Big Picture Medicine

0:00 Intro

0:18 Ali Parsa's Immigrant Story

1:57 Picking a Problem That Was Too Big

4:15 The Supply Induced Demand Problem

5:55 The Unit Economics Problem

7:37 The Misaligned Incentives Problem

10:11 The Friction Problem

12:06 The First Mover Disadvantage

13:30 Raising Too Much Money

14:55 The SPAC Problem

17:40 The Pig With Lipstick Problem

22:07 Should Founders be Liberal with the Truth?

26:06 What Will the Next Health Unicorn Be?

Articles Mentioned

0:00 Intro

0:38 VC Dirty Money (LP Sources)

8:30 Power Dynamics Founder vs VC

12:56 Trillion $ Alzheimer's Opportunity

14:26 Eli Lily's New Alzheimer's Blockbuster (?) Donanemab

19:01 More Issues with Donanemab Phase III Results

21:48 Will Anyone Pay for Donanemab?

24:13 Donanemab Side Effects

27:15 Startup Opportunities in Alzheimer's 

31:34 Outro

Articles Mentioned

Papers Mentioned—

Martin Shkreli is an American Investor, Pharmaceutical Executive and Hedge Fund Manager who became the most hated man in America in 2015 when he obtained the drug Daraprim and increased its price from $13.50 a pill, to $750 overnight.

0:00 Intro

1:56 The Big Short

8:04 How to price a drug

20:01 Should we price drugs like iPhones

25:36 Pharma's dirty secret with R&D spend

34:12 Why are we not discovering more drugs? Eroom's Law

43:59 Marting's new AI Doctor — Dr Gupta

51:08 What's the FDA going to say?

53:26 Problems with GPT-4; hallucinations and sources

1:00:00 Mental health impact of being the most hated man in America

1:02:30 How rich are you?

1:08:00 Outro

Daraprim is used to treat or prevent parasitic diseases, commonly in patients with HIV or AIDS.

He defended the move by saying “If there was a company that was selling an Aston Martin at the price of a bicycle, and we buy that company and we ask to charge Toyota prices, I don't think that that should be a crime.”

Unrelated to the Daraprim scandal, in 2017 he was charged with securities fraud and sentenced to seven years in prison and fined a total of over $70M dollars.

Martin comes from humble beginnings, his parents are Albanian immigrants — but he quickly ascended the world and became a multimillionaire polymath. And despite having no formal training in Medical Sciences — he has a penchant for consuming medical literature from PubMed, and making novel insights.

We talk about how Martin does this, his philosophy around drug pricing — and whether we should think about pricing drugs in the same way we price iPhones, we talk about whether blowing more money into pharma research & development actually leads to more exciting drugs, Martin’s new AI doctor that he just launched and the mental health impact of being the world’s most hated man.

Dr Ala Alenazi is a TechBio Investor at Ascension and holds a PhD in Molecular Genetics from Cambridge University — she describes herself as a recovering scientist with extreme FOMO.

0:00 Intro

0:47 Being bombastic

3:32 Do PhDs make good VC investors?

10:38 How much of VC is luck?

12:47 Network building in VC

19:16 Getting deal flow

22:15 How to ask for things

24:43 Experience being a brown woman in VC

28:42 No one gives you anything, you just have to take it

33:50 Main character syndrome

We talk about how being bombastic is the key to getting opportunities, why contrary to popular belief — PhDs don’t suck as investors, how to ask people to do things for you and what it’s like being a brown woman in VC.

Dr John Whyte is the Chief Medical Officer of WebMD, he’s also worked at Director level at the FDA and was also Chief Medical Expert at the Discovery Channel.

0:00 Intro

0:54 Anxiety as a content creator

2:33 Why should executives think like physicians?

7:23 Decision-making with limited information

10:47 Bayesian reasoning

12:57 Risk, acuity and stress

15:28 What should we NOT learn from physicians?

17:06 Future of health communication, health influencers

22:29 Regulation for health influencers?

24:22 Habit: I've never applied for a job

26:53 Networking building

28:24 Introspection as a habit for success

Dr Shivdev Rao is a Cardiologist and CEO/Co-founder of Abridge, who have raised over $22M.

Think of Abridge like an Alexa or Siri (or other voice assistant) that sits there whilst the physician and patient talk.

Instead of the physician writing notes during the consult, or staying late and charting — Abridge listens to the conversation and writes up the notes for them.

Similarly, instead of the patient frantically taking notes, or being bombarded with information — most of which they will forget — Abridge can send them an appropriately-pitched record of what was said, with key takeaways.

