From Medicine to Market: Danish Nagda on Breaking In and Building Boldly

How does a doctor become a startup founder? Danish Nagda, Co-Founder & CEO of Rezilient, joins First Builders to share his journey from the hospital floor to reimagining how care is delivered for high-risk patients.

Danish left medicine to co-found Rezilient, a virtual-first care platform connecting patients to their providers in ways traditional systems can’t. He’s also the host of Uncanny Valley, where he explores the real stories of founders and innovators breaking into tech.

In this episode, Danish shares:
– Why being an outsider in Silicon Valley became his advantage
– How adaptability shaped Rezilient’s growth through market shifts
– Lessons on founder-led sales and building a personal brand
– The co-founder dynamics that keep his company strong

It’s a conversation about identity, conviction, and building boldly—inside and outside of Silicon Valley.

Follow Danish Nagda
LinkedIn: https://www.linkedin.com/in/danishnagda
Company: https://www.rezilienthealth.com
Podcast: Uncanny Valley

Make sure you follow us on all our social channels below and watch full episodes on YouTube.
Subscribe to our newsletter to get new episode drops in your inbox.

Show Notes

• Danish’s path from medicine to co-founding Rezilient
• Breaking into tech as an outsider and building credibility
• Founder-led sales and personal branding for early-stage leaders
• Lessons on co-founder alignment, scaling, and team building

