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The health-tech start-up scene. All fart and no motion?

By Dr. Colin Coulthard |

When I was a trainee in A&E, in the last millennium, we had a ward sister in charge, and she was a legend in her own lifetime. Every other word out of her mouth was a swear word, and she had a particular turn of phrase. One of her favourites, was when she’d dealt with a threatening patient she’d say “Don’t mind him, he’s all fart and no motion.” Meaning that he’s all talk and very little action…

Recently I’ve been weighing up the pros and cons of staying in London. At the moment both of us are working part time as locums to support ourselves. The rest of our time we’re devoting to itamus. The problem for me, working in London, is that the amount of money I need to earn to support myself here is significantly higher than it is elsewhere in the country. This means that I’m working for seven sessions a week in order to keep afloat. This limits the time that I can spend on developing our business, and I think that this is holding us back.

However, there are also upsides to being in London. There are networking benefits to being in an area where there are other start-ups. This is especially true with health-tech feeling like the scene of the moment. Most weeks there are events happening where doctors can meet other entrepreneurs to network and exchange ideas.

Now here comes the “but”.

I’m not sure how useful these events are...

It’s nice to meet other people working in a similar field with similar ideas. However, I’ve yet to develop any productive business out any of them. Maybe that’s just me? Maybe it’s because our ideas aren’t any good? But maybe it’s because they’re more of a distraction than actually being productive....

At the same time, the ideas that I do see pitched are, shall we say, somewhat underwhelming…

Many of the people working on “big data” problems are falling into the same statistical traps that we’ve been aware of in healthcare for some years now. They’re data mining and erroneously applying it prospectively. They’re finding associations that are of no clinical value. “But”, they protest, “this time it’s different, because technology…”

I’ve lost count of the number of times people have pitched Uber, but for locums/GPs/carers/surgeons etc. That’s all well and good. However, Uber is a commoditised, transactional business. You want your taxi to be safe, affordable and on time. That is all you need. Locums, GPs, carers and surgeons are all in the relationship business. Healthcare is a relationship business. People want a relationship with the people they work with. A poorly chosen locum can easily create more work than they actually do. Trust in your clinician is a big part of why healthcare works. If you’re choosing a carer to help with intimate tasks, generally it helps to have a carer that you know and trust and get along with.

At the same time, Uber’s business model is to use their funding to subsidise drivers to make it attractive initially. Once Uber has network benefits they cut their rates. Setting aside the ethics of such a business model, it won’t work for skilled workers who have many options, such as medics.

Then there are the pie in the sky ideas. Artificial intelligence to replace GPs, but with no demo to show us. Blockchain technology for medical records. But with no demo to show us. Anecdotal reports about using VR on some patients. But with no demo or meaningful data to show us.

Stimulating, yes. Interesting? Most definitely. But productive? I’m not so sure.

Jam tomorrow anyone?

Our experience so far at itamus suggests that getting your product and pathway right is vital. The more we go along the path, the more I feel that time spent on anything apart from this core mission is time wasted.

So, for me, I’m leaving London for now. The cost of living means that I have to spend too much of my time staying afloat. This means less time working on our product and marketing. Less time on productive work.

I’d love to hear what others think. What’s your experience of the health tech start-up scene been like? Is it vital to be in London, or is it a hindrance…?

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