Startup Physicians

Beyond the White Coat: Building a Startup Career from Private Practice with Dr. Payal Adhikari

• Alison Curfman, M.D. • Season 1 • Episode 25

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In this episode of Startup Physicians, I sit down with Dr. Payal Adhikari, a pediatrician who made the leap from private practice into the startup world. We talk about what it takes to step into non-clinical roles and how networking, self-belief, and clinical expertise all play a part. Dr. Payal Adhikari shares her personal journey, the skills she had to build, and how she found real opportunities in biotech and consulting. This conversation is all about action and showing physicians that they already have what startups need while also encouraging them to take the next step toward building something new. 

Episode Highlights:

[00:00] - From Medicine to Startups: A Journey Begins
[09:28] - Navigating the Biotech Landscape
[18:42] - Building a Consulting Business
[28:22] - Empowering Physicians in Startups

Alison Curfman:

Don't have to choose between medicine and startups. She and I both still practice and do clinical work while also working with companies. I want people also listening to recognize the value that you already have. Welcome to Startup Physicians. Please like and follow our show to join our community of physicians who are reimagining healthcare delivery. Hi everyone, and welcome back to startup physicians. I'm Dr Alison Curfman, your host, and this podcast is really about one major thing, showing you the pathways between medicine and startups that nobody taught us in medical school. Today, I'm talking with Dr. Payal Adhikari, a pediatrician who went from private practice to a commercial team at a series D biotech company and then built a consulting business working with multiple startups while staying clinically active. So if you've ever wondered what physicians actually do at startups beyond being a token medical advisor, this conversation will show you. We're going to get into the specifics of what sorts of work she did at these different companies and what skills she had to learn, how she found the opportunities, and, most importantly, how you could do something similar. So Payal, thank you so much for joining me today. It's

Payal Adhikari:

a pleasure. I'm excited to be here.

Alison Curfman:

Awesome. Well, I'd love if you could get started by just sharing with us a little bit about your journey from being in private practice to where you are today.

Payal Adhikari:

Absolutely, and I apologize, because my career is so fragmented that sometimes I go back and forth between what I've done in my life, but I'm very happy where I am, so I'm happy to share with everybody how I got here, and all the things I needed to learn and do along the way. So first, I always knew I wanted to do something a little bit different than just straight clinical medicine. So I started out after undergrad doing one year of consulting work, which I know is kind of an ambiguous term, but my brother was at a big consulting firm. I joined it. It's called Huron Consulting Group, and I basically, for a year, was a glorified data entry person, but I learned a lot of skills there. I learned how to dress professionally, work in a large corporate environment, respond to emails, work past my hours, and it was, you know, I didn't get paid a lot and I didn't do a lot that was very meaningful, but I did learn a lot, I think. And then after that, I quickly started my medical career. I always knew I wanted to be a pediatrician, so I went into medical school and residency and then joined a private practice with the intention of becoming a partner. But the partnership track changed at my practice, and then that kind of derailed my whole career into where I am now. But it worked out, I think, for the better. So once that partnership track was taken away, I decided to do something small on the side. I was really busy at work and had two little kids, and did the creative outlet, so I started a little side gig making kids earrings, like fine jewelry for children, which I still have, but is just on autopilot now, but it was a really nice way for me to stay creative. Use my brain in different ways. I learned how to create an LLC and open a Shopify account and create a website. And all of this was mainly done by YouTube videos and vlogs of people that were willing to share their information. So very piecemeal, but it worked out, and I started it, and then a few years later, I decided I really needed a big career move, and so started hardcore networking. That was the biggest thing I did was, you know, updated my LinkedIn profile, and really utilized all my resources of people that I'd met along the way, you know, in residency, in med school, and just really reached out to gain some insight of what I could do next. That is

Unknown:

such an important first step. It's a lot of what I teach people is strategic networking, because you don't get the opportunities just randomly coming to you when you're not like, putting yourself out there to the universe and to other groups. And that's incredibly insightful of you to start there.

