Physician, Investor and Entrepreneur - Sohaib Siddiqui (Medly Therapeutics and Kettlebeck Ventures)

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Hi everyone, I'm really excited to bring you

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this podcast with Dr. Sohaib Siddiqui. Sohaib

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is the Managing Partner at Healthcare Ventures

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for Kettlebuck Family Office, which is his own

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family office. He's also an Innovation Fellow

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for Women's College. He's on the advisory board

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of GE Healthcare. He's an entrepreneur in residence

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at the Faculty of Medicine and University of

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Toronto. He's an executive in residence at the

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Toronto Innovation Acceleration Partners and

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he's the chief executive officer of Medley Therapeutics.

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We had an amazing discussion and we talked about

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what he looks for in general partners and funds,

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what he looks for in founders, upcoming tailwinds

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in healthcare investing. Is charm or aptitude

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a better predictor of success and founders and

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outsiders innovate in healthcare? Is contrary

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an opinion in healthcare and much more. I hope

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you enjoy this conversation as much as I did.

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Thank you. Hi, it was great to have you here

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today. Thanks for joining me. Thanks for having

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me. I really appreciate it. To get started, I'd

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love for you to talk about your childhood. Our

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childhood defines us in some ways. There are

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some things we learn from our childhood which

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help us, and there are some things at times we

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have to unlearn from our childhood. Talk to me

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about your childhood and talk to me about how

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it has shaped you into who you are today. Sure.

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No, thank you. So, my childhood, I would say,

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I think I was blessed to have an overall good

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childhood. But having said that, I think I saw

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quite a bit of adversity over time. So, I was

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born in Boksan originally. I spent a few months

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there. So I don't really recall much of it, to

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be honest. My family moved a couple of times.

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My dad was in some of the banking industry and

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had a few moves. So I lived in Egypt for a couple

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of years. I lived in England for a couple of

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years, all kind of in my very, very early days.

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So I only have a few fleeting moments of kind

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of recollection of any one of those places. Apparently

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Arabic was one of the... first languages I began

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to acquire as a toddler. I don't remember any

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of it anymore really, but then we came to Canada

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in the early 90s and you know it was kind of

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a serendipitous move for my parents. You know

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they applied for immigration in a few countries

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and Canada was kind of the first one that came

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up and very typical to the immigrant story where

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you know didn't have a lot of money. uh parents

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looking for a better life you know they really

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struggled they really sacrificed um you know

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just in the first few months of moving into canada

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we moved in a very very cold environment that

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we weren't used to as a family that's a shock

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to the system um my dad three months four months

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into working a job actually one evening got t

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-boned by a drunk driver uh had a fairly you

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know pretty extensive accident a couple months

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later my grandfather passed away I was sick,

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I needed surgery. So like the first year in Canada

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was kind of just this concept of when it rains

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it pours. And really, my parents struggled. Many,

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many years, I, you know, I witnessed my family

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struggle a lot. And, you know, it was a big reset

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for our family. But having said that, looking

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back at it, I don't think I appreciated the struggle

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at that time. I don't think I, you know, I was

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never felt, you know, my childhood, I guess,

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was in a way that I don't think I felt, you know,

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poor or lacking of kind of support and resources.

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I think my parents were really good. I think

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they made the best of, they could. So, you know,

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they gave me the best they could afford. They

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sent me to a good school. You know, my wishes

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as a kid growing up, they fulfilled to the best

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of their ability now. And, you know, it does

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shape you, right? It sort of appreciating the

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fortitude and the kind of focus and diligence

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of my parents working around the clock to make

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the next generation better. And that's kind of

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something that I aspire to with my kids. I've

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got two young daughters now. I would say their

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upbringing is better than my upbringing. And

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I think every subsequent generation, I think

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everyone hopes that the next generation is just...

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that much more privilege. So, and I think that

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kind of is what kind of drives me in my career,

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right? It's like, you know, I want intellectual

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stimulation, but I want to be able to spend time

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with my family. I want to provide a good life

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for my family. So I think the goals are pretty

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common, right? I think it's appreciating the

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struggle on how it shapes you for the good time.

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So unconsciously does really drive a lot of the

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push and drive that I have to do the best that

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I can. for myself. It's a common theme I find

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in people I speak with is they have moved a lot

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in their childhood and they have been through

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hardship. It's something I think about a lot

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and I have two young daughters as well as I want

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to give them a very comfortable life. Do you

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think it's necessary to have hardship in life

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and do you think the degree of hardship correlates

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with the degree of perseverance and grit you

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develop later on? I mean, look, like people's

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lives are relative. The word hardship is a relative

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concept. You know, I would view many things in

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my life as a hardship, but in a relative sense,

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I'm very privileged. But my struggles are different

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than other people's struggles. I mean, you and

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I, we're both clinicians. I mean, I would argue

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being a clinician is a hardship. But to the other

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person, their dream was to become a clinician.

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And that may not have transpired for many people.

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They always wanted to be a doctor. They wanted

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to be a nurse. And for whatever reason, it couldn't

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happen. So hardship, I think, is a relative concept.

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Having said that, I do think hardship is a necessary

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part of one's journey. I do think we're all tested

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in every way. I think it's unfair to compare

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yourselves to others, but I think it is a human

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trait and perhaps a human flaw. You do compare

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yourselves to friends, peers, and how are they

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doing? And you may notice, hey, that other person,

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the grass is greener on the other side, but if

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you take it a deep down analysis, like, yeah,

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they might be better off in certain ways, but

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they may have hardships in a way that you may

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never even begin to kind of appreciate. So I

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think we're all kind of in our own journey, in

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our own ways we're blessed and other ways we're

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tested. But I think the testing is important.

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Does more hardship lead to more perseverance,

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more grit? I don't know. I think over the years,

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I've kind of tried to look at it where I think

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I want to. I'm not saying that I do a good job

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at it, but I certainly aspire to appreciate people's

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achievements. in the relative context of their

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environment. So if they started out with very

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humble beginnings, are they going to be the unicorn

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tech star founder? Maybe, maybe not. But maybe

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getting a regular job is a fantastic achievement.

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Maybe getting an undergrad degree is an exceptional

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achievement. Maybe the first one in their family

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to achieve that. I think that's a fantastic achievement.

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For other people, the bar maybe is different.

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you know, being a tenured professor at Harvard

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is the trap. But if you come from a family of

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tenured professors, like your, you know, the

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delta in which you have to achieve is different.

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So I really do try to view it in terms of like,

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what were the substrate that you were given?

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What did you do with it? How far did you achieve?

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So I think the objective comparison between people

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I think is kind of unfair. but I do try to look

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at it. And it does come into the entrepreneurship

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world too. We'll get into it in a little bit,

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but comparing different founders, what they had,

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what they made of it, what indication were they

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going at? Some founders are very blessed. They

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don't have to raise money because they've got

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really wealthy family and friends and others

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who refinance mortgages, had divorces to keep

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their things afloat. So I think it's relative,

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but I do think the perseverance part. is important

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and it certainly is from the entrepreneurial

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side of it. And I actually think the perseverance

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part will get into this as well. I think it's

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an important part of the EQ of evaluating companies

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and founders. Can they kind of survive the marathon

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that this whole journey is, right? Another common

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theme I find is entrepreneurship is innate. people

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who are founders were always entrepreneurial

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and they would say this is just how I am, this

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is how I'm programmed to be. Do you think entrepreneurship

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is innate and what was your first entrepreneurial

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venture? Yeah, I think, look, I think entrepreneurship

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is a is a byproduct of your environment, regardless

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of what your career path or job path has been.

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I mean, I think many of us work jobs and kind

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of at some point reach a point where like, why

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is my job functioning the way it is? Why am I

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struggling in this aspect? Or why is this particular

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procedure failing at 5 %? You know, I think there's

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certain people are like, yeah, I'm happy with

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that. And I'm happy with the status quo. And

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there's nothing wrong with it. I do think perhaps

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there's a subset that says, hey, ask likes to

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ask five more questions and be like, why is it

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inefficient? Why doesn't it work? If you're a

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clinician, why are certain patients getting more

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sick than others? If you're in the food industry,

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why are certain things, why is food more expensive

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here than other places? So I think entrepreneurship

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is really a byproduct of the environment that

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you're in. And I think it forces you to think

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creatively, being like, look, the status quo

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has been like this. But if I... you know, take

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the algorithm and change it upside down, I can

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do something with it. Like take clinicians, right?

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Like we are very trained to follow algorithms.

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Like that's what we have been kind of trained

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to do. We've memorized algorithms, we publish

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algorithms, we read other people's algorithms.

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In fact, when we fall outside of the algorithm

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is when we get slapped on the wrist or get sued

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or, you know, go up in front of a disciplinary

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board. But the entrepreneurship world is actually

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quite the opposite. Like, let's take this algorithm.

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Let's tear it up. Let's understand why the algorithm,

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what's the blind spot in the algorithm. And can

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I insert a medical device, a technology, an algorithm,

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a therapeutic to kind of solve that delta in

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that algorithm? And can I make an impact? Can

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I make money? Can I scale it? Can I improve outcomes?

