The Physician's Guide to De-Risking your Startup Idea

Summary
This episode, I discuss the growing opportunities for physicians in the startup world and how to successfully transition from clinical roles to entrepreneurial ventures. I share why identifying real healthcare problems, designing thoughtful solutions, and building sustainable business models are critical steps—often without needing large amounts of initial capital. I also walk through some of the common challenges physicians face during this transition and introduce a new incubator program created specifically to support physician-founded startups.

If you're a physician even thinking about what's possible beyond traditional clinical work, this conversation will help you reframe your skills, explore real business opportunities, and approach entrepreneurship with clarity, courage, and purpose.

Episode Highlights:

[00:00] Introduction to startup opportunities for physicians and why now is the time.
[02:48] How to identify healthcare problems worth solving — and where to start.
[06:43] The critical role of discovery before designing solutions.
[12:49] Building a business model: who pays, how much, and why it matters.
[17:37] Overcoming common challenges: perfectionism, uncertainty, and starting small.
[24:15] Why community and structured support are essential for physician entrepreneurs.
[28:05] An inside look at the new incubator program designed for physician-founded startups.
 [31:42] How physicians can create scalable startups that attract venture funding.
 [35:00] Final thoughts on building momentum, creating impact, and forging your own path.

Transcript

Alison Curfman: 0:00

The first step that I would say is important is to start with the problem, not the solution. And I ask this to doctors all the time. I say, Is there a problem you can think of in healthcare that affects your patients? And in general, everyone can think of at least one. When you start with the problem, you're able to think a little more about how a solution may need to be designed. 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 the startup physicians podcast. I'm your host, Dr. Alison Curfman, and today, we are going to talk about other opportunities for physicians in startups, which is to go through some of the core needs for starting your own startup. I am making this episode in response to a number of conversations that I've had recently. Been getting a lot of feedback from other physicians, and having a lot of doctors coming to me to ask how they can work with startups. And they generally fall into one of two categories, either physicians who have a job, are interested in startups. Think it sounds intriguing, and could see themselves doing something on the side, such as consulting or advising a company, but maybe don't know how to get started or don't have a good pathway into this world. And so that is why I built the first course, which is the startup physician Launchpad. It is a six week course to really train physicians on the foundations of venture capital, private equity and startup life cycles, and how to provide value and create services that can really be valuable for them and for you. That is one type of feedback that I get is doctors that are looking to be consultants or advisors. And I know we've spent a lot of time on this podcast so far talking about that pathway, but today I want to talk about the other pathway, which is, I have a lot of physicians come to me and say, I have an idea, I have an idea for a company or a product or a service that I think could really help my patients, my practice or healthcare in general. And they say, I would love to make a company that does this, but I don't, I don't know how to do that. It's, it's a really foreign concept to try and figure that out. And so I think that one of the main things that I want to talk about today is all the things you can do to build a company before putting in any capital. And so I want to share my experience and give you all some examples of these concepts, because when I first started my first company, it was really more of sort of like a venture studio sort of environment. And a venture studio sort of environment is when a firm itself is starting a concept, and they find and hire founders and really put all the pieces around the business that are needed for it to succeed. There are other approaches. You could work in incubator or an accelerator as a founder, to provide community and a set of learning and network to find some of the really the validation or the expertise you need, or to help find funding. And so there are different pathways for how to put community around yourself when you're trying to build a new idea. But I wanted to share a little bit about the philosophy and approach that we took, because I think that some of it is very relevant. And no matter what sort of company you'd be looking to start. There's a lot of similarities among every business. So the first step that I would say is important is to start with the problem, not the solution. And I ask this to doctors all the time. I say, Is there a problem you can think of in healthcare that affects your patients? And in general, everyone can think of at least one. When you start with the problem, you're able to think a little more about how a solution may need to be designed, so identifying what is the problem and who really experiences that problem, and what are the consequences of that problem. So my example is that we were seeing a problem with the fact that the parents of children with medical complexity have so many issues accessing all of the things they need to keep their child healthy. They have medications and specialist