FOLLOW THE COUNCIL & FIRST BUILDERS

Newsletter

YouTube: @firstbuilderspod

Instagram: @thecouncilcapital

Twitter/X: @first_builders_

TikTok: @firstbuilderspod

LinkedIn: The Council

Transcript

0:04

Welcome to First Builders, the podcast for those who shape companies from the ground up. I'm Amber Illich, founder and general partner at the Council Capital, where we invest in early teams solving critical problems in essential industries. And I'm Rachel Choi, partner at the Council. This podcast is about a group of people who are more likely than average to land executive roles or found unicorn companies. We explore the moves that propelled them to where they are today and what early stage founders can learn to accelerate their own growth. We call them first builders. They don't just work at startups, they help to find them. And today's guest is a great example of that. Donna Chenanga didn't just take the typical tech path. He started out as a doctor and is now co-founder and CEO of Resilient, where he's rethinking how care is delivered to high-risk patients. He's also the host of Uncanny Valley, a podcast where he dives into what it really takes to build in today's climate. Now, this episode is very special to me as I had the chance to invest in Resilient early on out of our fund one and have worked closely with Donish ever since. The day we signed the paperwork for the deal, I remember that Resilient also closed their first enterprise customer, and it's been absolutely nonstop growth ever since. So I've seen Donish lead and scale the company with clarity and excellence through widespread market meltdowns and more. Donish, welcome to First Builders. Hey Rachel, how are you? Good, good. Excited to have you on. Yeah. I'm excited for this. I've known Amber forever. So this is great. Yeah, we're super excited too. So let's go ahead and start at the beginning. You trained as a doctor. What originally drew you to medicine in the first place? Well, my original interest in medicine came from I was already in the business world, not super happy with my day-to-day job, was volunteering a lot on the side. There was uh a uh free clinic in south side Chicago where I was volunteering. I was working out of Chicago at that time as a consultant and would go volunteer once in a while. And there was a physician there who happened to become a mentor who said, you know, you really are very good with patients. Are you sure you don't want to be a doctor? And I told him that my entire life being a brown person, I said I never want to be a doctor because that's what's expected of me. But then, you know, he was like, Well, you know, maybe you can rebel and go back to school. And so that was sort of the genesis of that. I went back, uh, did a post back, and during that time met um uh who became my mentor. He was actually the former dean of the School of Medicine at Wash U. I did a lot of health policy work with him. And unfortunately he passed this year actually, but he encouraged me to go and pursue my path. And he said, Look, medicine is funny that way. He was a nephrologist by training. And he's like, I haven't seen a patient in decades. But what I you don't need to be taking care of patients to take care of patients, and that was one of my favorite lines because he was honest about that and always remember that. But he said, Go and keep an open mind, and medicine is so broad and so deep that you'll find your place there. Um, and so I ended up going to med school at Penn and I did that, and you know, during my time there, just one big interesting part why I ended up doing ear nose and throat, which is not like one of the sexy specialties. Uh, it was uh primarily because of cochlear implants. And when I was doing, I was gonna be an ortho personality-wise, it fits. And so I was gonna be an orthopod. And uh one shift in doing pediatrics, I went in and I saw a cochlear implant case. It was kind of boring actually, it wasn't that interesting. But then the surgeon was like, hey, Dana, she should go to one of the activations where they like turned the cochlear implant on. And it was a child that I'd never heard before. And I walked in, I was sitting in the back, the family gave us permission, and they turned on the cochlear implant. And I can tell you that I may have cried, I was a bigger guy at that time. I may have cried more than the mom did. It was kind of kind of embarrassing, like big tears coming down my face. Because the kid was kind of like, you know, doing whatever, and then they turn it on, and the kid was like, What is going on? Well, that's now I was like, This is what I want to do with the rest of my life. So that's how I that was my path into medicine, and then I pursued DMT. Yeah, how long were you in medicine before you realized like, oh, I want to do something else or I want to build something new? Um, I was in residency at the time. I during residency, I kept on seeing myself gravitate towards many different things, was involved with doximity, was involved with other things. And so I uh I just always, Rachel, I couldn't stop myself. I always was dabbling in a lot of different things. And uh along the way, tried to do something in surgical devices, found that interesting. But I at some point it becomes very, very obvious that you can't just be a doctor, like you've got to do something else. So I would say it was even during residency that I already knew that I wanted to move on and and do something else after. And then from there you co-founded Resilient. So what made you confident enough to start a company from there? And then what was the first problem you set out to solve? Well, it's it's interesting because um, so with Resilient, I mean I'd been involved with several startups before, but with Resilient, it was because of my experience with my dad. So my dad's sort of the story of this company came to this country, worked really hard. All three kids went to the best schools in the country, sort of for brown people, like the American Dream, but for a lot of people actually, the American Dream. But uh despite having access to health insurance, my dad didn't have good access to health care. He ended up having his first heart attack at 53. At the age of 60, my father was largely bedbound uh with heart failure. And while I was in residency, I actually became his caregiver and then through residency and after took care of him until he passed uh a decade later. But that experience of both being a doctor, actually being a doctor, a caregiver, um, and an entrepreneur, I think those three sort of led to the genesis of this company. The problem that we were trying to solve in the beginning was the underlying problem that led to my dad's issue, which was around sleep apnea and access to sleep apnea care, but then expanded beyond that and wanted to solve the access issue to specialty care in general and realized that there was a bigger problem there. And then, you know, went down that road to solve the specialty care access issue. And, you know, this is pre-pandemic at some senses. Like it's right before the pandemic that we started doing this access to care situation. And we said, look, you can't deliver specialty care at the level that can be delivered in person remotely without being able to examine patients and get labs on them and do imaging on them. By the way, at that time, think pre-pandemic. People weren't even using patient portals that much. They weren't messaging their physicians that much. And so we were definitely a little early to market with the overall approach, but um man, the pandemic changed everything. It really did. Yeah. I remember when you first pitched me on resilient, I was getting a lot of pitches uh focused on healthcare at the same time. And everybody was saying, well, this is the new world. We're in a pandemic, it's all about telehealth, telehealth, telehealth, telehealth. And you were kind of the first one to be like, telehealth alone is not gonna cut it. We need hybrid care. I just remember that. And it was because of that orthogonal experience you had had where you're like, you know, these doctors are tied to the real estate. That creates all these inefficiencies, and then there's all these dynamics on the, you know, the patient side, the employer side, the payer side. And so I just always thought that was really interesting how you it was almost like you were two steps ahead. So well, and it worked out, right? Because we saw all of these virtual care companies go up and down. Some of them had had exits, most of them have not, most of them are zombies now. And it's largely because what we had thought at that time in virtual care, we as a community, it was actually not product