The why, how & what of doctorly.

I love talking about what we are doing at doctorly, it's a major aspect of my life and (simply put) building doctorly fills my life with purpose.

Whether I am speaking to VCs about our next round of investment, exchanging ideas with fellow health-tech entrepreneurs or taking part in a panel on stage, I regularly get asked a lot of the same questions.

These questions are totally valid, but, often lacking in insight & context.

So, below is a short Q&A regarding my thoughts on disrupting healthcare, selling to doctors and why we are doing things the way we are at doctorly.

I'll start with the 'why, how & what' of doctorly.

Why does our company exist?

• To enable people to live healthier lives.

How will we achieve this?

• By simplifying and improving the interactions between doctors, patients and the wider health industry.

What products do we make?

• Practice Management software: Help doctors by solving core practical day to day efficiency issues, while digitising the practice for continuous ongoing innovation.
• Patient facing health app: Help patients by digitising the relationship with their doctors and providing personalised digital services in a fully integrated way.
• Integration platform: Help the wider health industry by allowing key stakeholders to integrate their services, tools and products via a single interface for our doctors and patients.

We connect the above three products within an innovative B2B2C business model.

With the above in mind, here are my answers to the usual questions.

"You have chosen the, VERY, most difficult route to disrupting the health industry (Practice software), Why?!"

Me: Yes, we were fully aware of the challenge we have set ourselves and, yes, it was intentional and very conscious. 

My co-founders and I spent 6 solid months, prior to raising any money, thoroughly researching all of the various routes we could take in order to reach our vision of 'enabling people to live healthier lives'. 

We dove deep into the inner workings of, and connections between, patients, independent practices, hospitals, health insurers, pharmacies, pharma corps, research institutes, government bodies, digital-health companies, and more.

We were predominantly focused on Germany as our launch market, but with an eye on other GEOs too.

It became clear to us that all roads lead back to the practice.

We came to the conclusion that the relationship between the practice and patients IS the foundation of the health industry.

• This is where patients go when they are sick.
• This is where medical services are delivered.
• Where remuneration is determined.
• Where data is created.
• Where data is stored.
• Where data is interpreted.
• Where data is shared.
• Where patients are guided.

If this 'foundation' is built with 80s/90s technology and software, how can we expect to solve the systemic core industry problems by adding a simple app on top of, or around, it? 

Yes you can still build a successful company this way, and yes you can add iterative value with a straight B2C (non-reg) play, but with our vision in mind, it wouldn't cut it.

We could build the most beautiful and functional health app for patients, but if a patient wants to centralise, manage and better understand their health data (for example)... where will the data come from? Those pieces of paper in the doctor's office? You're asking the doctor to perform extra work, for very little direct benefit to themselves and they simply won't do it.

As for the assumed 'difficulties' associated with tackling this space (practice software), let's think about some of these for a moment:

• It's heavily regulated!

Indeed, there are very complex regulatory requirements to achieve before you're allowed to sell this kind of software to doctors. Also, the regulatory process itself, though well intentioned, is not setup for fast moving, young startups. 

However, at the end of the day, whether you want to build a challenger bank, a challenger insurer or any other greenfield regulated product tackling a MAJOR key-life industry... they are regulated for a reason and these are the hoops you simply have to jump through.

There are many compelling reasons going greenfield in an archaic industry makes sense, regardless of the obstacles that accompany that decision.

As long as you believe in your (well considered) vision it all comes down to execution really;

When building complex regulated software you need a strong founding team, smart hiring, dedication, perseverance and to be goal focused. The actual regulatory process itself is just another 'process' you have to follow step by step.

From a business perspective, investing in completing these regulatory accreditations ultimately creates a high barrier for entry for competition and strong defensibility of your market position (which is likely why the industry is where it is today, it's been TOO defensible, which breeds a lack of competition/innovation).

• Wide & complex feature set needed for 'MVP'.

This is very true. If you are building a (relatively) simple product in a non-regulated space, you can easily go to market with a BETA MVP product and iterate upwards from there.

On the other hand, If you intend to REPLACE the entrenched core software used by doctors and their staff for managing a medical practice, you better come prepared. 