We talk about how Shiv built and grew this company, I ask him about the existential threat of LLMs like ChatGPT, how being in the intensive care unit is similar to building a startup, and how operating from a place of abundance is a key to success.

0:00 Intro

1:35 Shiv's story

8:50 Cross pollination as a tech CEO

12:02 Abridge, idea to execution

17:19 Possibilities with big data

19:53 Threat of LLMs like ChatGPT

23:52 How will Abridge fail?

25:22 How to stay focused

27:10 Leadership lessons

31:14 Habits that have helped Shiv

Dr Ignacio Medrano is the Founder of Savana (raised $44M dollars with over 100 employees). They use AI to unlock all the value out of clinical records and produce real world evidence.

0:00 Intro

0:34 Ignacio's story

1:30 Learnings from Neurology -> Entrepreneurship

3:27 How to build good health products/services

5:03 Downsides of being a doctor in health entrepreneurship

7:21 Just in case vs just in time learning

9:14 Perils of perfectionism in healthcare

12:34 Do you need to be a d**k to be a good leader?

14:27 Dunbar's number — leading bigger organisations

17:52 Differences in operating in Europe

20:12 Diagnostic medical AI is a waste of time

23:15 SWOT analysis of Savana

26:07 Threats to Savana — LLMs?

29:22 Being eccentric as a competitive advantage

31:09 Becoming a better speaker/storyteller

34:02 Declining Royal Academy of Sciences invite

36:24 Arrogance as a competitive advantage

38:48 Tribes — exclusion criteria importance

40:27 Billion $ Health Idea

41:38 Not watching TV as a competitive advantage

46:40 Outro

Dr Stephanie Eltz is a Trauma Surgeon and CEO and Co-founder of Doctify, which is basically Yelp/Trustpilot for Doctors. They’ve raised >£22M dollar in funding to date.  

0:00 Intro 

0:41 Story 

2:34 Motivations 

3:47 Building Doctify 

8:25 Why do you have grit? Early childhood 

9:21 Are patient reviews good measures of a doctor? 

13:53 There is no growth hack 

16:34 How to stop reviews becoming a cesspit 

19:48 Monetising 

21:15 It's all about the destination 

22:46 Happiness as a founder 

24:31 Are you full of sh*t? 

26:48 First become a King, then a Philosopher 

28:10 Leadership and MBTI 29:28 Habits 

30:20 Insecurity and immigrant hustle 

33:16 Hustling 

35:00 You don't need to network 

36:17 Outro

Jason Foster is the CEO of Ori Biotech; a cell and gene therapy company who have raised $139M in funding. He also sits on the boards of companies like GripAble, Credentially, and Auxita — and is an active angel investor.

0:00 Intro 

0:34 Jason's story 

5:31 What was your goal? 

6:39 When did you make it? 

8:31 Taking calculated risks in life 

10:48 Creating value vs chasing $$ 

12:15 When should you say no? 

16:39 How to coach people 

20:53 How to find a coach? 

23:37 How to do cold outreach 

27:16 Being a marketer and making it in biotech 

31:54 Introversion vs extroversion as a CEO/founder 

35:37 How to build professional relationships, Neurolinguistic Programming 

37:54 The founders first zeitgeist 

42:05 Managing your ego 

45:07 Disagreeable givers 

45:39 Why do media? 

46:29 Jason's grand theory 

51:59 Why are health/life sciences/biotech unique markets? 

55:28 Billion dollar health idea 1 

59:57 Billion dollar health idea 2 

1:04:00 Money and happiness 

1:07:50 Habits that have helped Jason

Morgan Cheatham is Vice President at Bessemer Ventures and an MD Student at Brown. He was Forbes30u30 for Venture Capital.

Morgan is a super smart guy who has lots of interesting theses and billion dollar ideas in health and life sciences, including ones in generative AI and biosecurity.

We also spend lot of time talking about relationship-building, networking and using the content game to make it in health.

0:00 Intro

0:31 Relationship building

1:54 What you can offer people

3:33 Having strong beliefs as a competitive advantage

4:02 How to develop unique theses in health

6:56 How to avoid just following trends and have original ideas

10:09 How to network

13:15 How to use content as a USP in health

19:58 Is content-creation for charlatans?

21:54 Predictions in health: Generative AI + BioSecurity

27:19 BioSecurity Idea

29:27 Billion $ Health Ideas 

31:43 Generative AI in healthcare

34:11 Book recommendations

37:06 Habits

Dr Adam Bataineh is a Longevity Doctor and Founder of Span Health (acquired by EightSleep). We discuss:

0:00 David Sinclair's New Ageing Paper — Legit?

15:52 Amazon RxPass — All Hype?