market fit. It was just situation fit. You had a problem in that situation to solve that problem. And I think a lot of founders with AI and stuff were seeing it a little bit. They've got this new situation and they want to apply it to everything. It's not just a new solution, a new situation where everybody is getting behind it. We just always said, well, if we're not solving a real problem, like we don't want to be doing it. And so our, I mean, Amber, you remember our original approach was to use robots over the internet and distant memory. Yes. Yeah, distant memory. But it's interesting. I mean, like our cloud clinic. So what we do at Resilient now is provide same-day access to primary and specialty care across 70 specialties same day, both virtually at home on your computer, but also in person at physical clinics where you go in as a patient. But even when you go in and you sit down in the chair, the doctors are actually on the screen. And all the tools across all the specialties are connected. So think like a dermatologist and a dermatoscope and EMT and an autoscope or endoscope. We just we're doing all of it. And we're we're all of those devices are actually connected to resilient and live streaming to the doctor. And there's a person in the room, they literally grab the autoscope, they put it in your ear, and your eardrum is streaming live. But not only is it streaming live to the doctor, it's streaming live to you as the patient. And the doctor's explaining to you what's going on. Now, that human in the room, they're they're a paramedic. We thought that we could have the person, the thing in the room be a robot. And that was gonna be the crazy scalable, because again, the analog was telehealth, which was crazy scalable, right? And it was like, so if you walked into a VC meeting, this is lesson number one, if you walked into a VC meeting and you said, Hey, we're gonna put a human in the room, they'd be like, Why would you do that? I see all my doctors virtually. That's not scalable. And like that was the mindset at that time. What if they catch COVID? What if this h it was kind of like it was as if COVID was never going to end. Yeah. It was like, this is the new world. And I would sit there and I was like, You've never taken care of a patient. You don't know what the hell you're talking about. People are gonna go back. It's like I'm an ear-nose-throat doctor. Imagine I didn't look in your ear, nose and throat. Can we stop like making shit up and like actually have like real conversations around healthcare? And I think that those VCs no longer invest in healthcare, if you know what I mean. And so you know so, you know, taking a step back, our original idea, our solution was the wrong solution for the time. I still think that we'll bring the robot arm someday. But it's, you know, at the time it was the wrong solution. But as you know, Amber, Jeff and I were hyper focused on solving the problem. We were not in love with our solution. We never have been the type of people that like fall in love with a solution. It was hard. There was a lot of money spent. It was not easy. It hurt like hell. I love the robot. I swear to God, I still love it. You know what I mean? It's hard still, but we had to. I still have that last slide of the deck like imprinted in my mind. I'm like, someday that arm is coming. Yeah, exactly. Like someday it's coming. But it's like kind of interesting because the tech that we built allowed us to be 10 steps ahead of everybody else, the real-time telecommunication link that we built because we had to partner with the devices. So for robotics, I never talk about this part, but uh, but it's interesting. The robotics required a certain millisecond delay for it to work. Because the doctor would move a little and then the robot would move. And that whole system had to be really real time, otherwise, it would be off. So we built this super real-time movement telecommunication system that once we remove the robot, it makes you feel like you're literally in the room with the doctor. And like that is like the crazy secret sauce that I recommend every founder try to go and uh recreate. It's just incredibly hard from a technological perspective. And we did it with a bunch of roboticists, you know what I mean? And so it was something that we figured out that other people have not yet, because that's like the number one question I get now, which is like, how long until there's somebody who does what you do? Because I still can't believe we're the only cloud clinic people. But that that mistake led to what we are today. Yeah, it's super interesting what you were saying there because it sounds like again, no one's really doing it right now. And I know Amber has at least mentioned to me before, but like, you know, how not being from Silicon Valley maybe is you know an asset for you. I wonder if like something like this was like that. Um yeah, can you walk us through like kind of how you broke into tech and Silicon Valley and you know, if there was anything that really felt closed to you like early on? Yeah. I mean, it's not sexy to go with a black and brown founder from St. Louis trying to go raise some money in the Bay. You know, uh they there's you know, you all know the saying about the Bay, but you know, people are very nice, but not always as kind. And it's just the truth. Like we're from the Midwest, right? Sorry. I'm from the Midwest too. I feel you. Yeah, we're from the Midwest, right? And so ultimately, this is the truth of it, which is um, if you're a founder today trying to go build, you kind of have to maximize chances. And I would say go live in the Bay Area if you can. I was just taking care of my dad and I couldn't do it. You know what I mean? And so um, for me, I get that. There was some advantages to it though, Rachel. Nobody noticed we existed. And now we have hundreds of customers and millions in revenue, and it makes life much easier. And now Bay Area, uh, you know, we can get meeting. Starting to pay attention. Yep. Yeah, well, they can they can pay attention, right? And but at the same time, like we're incredibly grateful. And I get their point of view. Like if somebody came to me and said to me, hey, I'm from some random town in Nebraska, I'd be like, oh, okay, that's cool, right? Because that's the same version to me as to, you know, the Bay Area. I understand why they felt that way. They were like, this doesn't fit the pattern. Like they are pattern matching machines. And by the way, you know, and part of it is also if you really are serious about it, move to the Bay Area, which is a fair point, also. So it's just the life situation was not that way. And so I had to do what I do for my family. But it's uh uh, you know, I don't fault them for it. It's just kind of funny now in hindsight. Yeah. I was Amber was one of the ones who were was able to find you early, you know? That's right. Yeah. She got the valuation for it. Yeah. And and not not to project this on you, but um, one of the other super skills I feel like you had because you weren't in Silicon Valley was you really had to balance the that mindset of like big growth and vision that you see all the time in Silicon Valley. It's all about storytelling and just fitting the pattern. But then you and Jeff were just you were basically weathering multiple storms. Like we had COVID, then we had that FTX, you know, banking collapse that was in a totally different industry, but it impacted everyone. And then we had a banking crisis. And I just feel like being from the Midwest, you had this like unit economics like in the back of your pocket. You're like, you know what? We always knew something might happen. And here we are, we're ready. Yeah. Then it was like you could switch gears again and be like, you know what? Actually, now things are better. And like we've been steadily growing this whole time. Now let's pour fuel on the fire. So I think you just had like these two different maybe your personality is very like vision-oriented, but you also had that Midwestern like practicality. Well, it's interesting because it's like we run our company lean like a PE shop, but like our growth rates are VC growth rates, right? Like last year was 600%. I mean, like those are real uh 600% year over year in revenue growth rate. We're growing, I mean, two years ago, two and a half years ago, we had zero customers. Today we have over 300, right? Like these are like crazy VC oriented growth rates, and you know, uh, and we're not super quiet about it. We're pretty loud about our growth, but it's one of those things where I think that pattern is changing, maybe not in AI, but in other spaces now, where the VCs aren't falling for