Payal Adhikari:

Yeah, I think it's so important. And when I talk to medical students now, I encourage them to start their LinkedIn profile early, because, yeah, people along the way that you can connect with, and then years later, your career paths might align, or something you know might align from you too. And so it's Yeah, sort of early

Alison Curfman:

well, and sometimes people think of networking as like going to awkward receptions and like trying to make conversation. And I just feel like it's just relationship building, right? It's like you need someone at a conference, and you genuinely get to know what they care about and what they're working on. And. You support them and give them encouragement and and then you stay connected. And every once in a while, something will come along that's like, oh, you know, who really knows something about that? Is that person that I, you know, had this connection with? I feel like it's organic. It's like relationships and connections. It's not awkward receptions of making small talk. I mean, it's like how

Payal Adhikari:

you and I met. It was this six degrees of someone meets me, or introduces me to somebody, and then eventually I got introduced to you. And I feel like this is how it happens, and it's over weeks to months to years, but you network into the right people,

Alison Curfman:

absolutely. So you started there, and then what? So

Payal Adhikari:

I my cousin's wife was in biotech, and I reached out to her, and one of the most important pieces of advice she gave me early on was, you are a doctor. People think you're really smart, because I was like, why would a biotech hire me? Or why would a pharmaceutical company hire me? And she was like they will because you're a physician and they know that you are smart, you're capable, you're a quick learner, you're in you're a hard worker. So that was really helpful to me to give myself some confidence that I can do this and people are going to take me seriously. So I remember so vividly that first conversation with her, and I was frantically writing notes because she was using all this corporate jargon and medical jargon from, like, a pharmaceutical or biotech side that I had never heard of. And I was so intimidated. And quickly I, like, looked up everything she talked about, and I realized it's just a very steep learning curve, people will talk about like, you mentioned series D, and I think that was something early on, I wouldn't have known what that meant. And as you work with startups, you kind of realize that there are certain terminology, and we're all physicians, we're quick learners.

Alison Curfman:

Yeah, none of it is rocket science, no, but it's like,

Payal Adhikari:

you hear it over and over again, or you just look it up, you don't, need, and there's YouTube and there's courses like you have that can teach us all of these things. So that was one big hurdle I had. I got over was like feeling that I had some value to add to these companies. And once I realized that I just again, looked at my network, I joined some Facebook groups that were geared towards physicians looking for non clinical careers. And then it became very overwhelming, and I had to sort of undo what I had learned. So I learned like, okay, probably didn't want to go into pharmaceuticals. I probably didn't want to go into utilization management or insurance, and so I really focused on biotech. And the first company I joined was, like you mentioned, a series D biotech in the microbiome space, which I was not familiar with. This is not something that I learned about in my medical school, like, about probiotics and gut health and but a lot of my patients had been asking about it, so I knew that there was, you know, some resonation with the clinic, or the client side, the patient side. So the first company I joined was hiring an entire commercial team. And again, commercial was something that didn't make sense to me at the time,

Unknown:

either. Yeah, you're like, I don't even know what that is. Most people listening are like, I don't know what that is. And it sounds like they would need someone who has done, like, a PhD in, you know microbiology, and really knows a lot about gut microbiome, but it sounds like that's not what it was,

Payal Adhikari:

not at all, not all. They were hiring a team of physicians to help get their product to the market. So they needed people who understood the science behind the product, but also knew who was going to be buying it, which were hospitals, you know, neonatologists, anywhere from neonatologists to like parents buying this for their children. But they needed somebody that could kind of communicate that science to make it more bridging the gap, bridging the gap between industry and and consumer. And I was like, I'm a mom, which, sorry,

Unknown:

is something that we do every day, right? Is like our communication skills with parents, with patients, with with administrators, like all of that is something that physicians are perfectly