23:37 Metformin is San Francisco's New Birth Control 

30:58 Decline in Disruptive Science — Why?

Links

New series. We brainstorm billion $ health ideas.

Dr Anas Nader is the CEO and Co-founder of Patchwork Health; an end-to-end workforce solution which helps health systems tackle the staffing crisis. They have raised over $30M.  

Tess Cosad is the Co-founder and CEO of Béa Fertility; who have raised £2.2M in an effort to democratise access to safe and affordable fertility treatment.   

0:00 Intro 

1:15 Lessons from PR to healthtech 

2:25 Storytelling 

5:29 What do others get wrong? 

6:54 Does PR add value to the world? 

8:01 Béa Fertility origin story 

10:16 Advice on relationship-building 

11:13 Getting better at pitching 

12:15 Future of Béa Fertility 

16:28 Benefits of at home clinical care 

19:08 Do we need more babies? 

20:44 China/Japan 

21:57 Moore's Law in Fertility 

25:17 Opportunities in fertility tech 

27:23 Habits that have helped Tess 

30:23 Book recommendations 

31:27 Being bold  

Specifically, Béa deliver kit to carry out one cycle of intracervical insemination straight to the user’s door.  She was previously in the Public Relations world, as Managing Director of Emberson Ventures and we talk about lessons healthtech startups can learn from the PR world.  

We also talk about how she’s built Bea, crucial leadership advice she’s received from her mentors and big opportunities in the fertility market.  

I hope you enjoy.

Guillermo Vela is the CEO and Co-Founder of NeuScience, a VC-backed TechBio company using AI to discover novel cancer biomarkers.   

0:00 Intro 

0:55 Eroom's Law 

5:37 Contrarian View of Cancer 

15:54 AI Will Not Make Drug Discovery Fast, Better or Cheaper 

26:14 Failing is Not a Good Thing 

26:38 TechBio Funding 

34:07 Habits   

Dr Ivan Beckley is the Co-Founder of Suvera Health, a Google-backed virtual clinic which has raised over £6M in funding.  

Dr Daniel Kraft is a Stanford and Harvard-trained physician-scientist and inventor.  He serves as faculty chair for Medicine at Singularity University, is founder and chair of Exponential Medicine and has given four TED and two TEDMED talks.  

He’s also the inventor of the MarrowMiner, an FDA-approved device for the minimally invasive harvest of bone marrow, and founder of RegenMed Systems, a company developing technologies to enable stem cell-based regenerative therapies.  

He’s also served as an officer and flight surgeon with F-15 & F-16 fighter Squadrons. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.  

We discuss why — despite reaching the fourth industrial revolution — healthcare seems to be stuck in the third or second. Dark horses in healthcare and some of the magic that has helped Daniel get to where he is today.   

I hope you enjoy.

How do you spend £16 billion to improve the world’s health?

That is the job of Sir Jeremy Farrar, the Director of the Wellcome Trust. In 1936, British pharmaceutical magnate Sir Henry Wellcome left his fortune to improve the world’s health. Now Sir Jeremy must work out what to do with £16 billion over the next decade — and where to most effectively spend it.

Dr Imran Mahmud studied Medicine at Oxford, before studying Public Health at Harvard on a Fulbright Scholarship. He then ranked first in the country entering the Ophthalmology training programme — promptly leaving and joining McKinsey. In 2018 he co-founded NYE Health, raising over £4M. He is now a startup advisor, angel investor, digital health consultant and content creator.

We speak about angel investing — which was traditionally a way in which high net worth individuals could invest in small startups — but is now becoming possible for many more people. We speak about the digital nomad post-economic lifestyle — and whether doing whatever you want, wherever you want actually makes you happy. And one of my favourite one of Imran’s principles: To be interesting, do interesting things.

I hope you enjoy.

After missing out on getting into Medical School, Ahmed studied Computer Science — later completing his PhD at Cambridge University. As a student, he launched his own health AI startup — which diagnosed rashes on intimate body parts.

This didn’t work out and he pivoted and launched a data AI company called Catalyst AI. This company was later acquired by Farfetch; the luxury online fashion retail platform to help optimise their fashion supply chains.

He now sits on the Prime Minister of Pakistan’s Science and Technology task force, on the Development Council of the Woolf Institute and is the Co-founder of a sustainable fashion enterprise.

We speak the about the unlikely overlaps between fashion and healthtech — no seriously there are lots of them, we speak about how to find your ultimate purpose and how when building relationships — the ultimate form of self-serving is being a giver.

I hope you enjoy.

Dr Sandeep Bansal is the Founder and CEO of Medic Bleep; a pager replacement which raised over £3M. On top of that, he recently co-founded Carebyte Health — which offers personalised on-demand healthcare to Indians. He is also Faculty at Harvard Medical School and Barts.