just like the loud, heavy vision-oriented. Yeah, people are burned. They have PTSD. Yeah. As they should. I mean, again, uh the the challenge that's happened is uh, and you remember this, Amber. I can walk anyone through our financial model like that because we're so in the dollars and cents. You know, our gross margins are really, really high for a care delivery business. And so it's one of those things where we do think about that because we actually think you can't scale something unless your gross margins enable it, unless your unit economics enable it. Um, and cash is critical, right? And so uh we it's funny, I remember Amber might not remember this, but there's, you know, she mentioned to me once that there was a little bit of a scarcity mindset. Do you remember this? You said it to me once. I'm trying to remember what the context was. It was in the middle of something, and I was like, well, you know, like I don't know if we can go for this. And you're like, well, you know, that's a little bit of a scarcity mindset. And I was like, interesting. And I thought to myself, I was like, yeah, maybe that is part of the challenge of being a on Bay Area startup. And, you know, the money that we've received has been primarily from the East Coast and you know, you all and Acorn on the West Coast, but it's a lot of it came from folks that have built companies and you know have been big founders themselves. But we don't have that abundance mindset as like a default. I don't know. I don't know if I can build it. I've been building it, but it's hard. It's hard coming from the Midwest because you know, VC is very different out here. Yeah. But I mean, I think you've been able to like really just leverage that, right? Like that that disciplined mindset again, like in how you've built the company. So it's probably just paying off to have that still. Yeah, but now we gotta grow. Now it's time to go. I know waiting time. Now it's not like, can we stay alive? It's like, am I doing everything in my power? I even feel as an investor in you, I'm like, am I doing everything? Yeah. One of our uh board members, he was like, Hey, stop worrying about gross margin right now. You guys are growing so fast, you'll figure it out. Like you have so much margin that like you'll figure it out. And that was super helpful because it was kind of again, that scarcity mindset. Where's the cash gonna come from? How are we gonna think about this? Yeah. So it's kind of uh it's something that I'll work on in therapy. Yeah, totally. Speaking of things that are hard uh and things that may require therapy. What was what has been your biggest what the hell are we doing moment uh so far as a founder at Resilient? When we were in Tech Stars, there was, they made us talk to a hundred customers. Uh, that was really helpful. And I think we were on customer number 30, maybe 35. And the customer was like, hey, I love what you all are doing. She used to call me Danish. She was like, Danish, I love what you guys are doing. Can you do me just like one favor? Can you get rid of the robot? And I remember sitting there and just being like, damn it. You know, because they tell you, you know, Ford said that if they asked me what to build, they would just say, you know, a faster horse. And I kept on telling myself that I was like, just let me get this out there. Okay. So I kept on telling myself it was okay. But then CNN came down to headquarters, if you remember Amber, and CNN anchor was sitting there as the robots coming to her to do the physical exam, and she's like, This? And I remember just telling Jeff, I was like, we gotta have a conversation, man. Like, this is not gonna work. Like our user testing, I don't know what these users are telling us, but I'm like seeing regular people not being primed and looking, and it's just they're not liking what they're seeing. I think we're early to market. I said, look, this is a great tool. It's gonna be incredible someday, but probably not in the next five years. And that's okay. Like we have a bunch of IP around this, we'll be fine. But it um it was that was the what the what the hell moment for me, that was the biggest sort of what the hell are we doing? Yeah, it's funny you mentioned that because um the reason we love investing in first builders, including folks that have uh, you know, been involved in previous startups like yourself, is because we really like we look at it as investing in the captain of the ship. Like so many things can happen and the solution might not be the same as the one that you invested in. And so it was cool seeing you navigate that and just realize, hey, you know what, we're gonna cut our losses. This thing is not working out, and we're, you know, we still can solve the same problem in a different way that will actually be a little bit simplified. So you know what Vinod's uh line is about that? It's kind of Vinod Kosla's. He says that he invests in startups that have high pivot velocity. So they're pivoting totally a lot. So it's actually the opposite of what a lot of people like to invest in. He actually likes it when a startup is pivoted many, many, many, many times. Yeah. Because it's a sign that they're nimble. Yeah, and you're not too overly committed to like the thing that you thought you, you know, you're not, yeah, you're not locking yourself in. Yeah, taking in all the learnings from that too. So because it sucks. Pivoting is the worst. And for us, we didn't pivot on solving the problem that we were solving, but we definitely pivoted on our solution that I mean, that was a dramatic pivot for us. Yeah. Not to mention just how hard it is for you guys, but I imagine there was some whiplash with the team too. Like, how did you guys, how did you manage that sort of change with, you know, having team members potentially on board that then need to get on board with the new plan? Uh, we brought everybody into a room, we told them what we had heard, and we said we have no choice but to change. Either we die or we pivot. There's only two options. Which one should we go by? Everybody said pivot, of course. And we said, okay, let's come up with a plan together on how we can do this as quickly as possible. You know, this is the part of startup building that no one tells you, which is pre-product. There's only two portions of a company. Mark Andreessen talks about this, but uh pre-product market fit and post-product market fit. But pre-product market fit, don't think scalability. That's like completely useless. Like all those questions that people ask about are now in hindsight, like with this company especially, like scalability is like not the point. The point is iteration speed. Like, how quickly can you iterate? And so one thing that Jeff and I pride ourselves a lot on in the beginning years is that we iterated like crazy. Like work, you know, nights and weekends. Now it's supposed, you know, it's considered cool to like work a lot again, I guess. But we did it out of survival because we literally did not have enough money, right? To do this, uh, because scarcity stuff that we were talking about earlier. And so we just iteration speed is everything. Because I will tell you that uh product market fit, you know you are a product market fit. You you just know. It's like there's no, it's it's like falling in love. Like you literally, there's no way to explain it to somebody. When you get there, I swear to God, founder, you will tell people, I don't know how to explain this to you, but we're there. It is a crazy moment that goes, it's like when when you put a post on and it goes viral. Like there's no way to explain it. There's no like you can measure views, but it's it's There's no version of that for Yeah. Yeah. I want to go back to what um you're mentioning too with Amber of like getting everyone into the room. How big was your team then when you pivoted? And like, you know, how big is it now? Like has that changed like how you lead the team? Yeah. I mean, one, I think more than the size of the team, it's more about us being post-product market fit now. So, you know, we have we're post-product market fit with our core product. And so it's the team has, so at that time the team was five people, right? Because we don't run a lead. And now the team is 55 people. Wow, 11x. So, but that was also three and a half years ago. So four years ago. So it's in a while. But yeah, uh, what do we do now? We don't, I mean, to be fair, once you get to post product market fit, pivoting is really impossible close to. I mean, you can enhance what you're doing, but pivoting post-product market fit is incredibly hard because you have product market fit. You have this like lightning in the bottle in a