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So I guess it's not for everyone. but I do think

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many of us fall onto it by serendipity. I wouldn't

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have expected to be in the career that I'm in

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now. It's kind of just a random assemblance of

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steps and ideas that have happened to get me

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here. Talk to me about your first entrepreneurial

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venture. The first one really started out as

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our own kind of family business. I think my dad

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took a similar path in his own life where He

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worked in a particular industry. This happened

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to be banking for many years. And over many years,

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realized, hey, I have good bosses. I have bad

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bosses. I have departments that work really well.

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I have departments that don't work very well.

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And whether it's a pioneering mindset or a bit

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of arrogance, perhaps a bit of both, at one point

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my dad had reached a point like, I can do this

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job better than my boss. And then I can do this

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job better than this bank. So actually his first

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entrepreneurial venture, which became the kind

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of the focus of our family office, was starting

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an Islamic bank, because that was a kind of a

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gap in the market that he identified. He's like,

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okay, there's other banks out there trying to

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develop, you know, banking practices in line

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with sort of Islamic teaching principles. They're

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not doing a good job at it, or they're kind of

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on the ball kind of do it. So that was a learning

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process. Did it go well? In certain ways it did.

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It was kind of, it was the first in Canada. Did

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it go smoothly? By no means it didn't go smoothly.

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But I think, you know, that really changed the

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whole formula for my family and myself kind of

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taking a back seat in it. And I, and I, and I

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too kind of had that kind of exposure saying,

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Hey, I, you know, do a career where I learn the

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foundational principles, be good at that career.

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But then at some point, sooner or later, transition

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to, can I look and contribute in that career

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at the 30 ,000 perspective? Can I build something

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on my own? And that's how I kind of started to

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build my own fund within the family office, trying

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to change status quo, albeit in a very small

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way. I don't want to overinflate what we've tried

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to achieve, but can we do things on our own?

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Can we own a little piece of the pie? for our

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own and I think that that ownership and that

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kind of piece is you know it's it's kind of springboarded

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me into a lot of the other stuff that I do. In

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some ways we're all born entrepreneurs we hear

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about children endlessly asking why and it sounds

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like we educate them out of entrepreneurship

00:14:04.600 --> 00:14:08.100
in some ways. I'd love for you to comment on

00:14:08.100 --> 00:14:11.669
that and then if you can go deeper into the thesis

00:14:11.669 --> 00:14:15.169
of your fund? What are you investing in? What

00:14:15.169 --> 00:14:22.370
stage? Yeah, no, I think, you know, for many

00:14:22.370 --> 00:14:25.049
years, I think standard education really does

00:14:25.049 --> 00:14:28.769
teach you to follow a very predictable path,

00:14:29.330 --> 00:14:33.950
right? High school, go to undergrad, maybe you

00:14:33.950 --> 00:14:36.639
do a master's, you do some advanced degree. Maybe

00:14:36.639 --> 00:14:39.320
you go do an MBA, grad school, PhD, like it's

00:14:39.320 --> 00:14:42.440
a very linear path and job opportunities kind

00:14:42.440 --> 00:14:45.399
of follow that. Like if you want X number of

00:14:45.399 --> 00:14:47.179
dollars, you get an undergrad degree. If you

00:14:47.179 --> 00:14:48.899
want a little bit more and more responsibilities,

00:14:49.120 --> 00:14:51.720
you go to a master's degree. I think that was

00:14:51.720 --> 00:14:55.159
the case maybe 20, 30, 40 years ago. I think

00:14:55.159 --> 00:14:57.440
the job market and expectation is very, very

00:14:57.440 --> 00:15:00.419
different now. And, you know, growing up, maybe

00:15:00.419 --> 00:15:02.500
I asked, you know, those kinds of questions and

00:15:02.500 --> 00:15:04.500
I was told, no, no, don't think too creatively.

00:15:04.990 --> 00:15:07.269
fall in line because that's the predictable piece.

00:15:07.690 --> 00:15:09.370
I think, once again, going back to my upbringing,

00:15:09.649 --> 00:15:11.649
because we were immigrants, because we struggled,

00:15:12.169 --> 00:15:14.590
I think a lot of the kind of emphasis on the

00:15:14.590 --> 00:15:17.509
career path was more driven out of insecurity.

00:15:18.070 --> 00:15:20.269
Like, hey, I want you to have a stable career,

00:15:20.350 --> 00:15:23.409
so pick a stable path. In our culture, it's often

00:15:23.409 --> 00:15:25.570
a doctor, it's a lawyer, it's an engineer, it's

00:15:25.570 --> 00:15:27.909
an accountant. These are predictable, stable

00:15:27.909 --> 00:15:30.730
paths. Doing anything deviating from that is

00:15:30.730 --> 00:15:34.360
kind of seemed as too risky, unpredictable. you

00:15:34.360 --> 00:15:36.639
know, how are you going to, so it's really, you

00:15:36.639 --> 00:15:38.799
know, not for many nefarious intent, but it's,

00:15:38.820 --> 00:15:40.559
it's, I think, a byproduct or the crush that

00:15:40.559 --> 00:15:45.940
you develop from, you know, insecurity of financial

00:15:45.940 --> 00:15:49.100
instability that were kind of taught to, you

00:15:49.100 --> 00:15:51.960
know, don't ask too many questions, put your

00:15:51.960 --> 00:15:54.299
head down, study, get good grades, get good marks,

00:15:54.500 --> 00:15:57.000
and like move on to the next thing. And I think

00:15:57.000 --> 00:15:59.019
it's been a big career shift, even when I did

00:15:59.019 --> 00:16:02.320
it. It's been about six, seven years now. In

00:16:02.320 --> 00:16:04.580
the beginning, a lot of my colleagues who are

00:16:04.580 --> 00:16:07.620
positions or in sort of the life science PhDs,

00:16:07.620 --> 00:16:10.840
they're all like, hey, what's going on? Is everything

00:16:10.840 --> 00:16:15.279
okay at home? Why did you study so hard and kind

00:16:15.279 --> 00:16:17.279
of leave that all aside to do what you're doing

00:16:17.279 --> 00:16:20.919
now? I don't think they understood. Now, I think

00:16:20.919 --> 00:16:24.899
it's much more common for folks to have a couple

00:16:24.899 --> 00:16:26.759
of different career changes in their life. It's

00:16:26.759 --> 00:16:29.450
very rare now that you find people I've worked

00:16:29.450 --> 00:16:36.610
at one job nine to five for 55 years. So it's

00:16:36.610 --> 00:16:40.850
changing. And then going to your second question

00:16:40.850 --> 00:16:44.350
on kind of the portfolio construction. So I split

00:16:44.350 --> 00:16:48.470
my time across a few different funds. One is

00:16:48.470 --> 00:16:51.210
kind of private equity family office. The other

00:16:51.210 --> 00:16:53.970
is kind of an organization called Toronto Innovation

00:16:53.970 --> 00:16:57.710
Acceleration Partners. that works with academic

00:16:57.710 --> 00:17:00.789
institutions and spinning out IP from those institutions.

00:17:01.529 --> 00:17:03.990
And then I advise a few kind of traditional venture

00:17:03.990 --> 00:17:06.069
funds that you're kind of bread and butter ones.

00:17:06.529 --> 00:17:08.289
They're all in sort of the healthcare space that

00:17:08.289 --> 00:17:11.849
is kind of my, I don't know a lot of things,

00:17:11.970 --> 00:17:15.349
but healthcare is one where I think I can at

00:17:15.349 --> 00:17:17.670
least take a crack at it just with my background.

00:17:18.970 --> 00:17:22.420
With all those funds, it's typically, well, I

00:17:22.420 --> 00:17:24.680
run the gamut. I think a good chunk of my time

00:17:24.680 --> 00:17:28.720
is spent on very early stage companies. I would

00:17:28.720 --> 00:17:30.259
say some of them aren't even companies, they're

00:17:30.259 --> 00:17:32.799
ideas. But part of my job, especially at TIAP,

00:17:32.859 --> 00:17:37.319
is to take IP. So forget revenue, forget regulatory

00:17:37.319 --> 00:17:40.000
reimbursements. Someone has a molecule, someone

00:17:40.000 --> 00:17:43.039
has an algorithm, a device, a prototype, and

00:17:43.039 --> 00:17:45.380
they're like, what can I do with this? And it's

00:17:45.380 --> 00:17:49.019
my job to say, okay, does this make sense? would

00:17:49.019 --> 00:17:52.740
a doctor, nurse, physiotherapist use this? Would

00:17:52.740 --> 00:17:56.539
they pay for it? Is this reimbursable? Is this

00:17:56.539 --> 00:17:59.859
going to be regulated? Who's the right CEO to

00:17:59.859 --> 00:18:02.500
bring into the fold? Are investors going to get

00:18:02.500 --> 00:18:04.420
interested in it? So it's really company creation

00:18:04.420 --> 00:18:09.039
from its foundation. It's very challenging. There's

00:18:09.039 --> 00:18:13.019
no formula to it, once again. No company is like

00:18:13.019 --> 00:18:16.660
the next company. It's really kind of the creative

00:18:16.660 --> 00:18:21.029
part to it. So I like that part of it because

00:18:21.029 --> 00:18:24.349
I think building companies gives you an appreciation

00:18:24.349 --> 00:18:26.690
for existing companies, understanding how to

00:18:26.690 --> 00:18:28.890
create companies. I think when you look at well

00:18:28.890 --> 00:18:30.549
-run companies, you can dissect them a little

00:18:30.549 --> 00:18:33.410
bit better and you can say, hey, I know how to

00:18:33.410 --> 00:18:35.490
build companies like you. And these were the

00:18:35.490 --> 00:18:37.990
12 steps I took. Did you take these 12 steps?