Payal Adhikari:

skilled for. Absolutely we are capable of doing it. And if you find something you're passionate about, which, you know, a lot of us are passionate about, what we do in medicine, you can do that for a company. And I think industry gets this sort of bad rap right, like people hear the word industry and they think you're selling out. But the truth is, as clinicians, we need industry. Industry supports what we do. And so, you know, I found this great company that was really geared towards gut health and, you know, disease prevention, and I, my role was to take their science and speak with, like you mentioned, hospital administrators and neonatologists and people who are purchasing. The product and telling them, this is why it's important. This is all the research behind it, and I had to learn a lot. I had to learn a lot about the microbiome and immunology and the financial benefits of what this product could bring to teach people. And it does feel a little bit salesy, but I think, as a physician, when you say, like, Hey, I get a salary. I don't make money based on whether you purchase this product or not, I just truly believe that it is good for patient health and health outcomes. People take you seriously, like I was very impressed and didn't feel super awkward, like I thought I would in some of those environments,

Alison Curfman:

right? And how did you find that role?

Payal Adhikari:

Facebook? Of all places I found it on Facebook. It was on one of those non clinical career sites and and this wasn't just one that I came across. It was one of probably hundreds that I came across that I pursued, and the amount of the number of job applications that I completed versus the number of paths that I actually pursued was in the single digit percentage. I mean, I applied to so many positions and either didn't hear back or work was quickly rejected. And I don't, I can't, to this day, figure out why. But, you know, I think you find, you keep going, and you find companies that you believe in products. For me, it was like I needed to believe in the company and the product and the people. If I believed in those things, I was willing to risk part of my time to to work for them, and that's what I did. And it was, you know, wonderful, wonderful, first big non clinical career move for me.

Alison Curfman:

Yeah. So how long were you there, and did you how did you feel about the work once you were doing it?

Payal Adhikari:

Yeah. So the the learning curve was very, very steep, but it was quick and it was fun. I worked with other physicians, which was really nice, because we all had the same strengths and the same deficits, and we were able to kind of say, like, what, like, how do you learn about, you know, fundraising or whatever you're doing? And I was there for about a year and a half. It was a very fun ride. But, you know, as a lot of things in industry work, they're dependent on FDA, and there were some FDA changes, and funding was removed, and we I switched gears, but it was great, I think first, first nonclinical role for me, and it was something that I signed up for. I think when you sign up for startup world, there are high highs and there are low lows. And if you're up for the roller coaster, it's a lot of fun.

Unknown:

Yeah, yeah. And just for people who are listening, who may have the same question that you would have had about, like, I don't know what series D is. So startups usually start with some amount of funding, whether it's like founders own funding, or friends and family, or they can get a seed round. Then as they grow and kind of create their proof of concepts, they will raise their next round of funding, which is called a Series A, A lot of times, once people get to a series B, they have a concept that is operating and performing well, and they're wanting to scale it. So when you say series D, they've now raised at least four, if not five. You had a seed fund, five rounds of funding. So that means they're a pretty big company. That means they have funding. I do work with a lot of people who, you know, look at really, like really, really early stage companies as a starting point, which is great too. They just won't have as much funding. But this looks like it was a company that not only had a budget to pay you, but actually to create a team of physicians on a commercial team.

Payal Adhikari:

Yeah, yeah. So it was a much bigger team than I've since worked for. But that's kind of the fun of it. Is every company is a little different. Little different, and you, you know, kind of figure out their culture and where they are in that fundraising process, and you learn every step of the way.

Alison Curfman:

Yeah. And I think that one of the things that's coming out of your story, which is very similar to my story, is that, like we see our careers in chapters, and not feeling really anchored to any one thing. It's not a lack of loyalty, but it's really just assessing, like, Where can I contribute the most value right now? What's the best step for me right now? And being able to stop and recognize, like, there are times that you're not in the right place, and it's time for a change, even scary. It