bottle, and you just want to keep pouring resources into that. But the thing that is happening is we're now it's public, but we're launching, we've launched multiple specialties alongside primary care now. And luckily for us, product market fit's coming very quickly for those. But in those, you know, we listen to our customers and iterate. We listen to our customers and iterate. So it's only available to close customers we have existing relationships with. Uh, so it's a customer success-led model on those specialties. We're not going out to the market and trying to sell it. We're saying, hey, we have, we've delivered you single customer millions in savings. Can we partner with you to solve the next big problems that you have? And for that one, what we're doing, which is interesting, is we're actually building little teams of people that are just watching it like we were when we were smaller. So it's like think of them as like project teams. We're focused on that with the customer success. Sounds funny, but customer success actually being the leader on that. So customer success is actually leading. I love that. Especially like being from customer success. Like that was my whole background, actually. Oh, yeah, I forgot. Yeah. So that's why I was like, I love the customer success angle of it. Because I do believe that when you really know that, it's yeah, it can really add to you know, customer success has to know product very, very deeply. And so a product always thinks product solutions. Customer success just thinks about solutions. And so there is a big difference. And so from our perspective, if you're sitting there with a customer, you can throw products at it, you can throw people at it, uh, you can throw throw process at it. There's a lot of different tools in the toolbox that customer success has that unfortunately product does not have because product can really only work on the traditional product. So I think for us, that has been customer success is a we you know what our churn is today? Zero. 300 plus customers. Yeah. Because we're so obsessed with that. Well, we're just obsessed, right? And yeah, the upsell motion is a hard motion. People don't realize how hard it is because you're asking customer success to do something that doesn't feel natural to a lot of them. And so from our perspective, we tell them don't sell, just share, which is a big difference. And you know that. Because you have actual value, like getting away from that scarcity mindset. So, like if a if if an employer is sitting in front of us, so we provide primary care and specialty care, right? So they we look at where are our primary care doctors referring patients to. And then we say, hey, look, we sent 20 referrals to GI. If you got the GI solution, this is how much you would save. Would you like to consider doing a small pilot with us on that? And that is the approach that they're taking, which is the second part is the hard part, right? But essentially what we're saying is, if you're interested, let me hand you off to RevOps and sales to make that happen. So that smooth handoff is important. But you know who advocates the most for customers? Our customer success team. That's like that's their babies. It's a very and there's a level of like, no, no, that's because they're working with them every day, right? Like they're they're in there, they're helping them with the workarounds, right? Like sometimes if the product is not quite working, right? They're like, oh, you could try this, you could try this. Yeah. Exactly. And so they are very defensive. And I want that defensive posture, like that, like not defensive, like aggressive, like uh the opposite of defensive, like aggressive posture of like, no, you don't get to mess with my people, right? That we have to have that little friction in the organization so that things get done. Because if you're, you know, I I think back to like what got us a product market fit super quickly. And you know, early deal making is always funny. So, you know, your first five, 10 customers are are not, you're not gonna get them the same way you get your next 50. All right. So the first customer that we had was one of our investors, owns a company, and she was like, she wasn't even self-fun self-insured, she was fully insured. But she's like, I believe in you, Donish. You're the best. Let's just do it. I'll pay it out of pocket. And I was like, okay. And I defended that. Like, you cannot imagine. Me and Jeff, we used to like really go at it. I was like, he was like, Donish, I can't get this done this week. I was like, Well, how many hours of sleep do you think you're gonna get this week? And like that was the kind of like clashes that we had, right? Because we had that friction because I was customer success, right? It wasn't just a customer, it was an investor. And investors were a big deal for us, right? And so that that's sort of the sort of stuff that I want happening as we grow. I don't, I don't want to lose that mindset because I think, at least in our space and digital health and in hybrid care, think about every company that came before us, right? They were incredible and then they have faltered. Like it has been the repeat cycle. They do incredible and then that experience falters as they grow because it's hard to scale. And so, you know, I talk a lot about what Amazon has done, not in healthcare, just in general. And that customer obsession is what's what's what needs to scale. It's really, really hard. I will say, Rachel, that's what keeps me up at night. That's what I was uh before this call. Uh, you all overheard me kind of getting upset. That's what I was getting upset about. Yeah. It's like I never get upset about anything. I only get upset about my customers. And that's the um, but that trickles down. Everybody knows like that's when rubber hits the road. And I think that customer success culture is actually what's missing in our industry. That's huge because I feel like so many companies, even whether they're healthcare focused or non-healthcare focused, there's so many companies that just focus on sales and they're just like sell, sell, sell, and they've got all this contracted ARR. And then it's like you can just burn through that so fast and spend so many months chasing that annual revenue, and then it just goes away the second you're not paying attention to your customers. So I think that's great. But one thing I did want to talk about today is sales, and you already kind of hit on it. Those first five deals are very, very, very different than like all the deals that happen after that. And there's so many transitions that founders go through from like founder-led sales to founder-supported sales to founder-free sales. Where are you today? And like how have you how have you gotten there? Because I think, and I'm asking because I think this is something you've from afar, my my perspective is you've done it very well and maybe had some like natural inclinations toward it, but there have to be learnings along the way because it's not easy for anybody. Yeah, it's funny. I never sold before this company. It's wild. Yeah, I know. I'm like, how does a doctor just be this like natural-born enterprise sales founder? It was amazing. No, it's it's because I'm not. That's the key. I had zero, you know, like no one will ever, ever, no one will ever mistake, mistake me for somebody that's humble. But it's that's the one thing I was very humble about is, you know, that I'm not good at selling. I feel icky when I sell. And so I said, you know what? I'm just gonna do sales my way. And my way is how I talk to patients. I will actually talk to all the customers like their patients. And so, what do you do as a doc? You walk in, you have authority. So for me to know what my customer needs, I need to know everything about them. You can ask me any question about a health plan, and I can answer them like I am a health plan designer, like I am a benefits broker, like I'm a benefits consultant. Now, I don't know the tactical side of it, but I understand the plan design. In fact, I give a talk to all of our sales team called The Anatomy of a Health Plan that I designed, that I went through and learned from incredible benefits consultants and brokers. They were like, no, no, no, Donish, this is actually how a TPA works. No, no, Donish, this is actually how a PBM works. This is how stop loss works. I mean, all those pieces are critical. So I just overintellectualized it. I said, if I'm gonna sit there with them, I wanna be their chief chief medical officer. Let me come in and have this conversation with them and let it be a consultative sale. So the first five customers, I would act like it