doing some separate episodes with some product managers, because I think a lot of people don't understand what clinical product is.

Dr. David Canes:

Yes, my God, you're so right now, this was about three years ago. I will say, I have to say, AI has changed this completely. There are now AI prompt based software development tools, replit, R, E, P, L, i, t is one of them. Cursor is another one. Vercel V, zero is another where you could, by doing plain language prompts, if you're willing to sit there and iterate a little bit, create an MVP for yourself, or at least the first version to show a software development team more precisely what you mean, which can massively cut down on your costs. It's changing every week. So

Alison Curfman:

I use AI in almost every element of my business. So I use it as the first pass for almost everything, for contracting, for proposals, for, you know, anything that you would otherwise have to, like, pay someone a lot of money to do, or research or market research, if you use AI as a first pass and then run it by the expert that you're paying a lot of money to. It's a very, very good lean model. Yeah,

Dr. David Canes:

absolutely. So when we first started developing well prepped, it was pre chat GPT, so amazing, even though it wasn't that long ago, how, how the world has changed since then. So with this agency, we developed the first model. But one thing I'm very proud of, and I think you'll appreciate this, is that my prototype, I got the first paying customer with my prototype, before we even had a developed version, and that was an that was an accident. I didn't know that that's, that's the most often recommended way to way to go. I mean, you do want to validate an idea before you

Alison Curfman:

absolutely want an early like pilot opportunity. And I had the opportunity when I was building a complex care program at a hospital system that was funding the program, I had the opportunity to build kind of a model and measure it and publish it, and that was the data that we used to go build imagine. But I work with a lot of other companies that one of the very first things they try and identify is, is there a way they could do a very small piece of a version of this and get paid for it, even if it's going to ultimately be a very small revenue stream. Yes, but have that iterative feedback, because that is a really important step in actually able to generate revenue for future steps and iterate on the product? Yeah.

Dr. David Canes:

I mean, I wasn't gonna write checks out of my own pocket unless I had some signal. You need signals. You need strong signals that you're not just a crazy person and nobody else needs your solution. Did

Alison Curfman:

you build a financial model before you invested in it?

Dr. David Canes:

I didn't build a financial model because my hesitation there was, there's so many variables that I can paint a model and make it look like really anything. I mean, yes, you can calculate X number of physicians are in the US, and if only X number adopted your solution at y dollars per month, it could like that. Look like this, you know, increasing by a certain percent every month. I didn't go through that exercise any more than a back of the napkin type of approach at that point. It was, it was more about my passion for the solution. And I, I did, but I did have a paying customer with a the crappiest prototype you've ever seen?

Alison Curfman:

Yeah, no, that's That's amazing, and that's how a lot of startups start, especially ones that are not being funded. One of the reasons why it's worthwhile to for people who are in the same stage that you were at that point, it isn't. Investment to build a financial model, but that's part of what I learned at when I incubated this company at the private equity firm. We built the whole thing on paper. We knew exactly what sort of revenue streams it could generate. We knew exactly how to protect ROI. We knew exactly what variables it was 1000 or more assumptions all going into the same model, but all the variables we talked about over and over and over again, and got feedback and got new inputs and kept modifying it, modifying it, modifying it. And every time it's essentially spitting out, like this whole giant Excel is spitting out like one number. And so that's how, if you are going to go to VC for funding, you have to have, like, a really clear financial model, but in your case, it sounded like you didn't need that. Well,

Dr. David Canes:

yes and no, I'll say I made the mistake of not doing that when I was in the bootstrapping phase. But after that, I had reached the limit of how much I was able to contribute on my own. And we had more customers at that point. And so at that point, I assembled a team, and we raised a seed round, and it was, it was a safe round, and sort of Y Combinator style. We did create a financial model at that point. So when we did a more formal round, yes, we we, we formalized a model of how we thought growth might look like. Yeah, and I moved my development team offshore. At that point, I had a year under my belt and and the learning curve was just phenomenal and incredibly enjoyable. That's the other thing I should mention. It is so much fun along the way to have a startup. I mean, imagine the contrast of being an employed physician at a very large health system, where nothing happens quickly, everything happens by committee, which is okay, that's how safe institutions move forward, but the the pure joy of having your own startup. I'll give you an example. We're starting to get traction, and patients are visiting well prepped pages in high numbers every month. And I said, you know, we really ought to collect some patient surveys, and everyone on the team immediately. Yes, we should do that. So the next day, we put a survey together using an online tool, put it in the code and started collecting data. Within three weeks, we had 1000 survey responses from patients, and all of a sudden we knew how much they were loving it, and they were putting in anonymous quotes about, you know, I wish all my doctors did this and this, I feel so much less anxious about my condition. Now, that's amazing. That's just an example of, you know, you you, you have a vision for what you want to do. The team decides to do something, and you just do it. And even if you don't know how the the the attitude is, I'll figure it out. That's why people love working in startups. And, you know, I wouldn't change the way my life trajectory went, but if I could go back in time and talk to my 18 year old self, 19 year old self in college, I would have said, Listen, you're a creative person. Guess what happens when people work at startups and then the startup fails, it's considered fantastic experience, and you get rehired in the next startup, and it's, it's a wonderful roller coaster ride, and you get to be creative, and you figure things out on the fly. The classic description is, it's like assembling a plane in mid air while you're falling out of the sky. And it is. It's incredibly enjoyable, so long as the problem you've identified gets you super excited.