Payal Adhikari:

was so scary because I was working at a very well respected private practice. You know, for most people, it would have been their dream job. And I was very happy. I loved my patients and I loved my colleagues, but I just knew professional. I had plateaued so early in my career, and, you know, a lot of people I see are like, Oh, I'm working extra shifts, or I'm, you know, double booking patients, and it's to make extra money, and it felt like that I was too young, or I was just too creative to do that. I didn't want to take time away from my family to move up in my career. I wanted to be in a position where I had room for upward mobility. And I think with clinicians, a lot of times you just get stuck. And so it was a huge leap of faith for me to to move to something else. But I was really fortunate to have a partner who was supportive of it, and, you know, was sort of understood that it was a risk, but was supportive and willing to ride that journey with me. So I would say, for the probably six months prior to actually accepting this job, I felt like I had two jobs. I was working full time as a pediatrician, and then job searching was another, you know, part time or full time job. I was constantly on LinkedIn, constantly on these Facebook sites, looking for new things and networking and reaching out to people that I'd met in medical school or residency who were doing cool things. And, you know, it was worth it. It it was a lot of work, but it was

Alison Curfman:

worth it. I feel like there's a personality type of people that work into startup, in startups. So like, on the one hand, being able to tolerate some level of risk, and on the other hand, having this sort of like tenacity that you're describing, like it's not a passive process. So I feel like I do get some physicians coming to me that are like, I want to do something else. I want a different opportunity, but then they don't take any action. So you you can't expect any sort of results if you don't take any action. And sometimes the action itself is like, really low risk. And that's like, what I tell people. I'm like, Okay, you look up a company that sounds cool, and you read about them, and then you find them on LinkedIn, and you find who their founder is, or the CMO or someone, and you send them a message on LinkedIn, what is the absolute worst thing that could happen? They don't respond to you like, who cares, you know? And it's just like, if you're not willing to take action and take some level of risk, even if it's like, literally, the risk is that you wasted five minutes of your life. Like, that is the risk. But what's the potential upside you make that network connection you hear about sometimes I tell people, like, Okay, you're like an OB here you're looking at venture firms that do women's health, and then you find some companies, and then you look them up and try and understand what they're doing, and if you like that, and then you find them on LinkedIn, you find some people that work there. You start messaging them. The best thing that could happen is that you then make a connection, and you don't you're not even like, asking them for a job. You just want to know them and what they're working on. And maybe they're like, You know what? People who are in startups, we're all connected to other startups. We all know other founders. We all know other companies. We're all like, pretty hooked into our our own field and the scene of what's going on. Like, I know a lot about what's going on in pediatric startups, and frankly, I feel like, you know what you started with was, like, network connections. It's so low risk. All it takes is your time. You don't have to have capital. You don't have to and you have to be willing to take a risk of like, Oh yeah, I'm gonna introduce myself. So scary, right? And

Payal Adhikari:

it's good practice, because if this is really what you want to do in in your career, you're gonna need to be doing it over and over and over again and reaching out to people. So it's good practice, and you're right. So the risk is so low. And like I said, I had many applications that were unresponded to, or, you know, quick rejections. And you know, you get over it quickly. You build, you build, oh yeah,

Alison Curfman:

you realize that there are hundreds of 1000s, if not millions, of companies out there that could be an option. And then there's, you know, millions upon millions of people you could connect with that would be a good connection. I mean, people reject me all the time still, and I'm sure you too, and reject meaning like, ghost me, like, like, don't, don't respond. But it's like, who cares? Like, put, put 100 feelers out, and you might get 10 back, and one of them might be like, the best partner you ever found, or the best job you ever found. And so it's but I think that that's like a little bit different mentality than most physicians, because we want an A plus on everything we want. Oh, if I reached out to 10 people, I want 10 people to respond and think that I'm amazing, like I think that there just has to be this level of, you know, lack of hubris and willingness to try something and realize that someone might not like you and I. Or reject you and but just, like, not letting it mean anything, because, like that, that's not the right path. Like, I don't know, I just, I feel like I get a lot of people who want something different but won't take any action.

Payal Adhikari:

Yeah, I mean, it is a full time job, I would say, and you have to be really committed to it and learn that it's not going to be linear, like it's not going to be, oh, hey, I sent out this many applications, so I should get this many responses back. It's just unpredictable. But in a way, like you said, you get these, you know, you meet somebody, or they ghost you, or whatever, and it says a lot about them and their company. And so you learn those things quickly. Of that's actually beneficial, like, that probably wasn't going to be a good fit for you. And, yeah, yeah.