was residency. I would go in, I wanted to earn understand everything. I would sit down with the head of HR, I would understand every aspect. I was like, what's going wrong? No, no, forget about primary care for a second. Tell me what's going wrong with the health plan. What's happening? You guys had another 16% increase this year? What happened? Oh, this med. Oh, they just released Humera. Oh, that's interesting. What if we could change that in our formulary for our doctors and move to Sky Rizzy instead of Humero? Would that be cheaper for you? Okay. And I literally would was doing that with our first five customers at a crazy scale. Like I needed to understand every aspect of the health plan. Like my life depended on it because I just I was not good at selling. I couldn't just walk in there, put on a mock collar, a black mock collar, and be like, you know, welcome to the future. It was nothing like that. And by the way, we have, I would say, the most forward-thinking approach to hybrid care that you'll ever see. You're going to physical clinics where there are where the doctors are on the screen. I mean, this is, you know, compared to the other companies, we are light years ahead, right? In terms of tech. But I never sold it that way. I always sold it as, no, no, no, let me understand your health plan. Let me understand your employee base. So you have like a bunch of manufacturing people. Okay, what do tell me about their how the I'm not even kidding, this sounds crazy, but tell me about how their day-to-day works. Like, how do they interact with the health plan? Are they all digital natives? Or do they use, I mean, I was doing like a lot of like, I don't want to call it customer discovery because I don't believe in that. It was more existing customer sort of, I was embedding myself into that. This is how much one of our customers, Cosmos, they they they're very public about this because Stacey, their head of HR, speaks about this at conferences on our behalf. But we noticed that a bunch of people were coming in with back pain. And it was so specifically detailed that we identified that it was, I'm not kidding, the mats they had on their floor when they were doing manufacturing, that it was affecting their backs. That's how, like, because we got so embedded. I was so obsessive about the first five, 10 customers. And now our team does those kinds of things. We literally do a full walkthrough of their health plan. We understand their vendor stack, we understand how has it been doing? What are the problems? We get buy-in early on, you know, and not just for the giant enterprises, for the mid-market customers too. And I think that that is what makes it different. But yeah, no, Amber, I'm not a good salesperson. I just um I think we recreated our version of healthcare enterprise sales, which was we're we we're not just salespeople. We're not just coming here to sell to you. We're gonna be a big part of your strategy. Yeah, it's like a partnership. It's like I've spent time thinking about what it would be like to be in your shoes, and therefore we designed the solution for you. Um Although I would argue maybe that makes you like a really great salesperson. Maybe more people should be selling like that, right? Like just really understanding, you know, people don't want to feel sold to. Yeah. Nobody wants that. And I and I suck at it. I'm like really bad at it. When I like I've tried to do the hard sell, and it's like so obvious that I'm doing it. I remember we were really struggling at that point and had only a few months of runaway left. And I had this sort of biggish deal that I wanted to sell. And, you know, this is still like COVID days, and you know, everybody was taking stuff from home and meetings from home. And my wife was, you know, in the kitchen and then sitting in the living room doing her work. She's a landscape architect, and I was really doing the hard sale. And I got done, and she's like, You're not gonna get that one. And I was like, really? She's like, that was awful. Like, that's not you. Don't do that again. And I was like, okay, I promised myself I would never do the hard sale again. I just suck at it. I'm like so myself. Like I like Amber, I am this 24-7. Like I can't not be this. And so whenever I'm not this person that you've known for years, I'm awful. And I think that like that's the that's the big learning for me now is you just gotta be like authentically you in this in the selling process because you know, people have like this uncanny feeling of just like, uh, is this like real? Yeah, you're putting on an ad. Yeah, you can just feel it. Yeah, yeah. And I, you know, um, I noticed that too. I mean, like you're all over like X and Twitter, and like, you know, you're very just like authentic and outspoken, you know, you have like strong opinions on there. Curious, like how that visibility, you know, of just you kind of being in public, like how that's changed things for you as a founder. Did you start doing that like early on with Resilient? Or you kind of just it happened alongside? Yeah, Silicon Valley Bank fell. I was upset about it, and there was like a spaces, the Twitter spaces that was going on. And I just went up there and I was very much myself, just being like, you know, we need to do something about this. This is gonna affect the startup community. You know, remember, we had very little money and all of it was Silicon Valley thing. It took a lot of work for us to get here. How can they just let this all go away? I was like, this cannot be how my company dies. Like, no way. And Mark Cuban came on and others, Bill Ackman came on. Before you know it, I was hosting it, and it was, it just went crazy viral, and everything kind of went from there. They started talking about it in Wired magazine and all this. It just like started going crazy, and then and then I said, Well, this is like a really interesting place for me to build my voice. And I like I said, I was I kept on telling myself, I just want to be me as much as I can be. And uh, sometimes I say things that people don't like, and that's okay. But I saw the other big thing that I saw coming was that I think people are tired of like media trained CEOs. And I felt that we needed a lot less of that in healthcare, especially. And very few people in healthcare are just being honest about the problems in healthcare. Nothing wrong with people that want to be a little bit more careful. I just felt that what I mean, it sounds the one abundance mindset thing is I was like, I don't have anything to lose, right? Like we're right, I was like, it is what it is. I'm just gonna be me and put it out there. And then before you know it, you know, like the podcast and all this other stuff, it just it started ballooning. And for me, it's been, I mean, Rachel, we're you'd be surprised how many CEOs reach out to me and say they want to use Resilient because of my my how outspoken I am. Yeah, yeah, 100%. So they just they just resonate with somebody saying the truth. Yeah. But I feel like even if people disagree or agree with you on what you're saying, the fact that you have the confidence to put it out there when so many people are just trying to like kind of toe the line and um you know not make anybody upset. It's I think it's nice that you just put it out there and then people know where you're you stand and they know that you have the courage to do it. So yeah. Like, you know, I talk about really tough topics, like the fact that they're extracting all the wealth and giving it to the gerontocracy. Like these are real problems that young people are feeling today. That these are problems that everybody's feeling today, right? And so like these are things that I care quite deeply about. You know, we have socialism for older adults and capitalism for the rest. Like these are topics that I really, really care about. That, you know, like by the way, if we had socialism for for our generation in terms of healthcare, uh, my company would be dead. And that's okay. Like, I'm okay with that. It's the right thing to do. So I think like that's what people resonate with, which is I'm okay with me losing money, just so that like our country can be better, right? Uh but and we're going through some crazy times right now where people are scared to say things. And I have this like uh decent size, you know, place where I can say things, and you know, people do get mad at me on a daily basis and I can take it because I don't take anybody that seriously. You know what I mean? Yeah, um, yeah, and so that's sort of the idea. The most important thing that comes from it is that when you do reach out to somebody, they feel like they know you because you