Alison Curfman:

I think that's a great point. And just as we wrap up, are you still practicing clinically? And how have you balanced your your clinical work?

Dr. David Canes:

Yeah, so I'm still practicing clinically well prep has gained traction, and I'm I may soon be at a crossroads. You. Time is the most precious resource that we have, and because I'm waking up at 4am and burning the midnight oil in order to work on this on my own time, it's starting to come to a head. This balance won't be sustainable for very long.

Alison Curfman:

Yeah, and I mean, I think that we're all always having to juggle our all of our different obligations. And the thing about being an entrepreneur is that in a physician like you, you have job security as a physician, and if this thing ended up not working out, you would always be able to get another job as a physician correct. But you can kind of think of it as like dials that you turn up and down, turn your FTE up and down in different ways. And it was super important to me when I left full time practice to stay involved, stay credentialed. It's like you can stay licensed and. Anywhere if you just like, pay the fee. You could say board certified if you answer the questions. But staying credentialed in your field is something that is really hard to come back from if you take a few years off. And so I kept my foot in the door. I still practiced pediatric emergency medicine, even at the peak of the frenzy of building a company, of still going to the ER even if it was very part time. And then when I moved into this more advisory role, I took on some more er work. So it's always something you can play with. What

Dr. David Canes:

do you tell doctors? If they say, you know, is it clear with the minimum number of hours someone needs to work per month. There

Alison Curfman:

is no good answer to that. I can't even tell you how many other like doctors and startups I like, begged for the answer to that question. I was like, How much do I still need to practice to stay in my field? And for me, it was like I spent 10 years becoming a pedr doctor. I had no intention of leaving practice, even though I had this great idea that I was pursuing, and for me, it had to do with, you know, keeping up with I am in a very as as you are in a very procedural specialty, making sure that I was keeping up on procedure logs and making sure that I was meeting the requirements for the credentialing at my hospital and and I guess it came to a question when it came time to get credentialed in a new hospital, like, had I been doing enough? And fortunately, I had, and now I'm credentialed at three or four hospitals. So there's no good answer to that, but I would just tell people don't quit completely. Yeah,

Dr. David Canes:

yeah. It's amazing that there is no specific answer to that question, yeah. So listen, I really appreciate you having me on to tell my story. Since I suspect there's a lot of potential entrepreneurs listening to the podcast, I would just say you need to prime yourself to look for problems, and you don't need any permission to pursue them. Once you figure it out, nobody who has gone through this fantastic journey is any smarter, more capable than you are. Doctors are the brightest, most creative people, but they often don't, don't realize it.

Alison Curfman:

Those are such amazing ending words, and I am so grateful to have had this conversation with you. I feel like the more I've been doing this and trying to connect with other physicians, doing interesting things and sharing their stories, I I'm so inspired by by you and your your mindset and the work that you're doing. I'm also incredibly proud of both of us that between us, we have nine kids and four dogs, and no one interrupted this recording.

Unknown:

So I have four kids. You've got five. We've got dogs all over the place, and we managed to get through it without anyone barging in. So congratulations to both of us.

Dr. David Canes:

That's a triumph, right there. Yes. Well,

Alison Curfman:

thank you again so much. If people want to reach out to you, what's the best way to get a hold of you on LinkedIn, or is there a better way? Yeah,

Dr. David Canes:

I'm pretty LinkedIn is fine. It's David Kane, C, A N, E, S, I'm pretty active on x. My handle is Keynes. David C, A N, E, S, D, A, V, i, d, people can check out well prepped. It's a deliberate misspelling. It's W, E, L, L, P, R, E, P, t.com, great,

Alison Curfman:

and we will make sure to put all of those in the show notes as well for people to click on. Great, awesome. Well, thanks for joining me today, and we'll talk to you soon. Thank you for listening to startup positions. Don't forget to like, follow and share. You.