00:18:38.069 --> 00:18:40.910
Did you take nine steps? Or did you take 15 steps?

00:18:40.970 --> 00:18:42.890
Did you do three more things I never thought

00:18:42.890 --> 00:18:46.009
you should do? So I like to spend my time in

00:18:46.009 --> 00:18:49.289
like the very early sandbox thing because it's

00:18:49.289 --> 00:18:51.569
intellectually stimulating, it's incredibly difficult,

00:18:51.910 --> 00:18:54.309
but I think it gives you good didactic knowledge

00:18:54.309 --> 00:18:58.089
on how to build companies. And then the rest

00:18:58.089 --> 00:19:00.130
of my time, I'd say 50 % of my time, the remainder

00:19:00.130 --> 00:19:02.789
of 50 is probably spent in sort of your typical

00:19:02.789 --> 00:19:08.910
seed series A kind of things. I think for me,

00:19:09.109 --> 00:19:11.710
When I look at venture funding, I like to spend

00:19:11.710 --> 00:19:15.210
time in companies where I think I can add value

00:19:15.210 --> 00:19:18.470
intellectually. If there's a company that's kind

00:19:18.470 --> 00:19:21.289
of gone public or they've raised 300 million

00:19:21.289 --> 00:19:24.490
bucks, they're much smarter than me. Not that

00:19:24.490 --> 00:19:27.170
I'm very smart, but I feel my value intellectually

00:19:27.170 --> 00:19:29.950
just declines with time. And I'm happy to do

00:19:29.950 --> 00:19:32.769
that. If I'm of no value to a company, I think

00:19:32.769 --> 00:19:36.049
I've done my job because they have much better,

00:19:36.309 --> 00:19:38.359
brighter, smarter... you know, bigger pockets

00:19:38.359 --> 00:19:41.140
of checks to kind of chase after. That's why

00:19:41.140 --> 00:19:42.720
I like the early stage, because, you know, a

00:19:42.720 --> 00:19:44.839
founder is like, Hey, like, should I build this

00:19:44.839 --> 00:19:47.039
for the OR or should it be built for the emergency

00:19:47.039 --> 00:19:50.440
department? And that kind of, you know, objective

00:19:50.440 --> 00:19:53.099
and creative exercises is what really kind of

00:19:53.099 --> 00:19:55.519
simulates me. It raised 300 million bucks. We're

00:19:55.519 --> 00:19:57.240
not in, we're not asking those questions, right?

00:19:57.319 --> 00:20:00.500
We have a fully different set of problems. So,

00:20:00.559 --> 00:20:03.140
um, yeah, so, so that's a long answer to your

00:20:03.140 --> 00:20:05.480
question, but yeah, definitely spend, uh, you

00:20:05.480 --> 00:20:09.839
know, I would say Series A and before is kind

00:20:09.839 --> 00:20:12.940
of my expertise. And really getting a company

00:20:12.940 --> 00:20:16.259
lined up for Series A financing, just getting

00:20:16.259 --> 00:20:18.980
the house in order to make sure that they're

00:20:18.980 --> 00:20:21.579
going to be financing Series A. Because I really

00:20:21.579 --> 00:20:25.539
view Series A as like the real first grown up

00:20:25.539 --> 00:20:28.700
inflection point for a company. It certainly

00:20:28.700 --> 00:20:30.920
isn't the end of the story. But for most companies,

00:20:31.039 --> 00:20:33.240
I think that is like a major fork in the road.

00:20:33.299 --> 00:20:35.579
Can you make it to that point? Because that really

00:20:35.579 --> 00:20:38.900
signals that people are really bought into your

00:20:38.900 --> 00:20:41.819
idea, right? And now we're buying it on mass.

00:20:43.660 --> 00:20:46.339
It sounds like you're investing from pre -C to

00:20:46.339 --> 00:20:51.039
series A. And yeah, the evidence backs your experience

00:20:51.039 --> 00:20:54.039
as well. There's a 12 % chance of success or

00:20:54.039 --> 00:20:57.000
of an IPO post -series A, which is a considerable

00:20:57.000 --> 00:21:03.140
percent. I find diligence in the founding team

00:21:03.140 --> 00:21:06.269
specifically Diligencing how committed they are

00:21:06.269 --> 00:21:08.589
to this idea incredibly difficult at the pre

00:21:08.589 --> 00:21:12.109
-seed stage. Talk to me about some patterns you

00:21:12.109 --> 00:21:14.970
recognize in successful and unsuccessful founders.

00:21:15.509 --> 00:21:18.269
And then what is your framework or what is your

00:21:18.269 --> 00:21:21.430
process in diligencing founders specifically

00:21:21.430 --> 00:21:24.609
at the pre -seed stage? Yeah, no, it's a good

00:21:24.609 --> 00:21:27.470
question. I wouldn't say I've cracked the code

00:21:27.470 --> 00:21:30.509
on it because I have made some good bets and

00:21:30.509 --> 00:21:33.779
I've made some terrible bets and I think frankly,

00:21:33.880 --> 00:21:35.880
at some point it's just a temporal thing. Like

00:21:35.880 --> 00:21:37.660
you're going to see, you're going to see your

00:21:37.660 --> 00:21:39.400
answer over time. Time is going to be the only

00:21:39.400 --> 00:21:40.779
thing that's going to actually tell you what's

00:21:40.779 --> 00:21:43.099
right or wrong. But there are certain things

00:21:43.099 --> 00:21:44.920
that I think, you know, patterns, you know, once

00:21:44.920 --> 00:21:47.480
again, if Rashad, if we wanted to kind of talk

00:21:47.480 --> 00:21:51.380
on that, you know, I think technical expertise

00:21:51.380 --> 00:21:56.000
is the starting point. I don't think technical

00:21:56.000 --> 00:22:00.880
expertise is the, you know, wow, differentiating

00:22:00.880 --> 00:22:03.930
factor and the novelty. Like you are going to

00:22:03.930 --> 00:22:06.869
meet fantastic software developers, engineers,

00:22:07.670 --> 00:22:10.529
physicians, clinicians, you know, thoracic surgeons.

00:22:11.250 --> 00:22:13.210
Technical expertise, I think is what gets you

00:22:13.210 --> 00:22:15.410
in the door. Cause that gives you subject domain

00:22:15.410 --> 00:22:17.769
expertise to say, Hey, I am an expert in this

00:22:17.769 --> 00:22:21.549
space. And I am saying that this is a problem

00:22:21.549 --> 00:22:23.650
and this is a problem that I face. And it's a

00:22:23.650 --> 00:22:26.130
problem big enough that myself or my hospital

00:22:26.130 --> 00:22:27.650
would want to buy it. Therefore I want to build

00:22:27.650 --> 00:22:30.130
a company. So technical expertise is kind of

00:22:30.130 --> 00:22:32.730
just check. Okay, great. you can come to the

00:22:32.730 --> 00:22:35.670
table and have a conversation. So versus many

00:22:35.670 --> 00:22:38.210
founders, I think that's where they begin and

00:22:38.210 --> 00:22:40.130
they stop. They say, because I'm the technical

00:22:40.130 --> 00:22:43.170
expert, this is the beginning and end of the

00:22:43.170 --> 00:22:46.029
story. At my point, I think technical expertise

00:22:46.029 --> 00:22:48.589
is just the beginning. Now what needs to be added

00:22:48.589 --> 00:22:53.109
on top of that, right? I think that's the differentiator

00:22:53.109 --> 00:22:56.650
between okay teams and great teams is when they

00:22:56.650 --> 00:23:00.329
realize where their competency ends and the Delta

00:23:00.329 --> 00:23:03.759
where they need to fill in. So they are really

00:23:03.759 --> 00:23:07.420
good at one particular specialty. Can they understand

00:23:07.420 --> 00:23:09.420
the business? Can they understand regulatory?

00:23:09.880 --> 00:23:13.180
Can they understand reimbursement? Humans, factors,

00:23:13.420 --> 00:23:17.099
engineering, software development. Very rarely

00:23:17.099 --> 00:23:18.960
are you going to meet a person who's going to

00:23:18.960 --> 00:23:22.140
be the sort of da Vinci individual who can kind

00:23:22.140 --> 00:23:24.500
of be the painter, the sculptor, the mathematician,

00:23:24.740 --> 00:23:28.299
the astronomer. Some doctors, we think we are

00:23:28.299 --> 00:23:32.779
because we're God's gift to the world, but it's

00:23:32.779 --> 00:23:35.359
very, very rare that one person has all these

00:23:35.359 --> 00:23:38.380
attributes. So I think it's having the insight

00:23:38.380 --> 00:23:41.019
of your limitations and being candid and honest

00:23:41.019 --> 00:23:43.779
with it. And often for doctors, it's easy to

00:23:43.779 --> 00:23:47.880
pick on. They don't typically make great business

00:23:47.880 --> 00:23:51.779
decisions because why should they? They have

00:23:51.779 --> 00:23:54.460
never really been trained to be good businessmen.