appointments and DME and home health nursing, and they're dealing with Medicaid and prior auths and their own work and their own stress and their family and other kids, and it ends up having a consequence of, if these kids don't get what they need to stay compliant with their care plans, and their caregivers are not supported, they end up getting sicker, and they end up spending more time in the hospital. And some of the consequences. For that are worse outcomes for them, they're not at home and healthy, and much, much higher costs. So understanding what the consequences are of the problem that you're trying to solve is the first step. The second step is to really build your thesis. What makes this an opportunity? Why now and why you so this can be a challenge, but you have to be able to put this into a sentence to say we are building a company that is addressing the needs of complex children, because then you can say like, this is how big of a problem it is. This is how many patients are affected. This is how few solutions there are. And I'm doing it because I have built a similar program, or I've worked with these children, or in our case, it was our firm has built other value based companies, and we felt very confident that we could find an answer. The third step, once you have your problem and really your thesis statement of what you're trying to do, the next step is to really do discovery before design. You can have an overview and understanding of what you think you'll do, but I would consider that a framework, because I think that sometimes when you get too much into the solution from your individual perspective, you can get stuck down a pathway that maybe is not holistically addressing the problem. And so discovery is a process where we will figure out what variables or questions or pieces of the problem we don't understand or would like to understand, and really talk to people that have that perspective, whether it's patients or payers, other clinicians, hospital administration or operations people, and really trying to get their reaction on the problem that you're trying to solve, and then mapping that all into like an ecosystem. And my example of this when we were building my first company, we wrote out a patient journey we tried to map out everything that these parents, children and families experience related to their health care or their overall health, and how all of those factors play in and when and what some of the consequences are. And I remember thinking early on like I didn't know what to do to build a company. Like my co founder was like, typing away and trying to work out problems with our future tech stack. And I was like, I don't know what to do. And she just rolled in a whiteboard. She said, map it out. Write it out. Write out all the problems. Write out all the things that interact with these kids and their ecosystem, and then we'll have it on paper, and then we can start tackling each one of those problems and so understanding what solutions exist now and then, where the gaps still are. So for our particular use case, there are some amazing, complex care clinics that take incredible care of children with medical complexity, but they're not available to all kids, and there's still gaps. Understanding that baseline of the problem that you're trying to solve and really getting into the detail and multiple people's perspectives on it is so important. And then the next step is what becomes kind of hard for us as physicians, which is really creating the business model and determining what we call the unit economics. So if your intervention is like a certain type of telehealth visit, like your unit might be per visit, so per visit, how much does it cost you? How much revenue do you create when you look at it holistically? So when you're modeling the business, what you really have to do is identify who would pay for this. And that is a question that I ask most doctors who come to me with an idea, they say, Oh, I have this really cool thing. I've already started on it. This is what it's going to do and how it's going to help. And they're very eager to demonstrate this from their perspective of as a clinician and seeing their patients, but they don't have a good grasp on who would actually pay for this, and sometimes the answer can be multiple people. I have clients that I work with that maybe have a direct to consumer version of their product, and then they also will sell a version to employers, and then they're also, you know, looking to expand to other healthcare kind of ecosystems, and that's fine. You can have multiple people that would pay for your product, but you have to understand who would pay for it, and then all the really nitty gritty details of the cost of operations, as well as the revenue streams. So this could be very, very simple. If you have a more simplified business, or in our case, is very complex model that, like, broke my computer every time I opened it. But you have to go through and like for for us, we were modeling the clinical intervention that we were proposing for these children. Hmm. So in our case, when we were creating our business model, we were going through all the details of the intervention we were proposing. So what that meant was, if we think that each patient needs a visit with this person and a visit with this person, and then they do this, how long are those visits? How many of them? Do they get per year? Which patients need those visits? Are they virtual? Are they in person? And so we started with something pretty simple, but then continued to layer on more and more complexity as we continued to do discovery and continued to talk to people about what exactly goes into