Alison Curfman:

I mean, I'm embarrassed to say I've ghosted people too. I've been like, too overwhelmed as a founder, I'm like, That is like, not at all what I'm focused on right now. And what or I mean, I get like, hundreds of messages on LinkedIn all the time about, like, Hey, you want help with SEO. You want help with marketing. I just don't even respond. But it's like, actually, one of them, I did something you wrote was interesting, and it was just a cold outreach. I did respond, and I actually had a conversation with them, and might do some work with them. So you never know it's not you got to get over this, like it's scary sort of thing. And I know you just yeah, don't take it personally. Yeah, yeah. And, I mean, I know that you said it could be a full time job to look for a job, which is true the way you did it. I also, I mean, I've honestly never applied for a job. I've never taken that because I wasn't looking for a job when I moved into this role. But what you're talking about is, like, a very intensive, like, Hey, you want to find it. Go find it. Like, here are the pathways. Here's what you could do. Here's some. You just gave them, like, five things you could do if you want to do it every day and go look now, you have to know what you're looking for. You also said that you started by being like, you know what? I don't think I want to do Pharma. You have to know what you're looking for. And I, actually, I created like, a PDF of like, ways doctors can contribute to startups. And it's on the website, startup physicians.com and you can look at those. And I mean, I need people to start with a perspective of like, okay, look at these 50 different like, sorts of job opportunities. Which ones do you like? Like, I sometimes have people that are like, I don't know, what can I do? And I'm like, go through and pick 10. Like, pick something that you know you want to start going after and doing research on and and doing outreach on, because I can't do that part for you. Like, people have to know what they're looking for and what sort of time and commitment they're willing to put into it to learn and to network and to get to a different place,

Payal Adhikari:

absolutely. And sometimes it's process of elimination. Like I didn't go into this thinking I want to go into biotech. I just knew I didn't want to go into other things. And so, yeah, that was how I ended up in biotech, and it worked out. So,

Alison Curfman:

so what did you do after that, that first commercial role?

Payal Adhikari:

So after that first commercial role, and you know, I let me backtrack a little bit, I was able to maintain clinical hours as well. So I was very fortunate with my with my biotech role, that it was four days a week because it was a team of physicians, and we all wanted to stay part time clinical. So I had a one day a week role at a different private practice, which was an amazing fit for me and and I've been able to maintain that. So after that first nonclinical role ended, I just sort of ramped up my clinical hours and was like, let me just figure out what I want to do next,

Alison Curfman:

because you can always do clinical work. I know some people feel like, Oh, I can't leave my job or whatever. Like you will have no problem finding someone that wants your clinical work in some way, shape or form. You always have that

Payal Adhikari:

absolutely, whether it's locums or, you know, whatever, you'll figure it out. So I was blessed to be able to continue that. And then I did more research, and I was like, What do I want to do next? Like, I really like the microbiome space, but I also really like just kind of the commercial getting new products to market space. And I decided to just work with startups. So I started my own consulting company, which I think probably also sounds very overwhelming, but it's really just sharing your knowledge with companies. And I started it, and I had been already working with people on LinkedIn who had reached out to me and said, Hey, I see you're working at this company. We're starting a company. Can we have a quick call? And so I've been doing it more, you know, just kind of on the side, but I decided to make it more of a business. And so now I have a proper LLC, and I take clients, and it's been really fun. I think my end goal is to find a client that I want to jump on board with and see, you know, take on a more, you know, part time role than just clinical or just just consulting like a CMO. Or, yeah, CMO, or medical director role. I did one medical director role at another startup with in the microbiome space too, just because I loved it so much, and that was a part time gig. But it just it gives me so much flexibility. And I have young children, and you know, to be honest with you, that little break that I had between leaving my first nonclinical role and starting a consulting company. It was the first time in my life where I, like, had time to, you know, be mystery book reader at school or, you know, drop off clothes if they forgot something. And it was so meaningful to my children that I felt like, Okay. I like this flexibility in my life and being able to now I work two days a week clinical, and then three days a week I'm consulting, but those consulting hours are really on my own time, and so it's been just a blessing for our family, I think. And like you said, there's chapters. I think at this chapter in my life, my kids are little, and they need me, and I know there's going to be a chapter where they don't and I can put more effort into my career. And so it's just been a really nice change. But again, like, I think you need to have that personality of knowing that it's not like I'm working, I'm seeing patients from 730 to 430 every day. Like, that's not how it is. It's really day by day. There's times when I'm super busy with clients, and then there's times where I'm really not so. So it's just about being flexible