00:23:54.480 --> 00:23:56.950
They've been trained to be good clinicians. I'm

00:23:56.950 --> 00:23:58.930
expecting you to do something that is completely

00:23:58.930 --> 00:24:02.450
contrary to what you innately kind of been trained

00:24:02.450 --> 00:24:05.490
to. So I think it's having insight of where your

00:24:05.490 --> 00:24:08.250
limitations are. And I think most importantly

00:24:08.250 --> 00:24:12.670
is having good emotional intelligence, how to

00:24:12.670 --> 00:24:15.930
regulate yourself in rooms and conversations,

00:24:16.750 --> 00:24:21.289
keeping a temper mannerism when things get heated,

00:24:21.410 --> 00:24:24.809
when things become difficult as they will. And

00:24:24.809 --> 00:24:28.009
I think once again, that EQ, being able to engage

00:24:28.009 --> 00:24:30.910
with how do you interact with a clinician versus

00:24:30.910 --> 00:24:34.490
an investor versus a patient advocacy group that

00:24:34.490 --> 00:24:37.130
you would be dealing with versus a hospital and

00:24:37.130 --> 00:24:39.710
strategic, you cannot be the same person to these

00:24:39.710 --> 00:24:43.549
people. So it's having the EQ to navigate that.

00:24:44.069 --> 00:24:45.829
Because in the beginning, that's all you have.

00:24:46.130 --> 00:24:47.789
I don't know where the product is going to be

00:24:47.789 --> 00:24:50.769
because it's pre -seed. It's really the team

00:24:50.769 --> 00:24:55.190
and their potential ability to adapt to the adversity

00:24:55.190 --> 00:24:57.269
that they're going to face. That is a big chunk

00:24:57.269 --> 00:25:00.509
of the precede diligence. But the technology

00:25:00.509 --> 00:25:03.190
will change, it'll come, it'll fail, you know,

00:25:03.529 --> 00:25:06.849
but, you know, I think that's kind of how I approach

00:25:06.849 --> 00:25:15.710
it. So team is number one. Sorry, Yandhi. Do

00:25:15.710 --> 00:25:18.170
you think you need subject matter expertise?

00:25:18.490 --> 00:25:21.609
to be a founder and a healthcare startup? Or

00:25:21.609 --> 00:25:24.470
is this a field where outsiders can come in and

00:25:24.470 --> 00:25:32.210
that naivety is almost superpower? Yeah, I don't

00:25:32.210 --> 00:25:34.569
think there's, I mean, it might sound like a

00:25:34.569 --> 00:25:36.009
non -committal answer. I don't think there is

00:25:36.009 --> 00:25:40.970
a right answer to this. I do feel at the end

00:25:40.970 --> 00:25:44.069
of the day, you need both on the team. Now, whether

00:25:44.069 --> 00:25:47.190
that's the founder or the advisory board or the

00:25:47.160 --> 00:25:49.980
chief medical officer or the CEO, like, does

00:25:49.980 --> 00:25:52.680
the CEO need to be everything? No, by no means.

00:25:53.220 --> 00:25:57.019
If I had to take a pick for the CEO, would I

00:25:57.019 --> 00:25:59.539
want them technical competence or like more worldly

00:25:59.539 --> 00:26:02.019
knowledge? I would say worldly knowledge. Because

00:26:02.019 --> 00:26:04.960
you can always fill in technical competency specifically.

00:26:05.640 --> 00:26:08.180
But having someone who can fill in that sort

00:26:08.180 --> 00:26:10.779
of 30 ,000 foot perspective, that strategic vision,

00:26:11.319 --> 00:26:14.519
the, you know, aligning stakeholders, it's not

00:26:14.519 --> 00:26:17.740
a competency that's kind of taught as a by -part

00:26:17.740 --> 00:26:20.559
of a certification or degree, you know what I

00:26:20.559 --> 00:26:23.599
mean? Like that's not a, you know, but if you're

00:26:23.599 --> 00:26:25.619
a thoracic, if I need a thoracic surgeon, well,

00:26:25.619 --> 00:26:27.920
who's done residency and fellowship in that space,

00:26:27.920 --> 00:26:30.339
they should be good enough to give you an answer

00:26:30.339 --> 00:26:32.500
in that space, right? Like I know exactly where

00:26:32.500 --> 00:26:40.500
to go to. But, you know, I do think, I do think

00:26:40.500 --> 00:26:43.859
we kind of, in healthcare, we do have a bit of

00:26:43.859 --> 00:26:47.390
a clique mentality where we will value the opinion

00:26:47.390 --> 00:26:49.170
of another clinician. If you're talking doctor

00:26:49.170 --> 00:26:51.430
to doctor, it really is going to be like, okay,

00:26:51.890 --> 00:26:54.069
you're a colleague, you've kind of been in the

00:26:54.069 --> 00:26:56.329
trenches with me, I'm going to value your opinion

00:26:56.329 --> 00:26:58.930
more over maybe someone who doesn't understand

00:26:58.930 --> 00:27:00.930
healthcare, comes in with a naive perspective

00:27:00.930 --> 00:27:04.630
and is very bright -eyed and doe -eyed and going

00:27:04.630 --> 00:27:06.710
to change the world but doesn't understand the

00:27:06.710 --> 00:27:08.990
realities. So you need a bit of both because

00:27:08.990 --> 00:27:12.309
I think we can also, clinicians can get stagnated

00:27:12.309 --> 00:27:16.700
in our ways. And we need that gentle nudge. We

00:27:16.700 --> 00:27:19.660
need the gentle nudge from folks from other industries

00:27:19.660 --> 00:27:24.279
to be like, hey, let's incorporate AI. Let's

00:27:24.279 --> 00:27:26.599
not be too scared of it. In banking, we're doing

00:27:26.599 --> 00:27:28.779
it. In defense, we're doing it. In insurance,

00:27:28.779 --> 00:27:31.500
we're doing it. Other risk adverse industries,

00:27:31.880 --> 00:27:34.359
we're much further ahead in incorporating AI.

00:27:34.759 --> 00:27:37.960
Why can't you do this in health care? What is

00:27:37.960 --> 00:27:40.140
so inherently difficult and different? It's a

00:27:40.140 --> 00:27:42.869
different problem, but incorporate it. Yeah,

00:27:42.869 --> 00:27:46.170
you need both, I think. I don't think it's one

00:27:46.170 --> 00:27:52.650
or the other. If you had to pick between a founder

00:27:52.650 --> 00:27:55.970
who is exceptionally charming, but with average

00:27:55.970 --> 00:27:59.349
aptitude, versus a founder who has exceptional

00:27:59.349 --> 00:28:03.170
aptitude, 12 .1 % in their field, but average

00:28:03.170 --> 00:28:06.490
charm, who would you pick? Yeah, I would pick

00:28:06.490 --> 00:28:12.259
the charm piece. And I would say because at least

00:28:12.259 --> 00:28:16.420
in my opinion. I think aptitude is something

00:28:16.420 --> 00:28:19.299
that can be learned over time. I think charm

00:28:19.299 --> 00:28:22.859
is perhaps more innate. You know, some people

00:28:22.859 --> 00:28:26.539
have it or you don't. I think charm is much more

00:28:26.539 --> 00:28:30.559
difficult to coach into someone. And once again,

00:28:30.740 --> 00:28:34.200
technical aptitude, I hate to say it, but technical

00:28:34.200 --> 00:28:37.720
aptitude can be outsourced. If I have a specific

00:28:37.720 --> 00:28:40.519
problem, I need to build a medical device that

00:28:40.519 --> 00:28:43.559
has such and such dimensions, I can hire technical

00:28:43.559 --> 00:28:46.920
aptitude. If I need a neurosurgeon who also has

00:28:46.920 --> 00:28:49.660
a histopathology background, I can find that

00:28:49.660 --> 00:28:54.559
someone. But charm, and really charm, I think,

00:28:54.619 --> 00:28:56.220
I mean, when I think of charm, I really think

00:28:56.220 --> 00:29:00.119
once again of EQ is not just about being nice,

00:29:00.180 --> 00:29:03.880
but someone who can rally different stakeholders.

00:29:04.559 --> 00:29:06.440
Understand the needs of different stakeholders.

00:29:06.900 --> 00:29:09.220
Be empathetic, right? Understand what does the

00:29:09.220 --> 00:29:11.559
scientific founding team mean? What does the

00:29:11.559 --> 00:29:14.599
hospital need? What does a large med device strategic

00:29:14.599 --> 00:29:17.599
need? And being able to kind of connect those

00:29:17.599 --> 00:29:21.160
bridges. That's the charming piece. That's the

00:29:21.160 --> 00:29:22.960
creative part where there is no formula. There

00:29:22.960 --> 00:29:25.880
is no formal degree to do that. Now you can learn

00:29:25.880 --> 00:29:28.059
that over time. And I think people do because

00:29:28.059 --> 00:29:30.259
they've had two or three startups. They've failed

00:29:30.259 --> 00:29:33.349
a few times. They've struggled a bit. you can

00:29:33.349 --> 00:29:36.569
perhaps, maybe it's not innate, but you can get

00:29:36.569 --> 00:29:39.250
better at it. But definitely I think charm is

00:29:39.250 --> 00:29:42.690
what it is. Because ultimately it is your relationship.