are authentically yourself. And so as they know you, people do business with people. Yeah, corporations, totally, and people sell to people too. The person buying a product is also a person, not a company. Exactly. And so, like people think that they're buying something from company X, Y, or Z. I always, one of my sales side mentors, because I was trying to get better at it, used to say, people don't buy Apple products for the first 10 years post the iPhone, people didn't buy Apple products because they were buying it from Apple, they were buying it from Steve Jobs. And that is actually the truth. People felt his energy in everything, right? And so the truth is that if I'm gonna be the representative of the company, right, I'm not representing the company in my comments, but I am the leader. And so they need to know that my insanity is infused in everything we do. Like, and once they know that I'm so specific about all these different things, they know that I'm gonna be specific about the product. And I think like that does matter to people. People might not agree with everything that I say, but they know I care. And I think that matters a lot. The last things I want to ask about. So you've brought up Jeff a couple of times in the conversation. I would love to hear, you know, I've I've worked with you guys a lot, but I think for the audience, it'd be helpful to share a little bit about how you two are different. I sometimes think of you two as like a yin and a yang, like balancing each other out. So I'd love for you to kind of share a little bit about that dynamic and even just if you have any best practices or advice on how you manage a co-founder relationship because you guys have been working together for a while, like managing massive pivots, product market fit, now scaling. So yeah, how do you manage that? So Jeff is definitely the yin to my yang. I think he's it's funny because he has a quiet intensity that I think a lot of people take his laid-back nature as being non-intense. He's more intense than me. I just externalize my intensity. He internalizes it. And so that's one of the things about Jeff that's been very interesting, which is that communication style is the opposite, which is good because then we can communicate with each other, but intensity level is the same. So that's something that actually I think a lot of founders get wrong. You can't have an intense founder and not an intense founder. Yeah, that's where you breaks down. I'm actually gonna say something which is messed up. If you're not an intense person, you probably shouldn't be a founder. Don't do this. It's not worth it. There are so many good ways to make money. It's too hard. Yeah, exactly. Go work at Google. It's like retirement, right? Like, go do it. Like make your life awesome. Go, you know, go go to all your kids' soccer games. Like have a great life, like enjoy yourself. I'm not doing this because I like a good life. Like that is, I'm telling you, this is not the path. But if you're intense and you feel like that there is nothing else you can do with your life but do this, this is what you do. And Jeff and I both share that like insane intensity. Like, for example, there has not been a Saturday or a Sunday where we don't meet. It's been years, right? It does not end. We start texting at 6 a.m. every morning. That is that is the truth of it. That's just how we are. It's it's it's not like there's a shortage of things going on to text about. Yeah. And and you know, it's like after every single big like we just had like a big meeting where I was a little bit mean. And afterwards, I go to him and I talk to him about it, like right after. And he gives me, you know, he's like, that was good, that was good, blah, blah, blah. And we move on. It's like uh he is literally, it's a true, I will tell you this, it's easier to get divorced from your spouse than it is your co-founder. So just be very, very careful about who you pick. Now, people have been able to withstand that, but I actually think that that is the most important aspect of the company because you don't just have to have a good relationship. That's great. We have to have a shared intensity, a shared mission. And you actually have to have, and this sounds messed up, you have to have sort of the same level of capability over time. Yeah, that's true. Because some people can kind of like the skills required, you know, those grow. And if you can't move into that next chapter, it becomes awkward. And then there is that power imbalance. And it's like capable of it. Even if you want to be intense, you can't be as intense as you want to. And and for some reason, we've gone to this world where we say that people don't have ceilings. That's not true at all. There are people that don't have range, and there are people that don't have ceilings. That is a thing. It's the reality. Anyone that's hired anybody should know that, even if we don't want to say it out loud. And for me, having a co-founder that is smarter than me, that is harder working than me, that is different than me in some senses, because then we can kind of play off of each other. That was really critical. In this scaling mode, the hardest thing has been us telling each other where we're falling. Because, like, you know, pre-product market fit, it was never about us, right? It was always like, here's how we fight to get to product market fit. It was so clear. It's so clear pre-product market fit what the goal is. It's like product market fit. That's it. And you define what that means, you put it on a board and you say, I'm gonna get to that. That's what we need to get to, right? So for us, it was NPS. So usage of the product, return usage of the product, experience with the product, churn of the customer, and clinical outcomes. That was it. We hit these numbers, we are a product market fit. We are incredibly KPI driven. It's easier because we're both engineers. And so it was really easy for us to just say this is the way we're gonna go about it. Post-product market fit, it's endless. So you got to time bound it and you gotta say, okay, the next, I need to get here without losing these things, right? So I can't go down on NPS, I can't go down on clonal outcomes, I can't go down on this, but I want to get this growth. And the thing about the co founders is he has to tell me when I'm getting in the way, and I have to tell him when he's getting in the way. And that has been quite challenging, but it's easier because we've known each other forever. But it's sort of what we've done, which I would recommend to post product market fit founders. Is we actually have a session where we come in knowing, bracing for feedback. So we have feedback sessions where Jeff just tells me, dude, this week I really wish he wouldn't have done that. Here's what I would have done instead. Here's what's going on. And the most important thing, you know, people have given Brian Jesky a lot of issues and commentary, but he's right about one thing, which is when you're co-founders, the relationship is more important than the argument. And that's one of my favorite lines that he said that I really like. And I think that it's one of those things where we have chosen the relationship over the argument every single time. Because founders that don't argue are like marriages where there's no argument. Oh, that's a problem. Yeah. Yeah. Something's up there. Yeah. That's the pretty bad. Yeah. Real relationship, right? So, and you have to give each other space when there's a conflict. When there isn't a conflict, you have to be really close. But we have our own ways of communicating. Um, and I would say that I'm as close to Jeff as I am to my wife, which is saying a lot because I've known my wife for like 15 years, right? And so, but we are very, very close. I mean, at a at a like a like we are in meetings and he looks at me and I know what he's thinking. So that's where we are. We were just in the meeting right now. I could tell it's like I can I know when I'm messing up, I know when I'm doing well. It's like he's my counterpoint. He's your mirror, yeah. Um, cool. Well, we're gonna hit you with a few quick fire questions. So just say the first thing that comes to mind and we'll go from there. Yes. All right. So most underrated skill for a founder today. Hard work. Nice. One lesson from medicine that surprisingly applies to startups. Listening is more important than talking. A book or podcast that's influenced how you lead. That's a tough one, but I would say from all the podcasts that I watch, which is a lot of podcasts, how I lead, I would say it's a couple of episodes from Lex Friedman where he interviewed Elon. I think people can say