Feature sets fully complete. Stable and reliable infrastructure. On-boarding on point. Customer service processes in place.

As far as I am concerned, this is a GOOD thing. Setting high standards for the quality of your product and services from the get-go is imperative if you want to disrupt such an important industry.

Again, you need to be mission driven, have a strong team, high standards, keeping in mind who this product is for, move quickly, (because we are a startup after all), but never 'rush'.

You do need more early stage funding (compared to a typical B2C e-commerce play, for instance) due to the extra resources and time needed to build/regulate such a complex product, but when weighed up against the compelling business opportunity, the vision/potential social good and the lack of modern competition, it's a 'no-brainer' Founder/VC decision (though of course I am biased).

• Powerful established incumbent companies!

I can't, for the life of me, understand how anyone can see this as a negative. 

Do doctors like their current software? STRONG 'No'. 

We have spoken with thousands of doctors over the past 2 years with respect to their current practice software/way of working, the range of response is scaling, sharply up, from tolerate-to-detest. These sentiments are also mirrored across the wider health industry, no one likes working with doctors via the current software.

We are not pitting ourselves up against a modern tech-giant with the capabilities to pivot and build new industry defining software. 

We are going up against classic 80s/90s companies that always saw technology as a cost center and only talk about 'clouds' when planning the next company picnic.

These companies have been VERY successful (from a financial perspective) and were quite innovative once upon a time, but, whether due to a lack of competition, ability or vision, have stopped innovating and instead focused on squeezing doctors dry and actively working to prevent the disruption of their monopoly (elbows out, as opposed to innovating from within).

This has a VERY strong ripple effect across the entire health industry, playing a large role in causing many of the difficulties around digital innovation in healthcare.

While the incumbent players championed the digital revolution of the 80s/90s and were able to take doctors from pure paper to (more) computer based work, we (and companies like us) are set to usher in the next digital revolution and enable technology/software to work as an effective enabling tool for doctors to provide a whole new modern level of healthcare.

Building a whole new industry can be difficult, where as building the next generation of an 'existing' industry is fun! 

• Medical practices are perceived as a difficult market to sell to.

There are two ways people typically come to this thinking;

1) They anecdotally hear that doctors are old, boring, unhappy, masochistic people by nature, who like to complain about their lot-in-life, but won't do anything about it. 

and/or

2) Due to the decentralised nature of the market (i.e. so many individual practices you would need to sell to) it's not possible to scale sales with good unit economics.

To 1:

This is surface level insight at best and misinformation at worst.

Doctors are:

• Incredibly busy & stressed.
• Spending 60-70% of their time on administrative duties.
• Using old inefficient software.
• Working in dated inefficient ways.
• Trained to be doctors, not business owners.
• Stuck in some bad habits inherited from the doctors before them.
• Dictated to, with respect to digitisation, and not properly consulted RE the reality of implementation .

Doctors also are:

• Modern tech users (in their personal lives) who know the difference between good and bad software/services.
• Big fans of innovation and progress within medicine.
• Data and value driven.

Simply put, if you are going to sell something to a doctor - you better be selling them something that fulfills their actual needs, not something you 'think' they need or 'SHOULD' be doing for their patients.

From what I have seen, most companies selling to doctors aren't really thinking about the doctors ACTUAL pain points and needs, they a more likely to see the doctor as a BARRIER to preventing what they want to achieve for the patient.

An analogy I could use to describe modern sales to doctors:

You knock on a door. The person opens it. They are running late for a job interview. They are holding a screaming baby in one hand. A pot in the other, catching drops of water from a leak in the ceiling. The phone wont stop ringing and ringing. There is smoke coming out of the oven. The fire alarm starts to go off. You then try to sell them an iPhone, explaining how they can download cool apps and make an emoji of their face. 

It's not that the iPhone isn't good, nor that the iPhone wouldn't add value to their life in some ways. It's also not that iPhone isn't significantly better than their current phone.

It's that you have failed to understand that RIGHT NOW the iPhone is not what they really need or want. Upgrading their phone is SO low down on their agenda of needs that they don't even want to think about it. 

Over my 12 year tech-startup career I have been in charge of marketing/growth/sales for many excellent products, but I must say... never has the sales process been this simple.