00:29:42.869 --> 00:29:45.970
It is your personality that is going to kind

00:29:45.970 --> 00:29:51.150
of carry you through the tough times. And with

00:29:51.150 --> 00:29:53.009
that charm, you can hire the right people with

00:29:53.009 --> 00:29:56.150
the technical aptitude to compensate for your

00:29:56.150 --> 00:29:59.170
inherent flaws or limitations. But you can't

00:29:59.170 --> 00:30:02.920
hire charm. I don't think so. This is something

00:30:02.920 --> 00:30:07.460
I've changed my mind on, and I hesitate, but

00:30:07.460 --> 00:30:11.900
I agree. Charm is more important than aptitude.

00:30:13.339 --> 00:30:19.259
And we want to think that charm has no influence

00:30:19.259 --> 00:30:21.480
on your success, but I think that couldn't be

00:30:21.480 --> 00:30:25.160
further from the truth. If you could go back

00:30:25.160 --> 00:30:27.819
in time 10 years and talk to your 25 -year -old

00:30:27.819 --> 00:30:31.269
self. What would you say to him? And would you

00:30:31.269 --> 00:30:33.490
change anything you've done in the past 10 years

00:30:33.490 --> 00:30:36.990
if you could change one decision without it affecting

00:30:36.990 --> 00:30:41.410
other decisions? Yeah, that's a tough question.

00:30:42.809 --> 00:30:49.269
I think I would tell myself to, once again, push

00:30:49.269 --> 00:30:52.710
the boundary a little bit more. I, too, kind

00:30:52.710 --> 00:30:55.990
of fell into the pattern of just sequentially

00:30:56.779 --> 00:31:00.920
focus on the standard, the status quo, focus,

00:31:01.160 --> 00:31:03.579
get the degree, do as well in degree as possible.

00:31:04.039 --> 00:31:06.220
I didn't think creatively. I had no concept of

00:31:06.220 --> 00:31:08.680
thinking creatively, to be honest. It was just

00:31:08.680 --> 00:31:13.180
very singularly focused. While I enjoyed that

00:31:13.180 --> 00:31:16.579
time, I do think everyone needs some baseline

00:31:16.579 --> 00:31:19.799
technical competency in whatever field of thing

00:31:19.799 --> 00:31:22.680
that you're doing. I don't think no education

00:31:22.680 --> 00:31:26.900
is the answer to the world's problems. some foundational

00:31:26.900 --> 00:31:30.140
education and whatever it may be, I think you

00:31:30.140 --> 00:31:33.019
need some grounding. But I think pushing the

00:31:33.019 --> 00:31:36.180
limits, I do it now more often because I think

00:31:36.180 --> 00:31:39.680
my career and space is more forgiving and allows

00:31:39.680 --> 00:31:43.980
me to do that. But before really didn't, it was

00:31:43.980 --> 00:31:46.700
just very linearly focused and could it have

00:31:46.700 --> 00:31:49.779
changed the outcome? Could I have been better

00:31:49.779 --> 00:31:53.839
or more successful or more impactful in my career

00:31:53.839 --> 00:31:57.299
by now? probably, maybe, or maybe it was just

00:31:57.299 --> 00:31:59.380
a function of time. I don't know, I don't have

00:31:59.380 --> 00:32:03.920
that crystal ball, but I think certainly the

00:32:03.920 --> 00:32:06.740
career that I have now took a while for me to

00:32:06.740 --> 00:32:09.500
get comfortable in, even just speaking to people.

00:32:10.059 --> 00:32:12.259
As clinicians, yeah, we speak to doctors, we

00:32:12.259 --> 00:32:15.359
speak to patients, but going into a boardroom

00:32:15.359 --> 00:32:18.559
with people, interrogating you, criticizing you,

00:32:19.039 --> 00:32:22.259
getting up there, making that pitch speech, dealing

00:32:22.259 --> 00:32:26.029
with confrontation. happens a lot in the business

00:32:26.029 --> 00:32:29.609
world. In the beginning would really stress me

00:32:29.609 --> 00:32:32.289
out, would really cause a lot of angst and anxiety.

00:32:32.869 --> 00:32:36.430
Now I think I, I don't think I'm perfect, but

00:32:36.430 --> 00:32:38.529
you know, it doesn't, it doesn't bother me anymore.

00:32:38.529 --> 00:32:40.109
Cause I know it's kind of part of the course.

00:32:40.269 --> 00:32:43.609
It's like, I face it like any other problem that

00:32:43.609 --> 00:32:47.230
kind of comes towards me. So, so yeah, I think

00:32:47.230 --> 00:32:49.849
if I had done it earlier, I would be better than

00:32:49.849 --> 00:32:52.069
I am today. And ultimately you just want to be

00:32:52.069 --> 00:32:54.700
better. continuously striving to be better in

00:32:54.700 --> 00:32:58.319
your career, right? So more time in practice

00:32:58.319 --> 00:33:03.180
would have made me better than I am today. One

00:33:03.180 --> 00:33:05.819
of the biggest learnings I have from my startup

00:33:05.819 --> 00:33:09.519
is to have a structured, slow process for hiring

00:33:09.519 --> 00:33:13.700
and a fast process for firing. Do you agree with

00:33:13.700 --> 00:33:15.799
that? And does that resonate with your experience?

00:33:18.859 --> 00:33:23.869
It goes both ways, right? I think hiring is a,

00:33:25.869 --> 00:33:27.930
like in this whole business, I think the hardest

00:33:27.930 --> 00:33:31.269
part is the people. The technology, the algorithms,

00:33:31.630 --> 00:33:34.789
the pipettes into the receptors and molecule,

00:33:35.230 --> 00:33:37.309
that stuff is hard, but it's not as hard as the

00:33:37.309 --> 00:33:40.849
people. People are infinitely more complex. Figuring

00:33:40.849 --> 00:33:43.390
out a team that jives with each other, that works

00:33:43.390 --> 00:33:46.250
together, that supports each other, chemistry

00:33:46.250 --> 00:33:48.730
is aligning just from an interpersonal piece,

00:33:49.009 --> 00:33:53.019
that's really important. and one or two toxic

00:33:53.019 --> 00:33:55.779
kind of relationships, one or two toxic interactions

00:33:55.779 --> 00:33:59.420
really do derail, you know, a company. Or not

00:33:59.420 --> 00:34:01.460
even derail, it just doesn't, you know, we don't

00:34:01.460 --> 00:34:04.900
progress to the level that the organization can.

00:34:05.900 --> 00:34:08.460
Having said that, you know, I do think there

00:34:08.460 --> 00:34:10.219
is merit, sure, but if you know, if you don't

00:34:10.219 --> 00:34:13.159
fit, let's fire you quickly. That's the easiest

00:34:13.159 --> 00:34:15.739
solution. Having said that, you know, we're all

00:34:15.739 --> 00:34:18.550
kind of learning. We're all in that process.

00:34:18.710 --> 00:34:21.090
I'm sure if I went to another organization, people

00:34:21.090 --> 00:34:23.469
are like, hey, this guy doesn't know 10 of these

00:34:23.469 --> 00:34:26.329
things. He's not useful in this world. Let's

00:34:26.329 --> 00:34:31.349
get rid of him. He's not effective. But I've

00:34:31.349 --> 00:34:33.329
been given many chances over my life. I've been

00:34:33.329 --> 00:34:35.630
given many opportunities. And I've had patient

00:34:35.630 --> 00:34:39.530
people put up with my mistakes or inadequacies.

00:34:39.929 --> 00:34:41.949
If no one gave me a chance, I'd be unemployed

00:34:41.949 --> 00:34:45.269
many years after. So I do think there's a balance

00:34:45.269 --> 00:34:50.119
of, OK, Like the limitations that that person

00:34:50.119 --> 00:34:53.019
has, is that a fundamental flaw to their character

00:34:53.019 --> 00:34:56.460
or their EQ or they lack charm? Or is this something

00:34:56.460 --> 00:34:58.719
that is solvable? Is this a solvable problem?

00:34:59.239 --> 00:35:03.039
So if there's, once again, aptitude or competencies

00:35:03.039 --> 00:35:05.000
that they don't know today, let's say they don't

00:35:05.000 --> 00:35:07.300
know Excel today. Let's say they don't know how

00:35:07.300 --> 00:35:11.460
to use chat GPT today. Is this something that

00:35:11.460 --> 00:35:14.280
they can be taught over time? Yes or no. If you

00:35:14.280 --> 00:35:16.880
can teach it. fine, are you willing to invest

00:35:16.880 --> 00:35:19.579
in that person over three months, five months,

00:35:19.659 --> 00:35:23.679
six months a year? But they're still on the ball.

00:35:23.800 --> 00:35:26.559
They still show up. They're still working hard

00:35:26.559 --> 00:35:29.880
all day long. So I think there is a balance.

00:35:30.179 --> 00:35:33.659
I think, yes, getting rid of folks that don't

00:35:33.659 --> 00:35:38.739
fit the culture or the chemistry, I think that

00:35:38.739 --> 00:35:41.710
is unteachable. I think we're, you know, if you're

00:35:41.710 --> 00:35:43.429
just, if you don't work, nothing that varies.