the model and what would be needed to support that model. And then as you're able to really get a grasp on the cost, because you now are calculating, like, how many hours you need of this type of person, and then you're really determining, like, what sort of salary would that be? Are they employed? Are they contractors? And you just build on it. You just, I mean, we built this model all year, for an entire year, and put all of our assumptions in there, and when we started to see where our gaps are, that's when we would go find more people that would know that stuff. So it was using our network, using our firm's network, to really narrow in on, like, where would be the objection to paying for this, or where would be the problems with engaging this many patients who could tell us about this, and then simultaneously, on the other end, since we were a value based company, we were mapping out how much savings we felt like we could generate from their reduced hospitalizations. And it's all assumptions. It's not you can make very educated assumptions, but you have to realize that sometimes you're going with your gut and trying to create the best thing possible without actually doing it. So companies that aren't a value based company would want to map out their revenue stream. So what are the products that they offer or services and how? What are the payment models or plans? Who pays for it? And just really adding in more and more detail. And I don't think I see very many doctors taking this approach. So I think that by creating a model that's really solid and has a lot of good evidence behind it, and you've had a lot of conversations with very various smart people to help weigh in. It makes it so that once you do get funding and get off the ground, it's more like your playbook, and you know exactly what targets you're trying to hit. This also emphasizes the importance of advisors. For those of you who are thinking about becoming advisors rather than starting your own company, we have so little internal expertise. When you only have one or two or three founders, you rely so heavily in this stage on advisors, because you're really trying to come up with the solution for a problem, and you want it to be the right inputs. So when you don't have the clinical input, I think companies know they could end up in the wrong place. So I think that's my point about why it's such a great opportunity for physicians who have a really deep clinical knowledge to get involved. The other things to be doing while you're building your model and doing discovery is continuing to put it out there and find partners who are interested in helping you design, and maybe interested in advising, maybe interested in investing, so that you're not starting from scratch when you go to raise money, and you're really getting feedback along the way, and it's good to try and get the concept completely on paper. There is a resource that you can just Google called a business model canvas. That is something that I've used before, that you basically are challenged to put everything relevant about the business onto one page and then simultaneously really going deeper on the concept and determining how long would it take to become profitable, or what other value do you need to create. I think a lot of what we did was continuing to like whittle down the clinical intervention and identify ways to do it at a lower cost, such as doing more things virtually, while also trying to determine what interventions could we do that would really maximize savings. You really want to focus on your value proposition and how this product or service could could really grow. I have talked to people at individual hospitals who have a lot of ideas of like a program that they think their hospital should do, and I feel like my mindset has changed so much since being in this field, because I think, Well, I would rather just start a company that knows how to do that and then partner with children's hospitals or partner with hospitals so that you can replicate it and scale it. It's not like it's just a program at one place, figure out what repeatable process could work elsewhere and do it more than once. So altogether, we can think about when you have an idea and you're really. Trying to think through Do you want to pursue this? I just want to encourage you that there's actually a lot you can do without capital. So following a structured framework or process is something that you can do right now and understand what's possible without a big investment really clarifying your problem. You can build a deck to clarify your vision. You can even Google what's in a good pitch deck and start, start to build your deck. I think my whole year of 2022, centered around a pitch deck and an Excel sheet and a lot of meetings with people. And so every single time we were having new input, we were iterating on both of those things. Other things you can do when you have a vision is set up time to talk to 10 people that have something to do with this problem. Just the inertia of having conversations about this possibility, it will make you even more excited, and it will probably open your eyes to things that are possible. Other things you could do, you could, if it's a digital product, you could build a prototype or a mock up, in addition to a deck, you can create what we call a one pager, which is different than the business model canvas. The business model canvas is really like an exercise. The one pager is trying to say, can you put everything about what you want to do written into one page that makes sense and follows logic and is compelling and summarizes what you think you want to do, because you can't share your idea