We have spent time with thousands of doctors - we always start by talking about their current processes, what they like and (mostly) what they don't like. We then conduct a simple demo of the doctorly practice software and show them how they can do their usual work, but in a modern way, minus the traditional 'sales spiel' or 'marketing 'razzmatazz'. It's very basic.

"Where do I sign?"

What doctors appreciate is that we understand exactly how they currently work, what administrative work is required of them, what different problems they are facing and we have then created a software that simply focuses on fixing these problems and meeting these needs.

Hence the 'it's hard to sell to doctors, they don't like change' myth is ultimately perpetuated by many companies who have never truly understood (or ignored) the full realities (top to bottom) of a medical practice.

To 2:

I believe a decentralised market 'is' the VERY best way to disrupt such an entrenched industry. 

Before you get the majority of doctors to swarm through your pipeline you have to PROVE that your product is AS good as you say. There is a healthy amount of skepticism to be expected from doctors contemplating switching their traditional core work software.

You have to tackle this with proof and data, for which you need 'early adopters'.

We have been talking to, and working with, doctors since before we officially kicked off the business. We have doctor investors. We have a doctor cofounder. We have a select group of partner practices, who work with us on a monthly basis to ensure the product we build REALLY fixes current problems. On top of this we have quadruple digit practices who are also involved during the development process and baying to be customer number 1.

This was achieved with NO marketing, NO advertising and NO full fledged sales team. Just from talking to doctors and showing them what we are building.

These are the practices we will launch with. These are our product evangelists. These will be the case studies to show to the rest of the industry. 

This is an incredibly connected industry, one 3rd of our current leads already come via referral - as someone who has had the privilege of being involved in launching/scaling multiple successful startups, I know this to be a strong indicator of special things to come.

The above is achievable because individual practices/doctors can make the buying decision for themselves. Decentralised.

The scaling of sales will come after these early adopters share their story with the industry - the doctors will come to us. They are already coming.

Ultimately, 'selling to doctors' isn't hard, just as long as you have something that they will actively come to you to buy.

"Sure doctors don't like their software... but they don't like change either".

Me: Give doctors a little credit please. 

Their situation is fairly clear and simple for those who take the time to look; they are overworked, spending 60-70% of their time on administrative duties and using outdated software within outdated infrastructures.

If you offered them an easy route to 'change' these problems, they would be ALL for it.

Very often in life we see people running directly into (metaphysical) walls, over and over again.

• Why are you doing that?
• It's how it's done. 
• Are you happy doing it this way? 
• No... not at all. 
• Do it differently then. 
• How???

Show them you understand where they are coming from, what they are going through, where they are trying to get to and then help them get there... hold their hand if you have to!

Change can be difficult - successful tech disruptors make it easy.

"Why not 'just' make a non-regulated product that works WITH existing products and go from there?"

Me: You can glue a carrot to a horses head, but it will never be a unicorn.

A) Doctors are not particularly well trained in running a business (No modern efficiency boosting tools / processes in place).

B) The software they are using for their core workflows were built in the 80s (no proper APIs etc / not compatible with 2020 technology).

C) Doctors have the power to reject new modern tools. (Ultimately they can keep doing things how they have been for the past 40 years if they want, you can't 'force' them not to).

Logically, with the above in mind, you have to fix A & B in order for C not to happen.

So, for those of you that have made it this far, here is my summary:

1) Help the doctors. Help the patients. Help the wider industry. Is a structure/process that we strongly believe in. It's a logical and sequential route to meaningful disruption of health care.

2) Just because most would-be entrepreneurs would see this as too challenging to do (regulated, big product, tricky market), it doesn't mean you shouldn't do it. If anything, if you have the ability and means to do it, there is an argument to be made that you have an 'obligation' TO do it. Sometimes the right thing to do, is the hard thing.

3) Just because most VCs are too scared to invest (early stage) in a product like this, it doesn't mean you shouldn't do it. Most VCs typically 'follow' (quick, we need a block-chain play in our portfolio). If you are doing something fairly left-field, you simply have to identify the visionary VCs who properly understand the concept of risk capital in relation to the space you want to go in to. If the arguments against the venture are ALL execution related, you're in a pretty good place (as long as you have the team to back it up).