Alison Curfman:

and what sorts of things do. So I think you and I probably have different versions of consulting, because we have different backgrounds. What sorts of things do you do for clients?

Payal Adhikari:

So a lot of them are companies in the CPG or in the health tech space. So like people who are companies that have products, so either like a physical product or like an app, let's say, and they need to get their product to the market. So for example, I'm working right now with an app company that is geared towards families that have kids with eating issues, and so they want to market it to parents and pediatricians as a ancillary service that you know they can provide to their patients. So what I'll do is I will tell them, like, how do who are the pediatricians that you need to market to? What's going to resonate the most with them? Same with families, like, what are the what are the places that new parents look to for resources? So I'm just using my kind of background, both as a parent, as a clinician and in my startup world, and I'm combining all of it to help guide them. It's just giving them the knowledge that I have. That's it.

Alison Curfman:

Absolutely, yeah, and I think that, I mean, I've had doctors come to me be like, I don't know if I can do this, because I don't have a, I don't have, like, a golden idea that I think is worth, like, millions of dollars. It's like most people don't. Most people don't. You have some ideas of like, how healthcare could be better. You have a lot of experience. You've you've spent hours and hours upon hours talking to patients and changing the way you talk to make it more impactful. You. You have spent so much time developing an expertise and and communication skills and strategic skills and understanding resources, and it's just a perspective that companies need. They look for, they pay for. Sometimes I feel like doctors don't believe me that this exists, but I'm glad that I have you as another data point and many others in my network, but I just want to thank you for being so specific in this journey of, like, here are things I did when I put my head down and I was like, I'm going to go do research, I'm going to go find something, I'm going to go look for, things I'm going to, you know, apply to all these jobs. And even being like, yeah, I wasn't a microbiome expert, but that's what I got hired to do, is to sell a microbiome product and to help them strategize about their commercialization. So I just, I really think this has been a really great demonstration for people that are looking for pathways. And I just want people to know these pathways are real and accessible. Pile found her first role through a Facebook group, she learned business skills on the job, and she started consulting by saying yes to projects and figuring it out as she went. And for everyone listening, you don't have to choose between medicine and startups. She and I both still practice and do clinical work while also working with companies. And I want people also listening to recognize the value that you already have. You have clinical expertise, problem solving skills, a deep understanding of healthcare challenges, and that's exactly what startups need. So stop thinking that you need an MBA or a lot of specialized knowledge to contribute. You really need to shift your mindset. Set about what you bring to the table, and so the gap between where you are and where pile and I are is not as big as you think. It's just a series of small, intentional steps. So I just want people to feel encouraged, and if you want to reach out to pile, is LinkedIn, the best way to connect with you?

Payal Adhikari:

Absolutely, yeah. LinkedIn, my I'm sure you'll share my name,

Alison Curfman:

yes, yes. You guys can go to StartupPhysicians.com to see more about this podcast episode and to connect with pile and any, any last thoughts or words of encouragement for people along this path.

Payal Adhikari:

Yeah, exactly what you just said. You are valued people companies will look at you and know right away that you have a lot to offer them. You just have to have that confidence in yourself. That's

Alison Curfman:

true. Because if you go to them being like, I don't know what I could do for you, they will also agree, I don't know what you could do for me. You'll figure it out later. Yeah. So be confident. All right. Well, thank you so much for joining us.

Payal Adhikari:

Thank you. Alison, bye, bye,

Alison Curfman:

thank you for listening to Startup Physicians. Don't forget to like, follow and share.