00:35:43.750 --> 00:35:45.469
If you just don't work together, you don't work

00:35:45.469 --> 00:35:48.969
together. But I think competencies can be, you

00:35:48.969 --> 00:35:52.090
know, alleviated and kind of ironed out over

00:35:52.090 --> 00:35:55.429
time. So we do have to make an investment in

00:35:55.429 --> 00:35:58.590
people, right? You're not going to get fully

00:35:58.590 --> 00:36:02.170
baked, you know, individuals at a time. But,

00:36:02.170 --> 00:36:04.389
but yeah, I think there is a cultural difference,

00:36:04.389 --> 00:36:07.230
I think, in America and the US, I think, sorry,

00:36:07.769 --> 00:36:13.550
Canada and the US. I think Americans are, they

00:36:13.550 --> 00:36:16.329
fail fast and even employment is kind of like

00:36:16.329 --> 00:36:19.010
that too. And in Canada, we know maybe we're

00:36:19.010 --> 00:36:21.409
a little bit too nice and hold on to folks that

00:36:21.409 --> 00:36:24.090
maybe aren't the right fit. So, which can be,

00:36:24.090 --> 00:36:27.269
you know, stifling innovation too. So, it goes

00:36:27.269 --> 00:36:32.550
both ways. Yeah, scaling a service -based business,

00:36:32.789 --> 00:36:36.389
a people -based business is exponentially harder

00:36:36.389 --> 00:36:40.010
than scaling software, which is why I find VCs

00:36:40.010 --> 00:36:44.690
and investors and both me and you, we tend to

00:36:44.690 --> 00:36:46.610
deviate more towards the software businesses.

00:36:48.369 --> 00:36:52.250
Talk to me about your contrarian opinion in healthcare

00:36:52.250 --> 00:36:56.449
investing. Mine is that I think AI should replace

00:36:56.449 --> 00:36:59.170
physicians, and I speak to saying that as a physician

00:36:59.170 --> 00:37:01.809
myself. The goal of healthcare should be to provide

00:37:01.809 --> 00:37:05.170
excellent quality healthcare everywhere. The

00:37:05.170 --> 00:37:07.829
Harvard Mayo Clinic healthcare should be ubiquitous

00:37:07.829 --> 00:37:12.199
and cheaply accessible. You cannot do that if

00:37:12.199 --> 00:37:14.400
humans are involved, especially humans who need

00:37:14.400 --> 00:37:17.179
10 years of schooling and $300 ,000 in their

00:37:17.179 --> 00:37:20.159
education. The only way to do that is a software

00:37:20.159 --> 00:37:24.019
and AI which completely replaces us. So that's

00:37:24.019 --> 00:37:27.559
my contrarian opinion and I am working to make

00:37:27.559 --> 00:37:31.440
that happen. It makes my colleagues upset at

00:37:31.440 --> 00:37:33.920
times. What is your contrarian opinion in healthcare?

00:37:35.219 --> 00:37:37.500
Yeah, no, it's an interesting opinion. And you

00:37:37.500 --> 00:37:41.599
know, in your opinion, I think like, I don't

00:37:41.599 --> 00:37:44.199
think, I don't feel we'll get replaced. But I

00:37:44.199 --> 00:37:46.300
do think the nature of our job will significantly

00:37:46.300 --> 00:37:49.099
change. And I think what's expected of us will

00:37:49.099 --> 00:37:52.699
significantly change, as it does every year in

00:37:52.699 --> 00:37:54.860
medical school training. I mean, you know, even

00:37:54.860 --> 00:37:57.820
med school training. I know schools that are

00:37:57.820 --> 00:38:00.139
beginning to teach financial literacy, they're

00:38:00.139 --> 00:38:02.800
beginning to teach software development, because

00:38:02.800 --> 00:38:05.010
it's almost becoming an expectation like, 10,

00:38:05.010 --> 00:38:08.210
15 years ago, teaching research methods in medical

00:38:08.210 --> 00:38:11.849
school was like a groundbreaking idea. Now the

00:38:11.849 --> 00:38:13.989
expectation of physicians to also be researchers

00:38:13.989 --> 00:38:16.909
is kind of like, you should be. You should be

00:38:16.909 --> 00:38:19.510
contributing. You should be a deliverer of medicine

00:38:19.510 --> 00:38:20.969
and you should be the one doing the research

00:38:20.969 --> 00:38:29.449
too. So it's different. So I think my view, ironically,

00:38:30.590 --> 00:38:34.519
I don't like technology. that's too innovative.

00:38:35.039 --> 00:38:38.039
I don't like to invest in technology that is

00:38:38.039 --> 00:38:41.599
breaking the sand barrier. And maybe that's my

00:38:41.599 --> 00:38:43.980
conservative approach. But when I come back to

00:38:43.980 --> 00:38:48.239
making business decisions, making recurrent returns

00:38:48.239 --> 00:38:52.599
in a fund, I in fact don't want to invest. Ironically,

00:38:52.639 --> 00:38:54.980
even though I invest in innovation, I don't like

00:38:54.980 --> 00:38:57.659
innovative ideas that are too innovative. Because

00:38:57.659 --> 00:39:00.280
I know innovative ideas are going to take longer.

00:39:00.880 --> 00:39:02.300
They're going to be the ones that have to fight

00:39:02.489 --> 00:39:05.369
and create the codes with reimbursement for the

00:39:05.369 --> 00:39:07.849
first time. They'll be the ones having to negotiate

00:39:07.849 --> 00:39:11.170
with the FDA and justifying the whole class of

00:39:11.170 --> 00:39:14.590
their technology. And yeah, it does make for

00:39:14.590 --> 00:39:17.150
good headlines. Maybe you can get a little blurb

00:39:17.150 --> 00:39:19.750
in time. Maybe you can get a little blurb on

00:39:19.750 --> 00:39:23.610
BetaKit about this new tool that is revolutionizing

00:39:23.610 --> 00:39:27.030
health care. And we do need some of those kind

00:39:27.030 --> 00:39:29.750
of ideas. People often take Elon, whether you

00:39:29.750 --> 00:39:32.440
like him or not, but he's got some crazy ideas,

00:39:32.440 --> 00:39:34.760
but some of them are really interesting ideas.

00:39:35.320 --> 00:39:37.360
Now are they all going to work? No, many of them

00:39:37.360 --> 00:39:39.639
are going to fail. But some of them, yeah, like,

00:39:39.679 --> 00:39:42.840
I mean, I think he has, you know, commoditized

00:39:42.840 --> 00:39:45.059
electric cars in the last 10, 15 years. I think

00:39:45.059 --> 00:39:47.780
the concept of plugging a car in 20 years ago

00:39:47.780 --> 00:39:51.400
was just, you know, something you'd see on TV,

00:39:51.400 --> 00:39:54.719
but now, you know, it's growing slowly. So if

00:39:54.719 --> 00:39:57.460
I take it to healthcare, I rather invest in companies

00:39:57.460 --> 00:40:00.059
that are solving important issues. It has to

00:40:00.059 --> 00:40:02.960
be an important issue. But it might not be the

00:40:02.960 --> 00:40:05.360
one where it's transplanting a brain from one

00:40:05.360 --> 00:40:08.219
person to the next, you know, doing, you know,

00:40:08.380 --> 00:40:11.679
things in space. I like things that are boring,

00:40:12.260 --> 00:40:15.539
unsexy problems, because day to day life is,

00:40:15.539 --> 00:40:17.980
you know, repetitive, it can be mundane. But

00:40:17.980 --> 00:40:20.360
these are the problems you face every day, right?

00:40:20.599 --> 00:40:23.340
Like, you know, how do I schedule, you know,

00:40:23.480 --> 00:40:26.159
shifts in the OR effectively? How do I make sure

00:40:26.159 --> 00:40:30.219
that the the x -ray at one hospital can be efficiently

00:40:30.219 --> 00:40:32.619
transferred over to the other hospital? How do

00:40:32.619 --> 00:40:34.639
I make sure that I don't have a data breach?

00:40:35.039 --> 00:40:39.760
How do I make sure that if I have to sterilize

00:40:39.760 --> 00:40:43.420
a surgical tool, how do I do that in a cost -effective

00:40:43.420 --> 00:40:46.460
way? I'm not spending too much time. Many of

00:40:46.460 --> 00:40:48.219
these things aren't going to make headlines,

00:40:48.940 --> 00:40:51.119
but these are day -to -day problems if you're

00:40:51.119 --> 00:40:53.300
living in the clinical world that you're facing.