We, at doctorly, were privileged to be backed (from day one) by the best early stage VCs in Europe (Target Global, Seedcamp, Speedinvest), with UNIQA ventures, (who are big believers in the opportunities around digital-health), coming on-board a little later too.

But of course we have faced out fair share of 'nos' from VCs who can't see beyond the challenges.

4) Selling to any particular demographic is never objectively 'hard' nor 'easy'. If you truly understand the needs and situation of those you are selling to (this takes significant research time and a wide open mind), build an excellent product that addresses those needs, taking service level for users to a whole new level, if your product is affordable, if the change management is painless and well-managed... you'll never have to 'sell' a day in your life.

Ultimately we have positioned doctorly as the 'friend of the health industry' (unless you are a current practice software provider of course, sorry).

For doctors:

• Put simply, we hear you. 
• We start by providing you with practice software that solves all of your ridiculous administrative & process related problems.
• We use modern digital tools to enable you to spend less time typing and more time with your patients.
• We don't do this in a modular non-reg way, forcing you to continue to use the old software. We totally replace it.
• We also know you hate using multiple disconnected modular softwares and tools, so we also enable the best services and tools across the market to integrate directly into our software, for your ease of use.
• We don't TELL YOU TO DIGITISE (perched upon our technical-high-horse), we provide you with a centralised (non-modular) suite of functionalities to support you in being a doctor in 2020 and beyond.
• Reach out to us and ask for a demo, you'll understand what we mean within 30 minutes.

For patients:

• We enable your doctor to BE DIGITAL. In doing so we then enable you to have a meaningful digital relationship with them.
• Booking appointments, accessing and enriching your health records, secure communications and personalised digital health services.
• Your doctors will still be an important aspect of managing your health, but you will now be an active participant with agency in the processes involved.
• We know you don't want to use 25 health apps at once, so we work with the wider digital-health industry to integrate the best tools and services for your convenience.
• By being fully integrated into the doctor's practice software, the union of purpose, data exchange and service access is seamless.

For health-tech companies:

• Imagine if your products, tools and services could directly integrate into the main working interface of the doctor.
• Imagine if you didn't have to 'SELL' to doctors/patients directly.
• Customer acquisition/sales costs slashed.
• Your tool seamlessly integrated within doctors workflows.
• That's the point of our platform - we don't have the time to build EVERYTHING, but we do intend to make EVERYTHING possible.
• Reach out to us to find out how working with/through a modern practice software will help you skyrocket your business. 

For investors with health-tech startups in their portfolio:

• If you see doctorly as competition for that tele-medicine service, health app or ML driven radiology scanning tool within your portfolio. You're wrong.
• doctorly is HOW these products are going to be embraced by the doctors & patients. Doctors like new tools, but they don't want extra work in order to use them.
• Reach out to us to better understand how doctorly can enable your startups to achieve faster scale and why doctorly will be the biggest and most innovative health platform in the world.

For the wider health-industry (insurers, pharmacies, services providers, research institutes, governmental agencies and so on...):

• Without the proper infrastructure and pipes in place for digital integrated workflows between you all, you are doomed to continue down a path of inefficiency and waste.
• Doctors deserve to work in a modern and efficient way.
• People deserve a holistic and connected healthcare industry.
• This would ultimately be better for all of your bottom lines.
• doctorly helps you achieve this. It's a win, win, win.
• Reach out to us to better understand how we can help you modernise your processes, save you time, money, and ultimately give a better life to doctors and patients.

I hope the above:

a) Gives you a better insight into why we are building doctorly, how we are going about it and what (precisely) we are building.

b) Provides a little inspiration for people working within this industry to think a little bigger and wider.

c) Means we can skip to the more interesting parts of the discussion in future ;)

I believe in the power of collaboration and synergy, so I am always happy to hear from people who work within the healthcare industry. Whether you are part of the incumbent system or part of an exciting digital-health startup, if you want to help to drive this industry forward, I would love to hear from you.

We are also always looking for amazing hires to join the team!

Please each out if you are interested in using your skills to help make our (admittedly BIG) vision into a reality :)

S