whatever they want about Elon. He's an incredible delegator, and it's something that I aspire to be. Best decision you've made as a founder so far? Jeff. Choosing Jeff as my co-founder by far. Nice. We teed him up for that. Yeah. A personal habit or mindset shift that's changed your game. I think moving to an abundance mindset, I'm working very hard on that. And I think it's helping the company quite a lot. And last one, what's a piece of conventional startup wisdom that you actually disagree with? The way that they well, one, I don't believe in the business model canvas. I think the lean startup model is bullshit. I think that's like one of the worst things that's happened to startups. Uh, but also I think that a traditional sort of the belief that you have to have a good pitch to get investors, that's a complete lie. Your pitch actually is the more your pitch is a conversation, the more likely you are to to win. And number two, um you have to walk into that with insight, not a pitch. And there's a big, big difference there. I think a lot of pitches get very pitchy. Like here's the problem, here's the solution, here's the market, here's this. And I think that um it's like a checklist. Yeah, and people actually invest in people and uh unique insights. If you're a human being that has like a really, really good relationship with the person, and you have a unique insight that makes you 10x like far ahead of everybody else, and unique insight about a problem, right? Amber, even to this day, the unique insight I had was that telehealth was not enough and you still remember it. How many years has it been? Like three, four years, right? Yeah, at least probably three years. Yeah. And so that's what people remember is the unique insight about a problem that only you somehow have figured out. Because you know what's really interesting about VCs? VCs are chronically curious people. So even if you walk out of that meeting and you can accept them with an insight about a problem, they'll be taking a shower and they'll be like, man, that was a good idea. Yeah, you're taking up real estate. Yeah, you're like taking, like you want to live in their mind space, and you're not gonna do that coming in and pitching just like everybody else did. You're gonna walk in and you're gonna say something that in the moment, like uh uh in the moment, it may not register completely, but a day goes by and they'll be like, oh my goodness, that's so true. Oh, I just noticed this. Oh my God. And like that inception that keeps becoming an idea in the VC's head is actually like the most powerful thing you can do. And that conventional wisdom of like, this is how, and by the way, every business school in the country has been teaching this. So you think that if any MBA grad could just put this formula together and raise money that it's gonna work a hundred percent of the time, bitch that formula completely, think about your problem incredibly deeply and come up with that unique insight and just walk up to a VC at a networking event and say, hey, I'm solving this problem that other people aren't paying attention to. It might not be a problem today, but it's about to become a really big problem, right? And here's kind of how I'm approaching it. What do you think? Make it a collaborative conversation, and before you know it, you'll have a term sheet. So I think like that's the approach that I would take. I think pitching rarely works. Well, Donish, thank you so much for being here. Where can people find you online and follow along with your journey? You can follow me on X on Operation Donish and then which spells like Operation Danish, or you can follow Resilient on LinkedIn by just uh looking up R-E-Z-I-L-I-E-N-T uh health dot or you can go to resilient health.com. Amazing. Awesome. Thanks so much for being on. Yeah, thanks for having me. Yeah, it's awesome. I feel like I got to learn more about you, even though we've we're on the phone like all the time. So it was nice to nice to be outside of the problem solving mode and in like figure out who is Donish behind all the screens. Right. And thank you for the therapy session. Of course. Awesome. Well, thank you so much. Yeah. Oh, it's all good. Thanks, everybody. See ya. See ya. That was an awesome conversation. Amber, what stood out for for you for the conversation? Man, there was so much. I feel like one theme that just kind of spanned the whole conversation for me was adaptability. I think you saw it in multiple parts of the conversation. Like he talked about how he approaches things differently with the team and with the concept of pivoting pre-product market fit and then post-product market fit. He almost has a different style of leadership and even strategy, depending on where the company was at. And then he talked about it again when he was talking about how the first five sales that you make as a company are very different than every sale you're going to make after that. And then just pivoting in general, it seems like, especially early on in the company. And I saw that firsthand as an investor in the company. They were not afraid to say something was not working and move away from that thing and move toward the thing that looked like it was going to be promising. So I think that that adaptability has really helped him over time. Um, and then the other one that stuck out to me was sort of this concept of just don't be a salesperson. I think that is why he's so good at sales. I think his point was that it's better to be customer obsessed. So I think those things, those truly stuck out to me as just like top skills that a first builder could have. Yeah, totally. And I love the customer obsessed mindset. I mean, I'm always biased when I say this just from the customer success background, but I love that he was talking about how his customer success team at Resilient, they're the ones that really manage kind of like that upsell and pilot and the fact that they've developed this trust and partnership and they can actually suggest to their customers, right? Like, you should consider this. This might be actually really valuable for you. Um, but yeah. On my side, the other things that really stuck out to me was his co-founder relationship and how, you know, how important that relationship is, how they're able to really push on each other. But they've also developed a relationship where they can have those honest feedback and they can really work through things together as well. And then the other thing was the scarcity versus abundance mindset and how that scarcity mindset really served them well very early on, focused on unit economics. And now the fact that, you know, he has to really think more in that abundance mindset, just given where they're at and, you know, really go after all that growth. Yeah, totally. And we see that the co-founder thing, we see it across the portfolio and even in talking with other fund managers. It's kind of like the number one reason why startups fail. And honestly, frankly, one of the number one reasons why VC firms fail is because the GPs can't get along or the co-founders can't get along. So it it is, you know, I've heard that multiple times before. It's it's just as important, if not more, as a marriage. And it's very much like a marriage. So I think it was good, nice as an investor to see that he's taking it seriously. But I've always gotten that impression because they've been working together for so long and they do seem to balance each other so well. But, you know, it just goes to show there's a lot of work that goes on behind the scenes. It's not just what meets the eye. Yeah. And I was just thinking when he was saying that, I was like, maybe we should have like just feedback questions regularly too, where you and I can just like come in and like brace ourselves, right? What he was saying, you know, about just being able to like give that feedback freely, you know. Yeah, yeah. I like the fact that they have a dedicated space for it because I think if you're doing it in your one-on-ones every week, it becomes overwhelming where it's just like, oh, we're always giving each other feedback when we're supposed to be talking about the work stuff. But then if you don't do a dedicated space, you you feel like you're wasting time or something like that. But then if you take that time, it's like the most valuable nuggets come out that you can work through. So yeah, I like that idea. Yeah. Yeah. One thing that we can take away from this for sure. Yeah. Awesome. Um, well, if this episode sparked ideas or inspiration, leave us a review, send it to a founder friend, and subscribe to First Builders whenever you get your podcast. Yeah, we'll see you next time.