00:40:53.860 --> 00:40:56.719
and if someone solves it for you, yeah, it's

00:40:56.719 --> 00:40:59.800
a small piece, but it saved you $10 here, it

00:40:59.800 --> 00:41:02.719
saved infection rates, it saved potential morbidity

00:41:02.719 --> 00:41:07.519
or mortality in a patient. And sort of in the

00:41:07.519 --> 00:41:11.320
venture fund land, I can quantify the value proposition

00:41:11.320 --> 00:41:15.059
of something boring and mundane and predictable,

00:41:15.059 --> 00:41:18.900
because I know what that means. If I'm kind of

00:41:18.900 --> 00:41:21.699
trying to be like Elon and really changing the

00:41:21.699 --> 00:41:23.869
face of the earth, And maybe I'm not ambitious

00:41:23.869 --> 00:41:26.869
enough, and maybe there's other people out there

00:41:26.869 --> 00:41:29.489
who can better tackle. You need the Elans, but

00:41:29.489 --> 00:41:31.909
you need the boring folks like Zohaib to kind

00:41:31.909 --> 00:41:34.690
of tackle the recurrent problems. Because as

00:41:34.690 --> 00:41:37.750
a fund, I know that, hey, if I get a two or three

00:41:37.750 --> 00:41:41.250
or four X return on five boring problems, I'd

00:41:41.250 --> 00:41:45.230
rather have five or six decent returns on five

00:41:45.230 --> 00:41:48.269
boring problems than one fantastic return on

00:41:48.269 --> 00:41:52.039
the next thing launching to Mars. Um, and that

00:41:52.039 --> 00:41:54.239
kind of leads into portfolio composition as well,

00:41:54.400 --> 00:41:57.059
right? You know, do you want to have a portfolio

00:41:57.059 --> 00:42:00.360
that's comprised of 10 potential unicorns or

00:42:00.360 --> 00:42:02.460
do you want to say to your LPs like, you know,

00:42:02.619 --> 00:42:05.300
75 % of the time I'm going to return you two

00:42:05.300 --> 00:42:08.039
or three X on, on your money. Or do you want

00:42:08.039 --> 00:42:10.199
to say, Hey, one in 20 of my bets is going to

00:42:10.199 --> 00:42:14.320
give you a 20 X or a hundred X. Um, that's the,

00:42:14.320 --> 00:42:16.699
that's the portfolio composition angle you have

00:42:16.699 --> 00:42:20.530
to kind of, you know, way out. And you'll attract

00:42:20.530 --> 00:42:22.889
different investors, right? Venture investing

00:42:22.889 --> 00:42:27.929
is typically a risky asset class. I think people

00:42:27.929 --> 00:42:33.429
treat it as such. But I do think there's a way

00:42:33.429 --> 00:42:36.750
to improve incrementally your returns across.

00:42:36.969 --> 00:42:38.949
And I think in a portfolio, if you've got 20

00:42:38.949 --> 00:42:42.429
companies, maybe 10 % can be ultra for risky.

00:42:43.099 --> 00:42:45.619
And, you know, other things are a little bit

00:42:45.619 --> 00:42:47.840
more stable, more predictable. Some are early

00:42:47.840 --> 00:42:50.679
stage bets, some are later stage bets. So, you

00:42:50.679 --> 00:42:53.400
know, I kind of think it ties back into my kind

00:42:53.400 --> 00:42:55.780
of portfolio composition angle as well, right?

00:42:55.820 --> 00:42:59.820
You know, I like safer bets. And I do think you

00:42:59.820 --> 00:43:02.079
need technical, once again, technical expertise

00:43:02.079 --> 00:43:08.500
to be able to vet, you know, some of the unsexy

00:43:08.500 --> 00:43:11.519
kind of ideas. You need deep market expertise

00:43:11.519 --> 00:43:14.590
to know. you know, what's the price point people

00:43:14.590 --> 00:43:19.289
are willing to pay for a simple tool? Are nurses

00:43:19.289 --> 00:43:21.010
going to, you know, use this at the end of the

00:43:21.010 --> 00:43:25.269
day? Are they going to like use it? We've talked

00:43:25.269 --> 00:43:28.449
about patterns in founders. What are some patterns

00:43:28.449 --> 00:43:30.869
you've seen in successful and unsuccessful fund

00:43:30.869 --> 00:43:35.949
managers or VCs over your time? Yeah, I think,

00:43:36.070 --> 00:43:40.829
you know, it's and I would break it down in two

00:43:40.829 --> 00:43:44.650
ways. One is their investing mindset. And I would

00:43:44.650 --> 00:43:46.489
bring like that's one topic. And then the other

00:43:46.489 --> 00:43:49.469
topic would be kind of their fundraising perspective

00:43:49.469 --> 00:43:52.309
as well, how they feel about fundraising is like

00:43:52.309 --> 00:43:54.150
the startups, the fund managers also have to

00:43:54.150 --> 00:43:56.429
fundraise, right? So, you know, I think there's

00:43:56.429 --> 00:43:59.429
a degree of empathy that the funds kind of established

00:43:59.429 --> 00:44:01.130
because they also go through a fundraising piece.

00:44:01.750 --> 00:44:04.010
I think in terms of investing too, I think, you

00:44:04.010 --> 00:44:08.289
know, I think if you don't have the subject matter

00:44:08.289 --> 00:44:12.940
expertise, it's very easy to chase the new shiny,

00:44:13.679 --> 00:44:19.300
glamorous thing. I think sometimes venture funds,

00:44:21.340 --> 00:44:24.000
once again, going after the thing that Elon Musk

00:44:24.000 --> 00:44:26.579
is investing in. I'm not against Elon Musk and

00:44:26.579 --> 00:44:28.800
his investment thesis by no means. I keep picking

00:44:28.800 --> 00:44:31.340
on him. But I think going after the new shiny

00:44:31.340 --> 00:44:34.199
thing and where healthcare is going to go, healthcare

00:44:34.199 --> 00:44:36.219
doesn't move in that rate. Healthcare is a very

00:44:36.219 --> 00:44:40.519
slow moving gradual piece. It doesn't like to

00:44:40.519 --> 00:44:43.260
change. If you push the boundaries too much,

00:44:43.699 --> 00:44:46.300
you're not going to see the returns in the timeline

00:44:46.300 --> 00:44:49.420
that's going to be conducive to your fund. If

00:44:49.420 --> 00:44:51.619
you've got a 10 -year lifecycle, if you're pushing

00:44:51.619 --> 00:44:53.460
the envelope, if you're breaking the sound barrier,

00:44:53.760 --> 00:44:56.579
you're not going to see that thing built, scaled,

00:44:56.780 --> 00:44:59.739
and returned to you within 10 years. And that's

00:44:59.739 --> 00:45:02.659
going to affect your ultimate returns. So I think

00:45:02.659 --> 00:45:05.219
that's why you got to go, once again, for fund

00:45:05.219 --> 00:45:09.400
managers, figure out and I'm biased because I

00:45:09.400 --> 00:45:12.599
think this way I could be wrong, figure out the

00:45:12.599 --> 00:45:15.860
boring but problem, nagging problems, boring

00:45:15.860 --> 00:45:18.980
nagging problems that healthcare has that A,

00:45:19.059 --> 00:45:22.800
they feel it and B, they have a budget to support.

00:45:23.320 --> 00:45:25.539
Many times you and I see technologies that are

00:45:25.539 --> 00:45:29.019
really, really cool, but do the hospitals have

00:45:29.019 --> 00:45:32.199
the budget and the support to actually support

00:45:32.199 --> 00:45:34.480
that kind of technology? Because otherwise you're

00:45:34.480 --> 00:45:36.260
going uphill, right? Yeah, it can be a great

00:45:36.260 --> 00:45:40.599
technology. Yes, I can use my smartphone to detect

00:45:40.599 --> 00:45:44.780
cancer, detect murmurs, detect signs of depression,

00:45:45.179 --> 00:45:47.800
but is there going to be reimbursement and payment

00:45:47.800 --> 00:45:50.539
for it? I think that's the tricky part. I think

00:45:50.539 --> 00:45:52.840
the other piece that I think venture funds get

00:45:52.840 --> 00:45:57.239
too caught up on, and partly because it's kind

00:45:57.239 --> 00:46:01.469
of market size on certain products. I've seen

00:46:01.469 --> 00:46:03.590
so many times where companies have overlooked

00:46:03.590 --> 00:46:06.230
because they don't see the billion dollar market

00:46:06.230 --> 00:46:10.530
of that problem. I view that as a very myopic

00:46:10.530 --> 00:46:14.230
way of thinking. You know, no company or very

00:46:14.230 --> 00:46:16.530
few companies reach that billion dollar market

00:46:16.530 --> 00:46:18.710
capture. You know, you don't. I mean, most companies

00:46:18.710 --> 00:46:21.190
are sold at, you know, if you go well, you get

00:46:21.190 --> 00:46:24.110
100, 200, $300 million exit. Very few companies

00:46:24.110 --> 00:46:26.349
are going to go up to the billion dollar size.

00:46:28.360 --> 00:46:30.800
you know, and I know when you're evaluating companies,

00:46:30.800 --> 00:46:32.820
you want to have a standard process to evaluate

00:46:32.820 --> 00:46:34.260
it. You want to make sure there's enough meat

00:46:34.260 --> 00:46:38.380
on the bone, but insisting, you know, that the

00:46:38.380 --> 00:46:40.159
company has got to hit a billion dollar market

00:46:40.159 --> 00:46:42.159
size, I think is like, what's the difference

00:46:42.159 --> 00:46:44.880
between a $2 billion market size and $100 billion

00:46:44.880 --> 00:46:47.920
market size? Like, really, like, I see pitch

00:46:47.920 --> 00:46:51.079
decks proposing such astronomical figures on

00:46:51.079 --> 00:46:54.059
their little widget and gap. And they have like

00:46:54.059 --> 00:46:56.179
$2 ,000 a month, they recurring revenue, and

00:46:56.179 --> 00:46:58.139
they're pitching a pipe dream of like, a trillion

00:46:58.139 --> 00:47:02.119
dollars. Let's get down to basics. Let's do some

00:47:02.119 --> 00:47:05.059
bottom -up calculations. How many hospitals do

00:47:05.059 --> 00:47:07.719
you have? How many hospitals can you tangibly

00:47:07.719 --> 00:47:10.599
get in the next six to 12 months? How much money

00:47:10.599 --> 00:47:11.860
are you going to get from each hospital? Is it

00:47:11.860 --> 00:47:13.780
going to be $1 ,000? Is it going to be $100 ,000?