or find the next steps if you don't know how to verbalize it, and having it as a one pager is great. It's a great way to really share your thoughts. I would caution people that one pages are great if you can keep them at a high enough level that there's no like secret sauce in there. It's not all of your detailed calculations. That's a great what I consider like a pre NDA sort of document. And then your deck should have everything in it, and you should not send that around to everyone. You should be very careful with your business case and your pitch deck, because I actually have seen doctors just hand over their entire business in in paper form, trying to get feedback. So it's good to have an NDA in place before you send something like that. So next, I want to talk about where most people get stuck, because a lot of people, like have an idea and then don't do anything with it for a long time, or they do something and get a little bit of inertia, and then they kind of put it on the back burner and it fizzles out, even if they might have invested capital and time. I really feel like there's so much value of doing this in a community with structure, to have other people that are, you know, similarly building healthcare companies, and you are able to hear from their experiences and their learnings, and maybe benefit from some of their connections. Some of the reasons why people get stuck is just feeling isolated or like they can't do it, which I think we all feel that way, but no business would exist if someone didn't just try to do it. The other thing is perfect. Is perfectionism. We want to have a plus plus work. We want to have the very best solution completely worked out, and you're just never going to get that. Like I said, so much of what we put into our model were just assumptions. They were our best guess, and then we set up mechanisms to be able to measure them once we launched, so that we could course correct whichever ones came in as a surprise. So maybe we thought we were going to do something at 60% and we're actually performing at 40% how does that affect the total cost or revenue, and how are we going to make up for that once we're actually running so it's okay if your first assumptions aren't perfect, because you will learn more once it's running and you just can't get stuck wanting everything to be a plus plus, you absolutely can have high standards for what You would personally invest in I recommend that I am very strategic and careful about assessing investments, but you can do a lot on paper, but it doesn't have to be perfect. Another place that I see people get stuck is when they feel like they need an MBA or a fund to get started. And I just don't think either of those things are true. I think that a lot of doctors want to just keep getting degrees, because we just want to be such experts before we start doing anything. And it's evidenced by the fact that, like I did, four years of medical school and then three years of residency, and then three years of fellowship, and 10 years into my career, I still consider myself like a new attending and not that much of an expert. And I see a lot of people thinking like, oh, I need to get an MBA or take another degree to be able to get started. And that's just not true, you know, a lot, and if you're a physician, you. Probably also know how to call a consult. So I think about it that way, because I'm an emergency physician, and I know what I know, and I know what I don't know, and the things that I don't know, I call someone. And the same thing goes for these business concepts. So altogether, I feel like there is incredible momentum in doing something right? And you can be a physician and a founder, and you can make your business rooted in strategy and really a clear scaling plan of how something can actually make money, like not building something just because you think it's a good idea, without identifying revenue streams. So you don't want to just start a company and put money into it. You want to build something that has traction before you raise your first dollar or invest your first dollar. So that's a lot of what I learned working at a firm and building a company from scratch. I have this vision of helping support other physicians to to build their companies and to create something that is scalable and is more than a small business, but could actually be like a startup that can get venture funding. And so that's why I am excited to let you all know that another resource that I am currently developing is an incubator program for physician founded concepts for physicians that want to work through this framework and process on a more intensive level together and to use these resources and these methods to really build a model on paper that's really excellent before you put a bunch of capital into it. And so I will be sharing more information about the incubator soon. You can sign up to follow our mailing list on the website if you'd like to hear more about it, or you can reach out to me anytime. I am just loving meeting all of these doctors who are building such amazing things or contributing to cool things, and it's just really exciting to see how people are stepping out of their more traditional roles to think of other things they can do. So I am really excited to continue to work with you all. I am responding to the feedback that I'm getting about people that want to be advisors and people that want to start companies, and I'm so excited to support all of you. So thank you so much for listening. I'd love to hear from you. Please give me feedback, and I'll see you next week. Thank you for listening to startup positions. Don't forget to like, follow and share. You.