This is a super interesting conversation in which Sandeep explains how he has partnered with some of India’s largest companies, to pay Indians to be healthy, how crypto fits into that mission and the fascinating new HealthTech/FinTech fusion model hitting emerging markets.

I hope you enjoy.

Dr Molly Gilmartin is an Investment Manager at AlbionVC who manage over $1bn in assets and have invested in companies like Arecor, Healios and Pando.

She studied Medicine at Oxford, was a founding team member of Pando, Chief Commerical Officer of Induction Healthcare, a Consultant at McKinsey and now an Investor at AlbionVC.

We talk a lot about the psychology of communication, about strength-based feedback and radical candour, about how being inquisitive can get you very far, how energy is Molly’s superpower and lots of other frameworks that Molly finds useful in her career. We finish off by discussing her thesis on the emerging B2C2B model in healthcare.

This is a really value packed interview — I hope you enjoy.

Joe Stringer is a Partner at Octopus Ventures, one of the largest European Venture Capital firms with £1.8 billion under management.

He was Partner at Ernst & Young for 10 years, before leaving his cushy position to launch his own venture fund TenX Health. He then led Google Health in the UK before becoming Partner at Octopus Ventures.

We talk about his thesis on the future of health, the importance of hard work, grit and resilience, as well as building and managing relationships — in particular, trying not to be too British.

Dr Patrick Malone is an MD, as well as having a PhD in Neuroscience. His research focused on computational cognitive neuroscience and AI applications in radiology.

Niklas Rindtorff is a Physician-Scientist and one of the Pioneers in decentralised healthcare and life sciences.

He has an MD from Heidelberg University and he received his Master's Degree in Biomedical Informatics from Harvard Medical School as a Fulbright Scholar.

He is a founder of LabDAO, an online community of life scientists collaborating to increase the accessibility of life science tools both in the dry lab and wet lab. He’s also a Core Member of VitaDAO, a collective funding early stage longevity research.

DAOs are Decentralised Autonomous Organisations and a staple of the ongoing WEB3 revolution.

Investopedia defines DAOs as having no central governing body, every member within a DAO typically shares a common goal and attempts to act in the best interest of the entity. Popularized through cryptocurrency enthusiasts and blockchain technology, DAOs are used to make decisions in a bottom-up management approach.

Or as Niklas describes them, DAOs are basically a WhatsApp group chat with an attached cryptocurrency bank account.

In this conversation, I find out about how DAOs can be used in healthcare. From enabling rare disease research to fixing science’s publishing problems. I hope you enjoy.

Nikhil Patel is the Founder and CEO of Craniometrix, where they’re using innovative deep learning and digital health tools to diagnose Alzheimer’s Disease — and position themselves as the all-in-one Alzheimer’s care platform.

Nikhil studied Computer Science and Economics at Yale University, before launching Craniometrix — which was accepted into Y Combinator and have raised $6M in their seed round.

We talk about how he’s been able to build Craniometrix as a 22-year-old and get investors really excited about his vision, how a digital tool can unlock new levels of diagnostic ability and why Nikhil talks so fast.

Neil Daly is the Founder and CEO of Skin Analytics; a company which uses AI to detect skin cancer. 

Neil started Skin Analytics in 2012 after working extensively in mobile innovation and strategy consulting. They’ve raised a total of $9M.

If detected early, melanoma can have a 99% survival rate — which dramatically decreases the later it’s picked up — creating a very important opportunity for companies like Skin Analytics.

But there are some important caveats to clear up. For example, I ask Neil: Whose fault is it when the algorithm misses a cancer? The doctor’s or the algorithm's?

I also ask if algorithms are unfairly held to a higher standard than human doctors, and we speak about the making of the Skin Analytics algorithm — and how it broke away from conventional wisdom.

Gian Seehra co-founded Pebble Labs and Trait Biosciences — having raised a total of $16M.

He was also a VC at Octopus Ventures, where he oversaw over $200M in funding. He led QuitGenius’s $12M Series A and also facilitated follow-on investments into companies such as Elvie, Big Health and Depop.

He now takes his knowledge built from being on the other side of the table — to coach entrepreneurs on how best to pitch and tell their story in order to raise money.

We discuss how to pitch to investors — good ways of doing so, but also common mistakes. We also discuss the core tenants of authenticity, logic, empathy and the X factor.

Essentially ways of sidestepping the monotony of “here are the 10 things investors want to see” — and instead really getting investors excited about what your vision and what you’re building — and hopefully throwing money at you.

I hope you enjoy.