00:47:13.780 --> 00:47:16.380
Is it going to be $100 million? And how many

00:47:16.380 --> 00:47:19.079
users are you going to be able to get? And let's

00:47:19.079 --> 00:47:22.460
work with that. And what can you do meaningfully

00:47:22.460 --> 00:47:25.559
with three to five years and maybe a couple million

00:47:25.559 --> 00:47:28.119
dollars of capital? And is that, you know, with

00:47:28.119 --> 00:47:30.820
that, you've done a bit of a study, a pilot,

00:47:30.980 --> 00:47:33.940
if you could do that, and what can you return?

00:47:34.800 --> 00:47:38.219
So that's the, I think, myopic thinking and funding.

00:47:41.199 --> 00:47:44.440
They're, they're pushed to get returns. And then

00:47:44.440 --> 00:47:46.440
they're also getting pushing themselves to find

00:47:46.440 --> 00:47:49.179
the new shiny thing in hopes that LPs are going

00:47:49.179 --> 00:47:51.579
to gravitate like, oh, we've got the coolest

00:47:51.579 --> 00:47:53.920
deal. Well, we got into this very interesting

00:47:53.920 --> 00:47:56.920
deal. Returns are the only thing that matter.

00:47:58.699 --> 00:48:01.139
Yeah. How much money will you give me and how

00:48:01.139 --> 00:48:03.320
much money will I return? Everything else is

00:48:03.320 --> 00:48:06.679
noise and signals, either positive or negative.

00:48:07.039 --> 00:48:09.639
It's not a red flag, but it's almost a yellow

00:48:09.639 --> 00:48:12.500
flag when a founder tells me if I get 10 % of

00:48:12.500 --> 00:48:14.519
this market, this is how big my company will

00:48:14.519 --> 00:48:16.860
be. And I think this is one piece of advice to

00:48:16.860 --> 00:48:19.880
founders. Do a bottoms up approach. Do not do

00:48:19.880 --> 00:48:24.489
a top down approach for market sizing. You're

00:48:24.489 --> 00:48:26.170
almost setting yourself up for failure because

00:48:26.170 --> 00:48:30.590
I have basically never seen a company hit their

00:48:30.590 --> 00:48:35.250
target forecast. It just never happens. So investors

00:48:35.250 --> 00:48:38.230
on this side, I think we become jaded. When you

00:48:38.230 --> 00:48:41.190
say that, I think it actually lowers your credibility

00:48:41.190 --> 00:48:43.349
or lowers your competency, even though you're

00:48:43.349 --> 00:48:48.070
very competent. Give me that bottoms up calculation.

00:48:48.809 --> 00:48:50.989
And that's something I can actually hold you

00:48:50.989 --> 00:48:53.710
to. and I can help you assist and say, hey, I've

00:48:53.710 --> 00:48:56.090
got five hospitals, I need to get to 10 more.

00:48:56.449 --> 00:48:58.889
That's a tangible goal in the year that you as

00:48:58.889 --> 00:49:02.329
a founder and me as a fund can help you achieve.

00:49:02.530 --> 00:49:04.530
I can introduce it to five hospitals, 10 hospitals.

00:49:05.130 --> 00:49:08.369
I can't get 10 % of the market share for you.

00:49:10.309 --> 00:49:15.969
We got to take baby steps first. So I think investors

00:49:15.969 --> 00:49:21.340
are just kind of... jaded by that altogether.

00:49:21.920 --> 00:49:25.599
No one's impressed. What's one thing you've changed

00:49:25.599 --> 00:49:30.860
your mind on in the past 12 months? Yeah, I think

00:49:30.860 --> 00:49:34.920
historically, I would really expect companies

00:49:34.920 --> 00:49:39.360
to have a really long runway of funding. You

00:49:39.360 --> 00:49:41.860
know, this concept of like, you know, you need

00:49:41.860 --> 00:49:45.920
18, 24, 36 months of funding. You know, venture

00:49:45.920 --> 00:49:49.000
funds typically like to see that. You know, venture

00:49:49.000 --> 00:49:52.139
funds are an interesting base because they expect

00:49:52.139 --> 00:49:57.039
companies to have the traction and scale of like

00:49:57.039 --> 00:49:59.659
a series D company. And they want the valuation

00:49:59.659 --> 00:50:01.760
of like a pre -seed company, right? They want

00:50:01.760 --> 00:50:03.820
like the world and want to give you nothing in

00:50:03.820 --> 00:50:08.099
return for it. You know, yes, in an ideal world,

00:50:08.119 --> 00:50:10.699
you have all your ducks in a row and you're served

00:50:10.699 --> 00:50:13.360
things on a, on a silver platter. I think that's

00:50:13.360 --> 00:50:16.579
what venture funding typically is actually expecting,

00:50:16.880 --> 00:50:19.699
this is the disconnect between founders and venture

00:50:19.699 --> 00:50:22.079
funds. Venture funds are often expecting the

00:50:22.079 --> 00:50:23.800
world, are all the problems to be solved and

00:50:23.800 --> 00:50:25.860
all they're really thinking to do is I'm gonna

00:50:25.860 --> 00:50:29.159
inject some capital and it's gonna grow. Sometimes

00:50:29.159 --> 00:50:32.199
that is what happens and a couple million or

00:50:32.199 --> 00:50:35.679
10 million bucks solves the problem. But that's

00:50:35.679 --> 00:50:37.840
assuming that money is the only problem that

00:50:37.840 --> 00:50:40.639
you have. And very few companies, particularly

00:50:40.639 --> 00:50:43.699
healthcare, money is just the tip of the iceberg

00:50:43.699 --> 00:50:47.239
of of what the company needs. So yes, I can tell

00:50:47.239 --> 00:50:50.019
them to have 18 months of runway or 19 months,

00:50:50.760 --> 00:50:53.920
but without that MVP, without that pilot, without

00:50:53.920 --> 00:50:56.900
that data, without US data, they're not going

00:50:56.900 --> 00:51:00.760
to get the traction to kind of get that of them.

00:51:01.099 --> 00:51:03.440
So yeah, I'm not expecting that they can survive

00:51:03.440 --> 00:51:05.559
with one or two months of runway, but I think

00:51:05.559 --> 00:51:07.579
as fund managers, you have to be a little bit

00:51:07.579 --> 00:51:10.000
more realistic, be a little bit more empathetic

00:51:10.000 --> 00:51:13.099
on you are going to have to roll up your sleeves.

00:51:13.799 --> 00:51:16.780
with alongside the company and, you know, actually

00:51:16.780 --> 00:51:19.639
contribute and getting them to that end point.

00:51:19.800 --> 00:51:22.519
It's not going to be a passive exercise where

00:51:22.519 --> 00:51:25.059
you expect them to just kind of, you know, solve

00:51:25.059 --> 00:51:26.760
these things in five years. Now you're going

00:51:26.760 --> 00:51:29.260
to get lovely exits. Like you also have to be

00:51:29.260 --> 00:51:31.480
in the trenches with them. And that's when I,

00:51:31.480 --> 00:51:33.820
when I speak to founders, I think that's what

00:51:33.820 --> 00:51:36.099
founders should be vetting. Founders should be

00:51:36.099 --> 00:51:37.579
vetting the funds that are investing in them.

00:51:37.599 --> 00:51:40.380
Like what are you going to provide beyond capital

00:51:40.380 --> 00:51:44.969
into, into my company? And if they can't do that,

00:51:45.050 --> 00:51:48.269
then yes, the money's great. But I think you

00:51:48.269 --> 00:51:50.710
are setting yourselves up for failure if like,

00:51:50.710 --> 00:51:52.250
money's the only thing you're getting from your

00:51:52.250 --> 00:51:54.730
investors. Because then you still have to find

00:51:54.730 --> 00:51:58.389
that Rolodex, that connection, the chief operating

00:51:58.389 --> 00:52:00.269
officer is gonna help you build that company,

00:52:00.469 --> 00:52:06.570
right? So it's, yeah, I think it's just investors

00:52:06.570 --> 00:52:09.170
being a little bit more realistic in what they

00:52:09.170 --> 00:52:11.820
expect of the others. And especially the last

00:52:11.820 --> 00:52:15.539
two, three years has not been kind to the market

00:52:15.539 --> 00:52:18.059
in general, especially companies. Many companies

00:52:18.059 --> 00:52:22.400
have gone under. And I think some of that needed

00:52:22.400 --> 00:52:24.780
to happen. Some of it could have been prevented

00:52:24.780 --> 00:52:29.000
if supported in the right way. Thank you, sir.

00:52:29.079 --> 00:52:31.360
This was amazing. Is there anything else you

00:52:31.360 --> 00:52:34.579
want to share with our audience? No, I think

00:52:34.579 --> 00:52:38.219
this is good. Thank you for having me. I really

00:52:38.219 --> 00:52:38.960
appreciate it.