I had intended to post this around New Year’s day along with others who were sharing their reflections of the year past. And while an unexpected event delayed this posting to the point that it no longer seemed relevant, it has become clear to me that some of my readers have not been kept abreast of my career transition. I’d like to share the details of a whirlwind 2 years but it would be the length of a short novel, so here I take a brief look back and share a key point related to being a doctor in a startup in healthcare.
At the end of 2017, there was little I could say about what I was up to. A year prior to that point in time, I had fully transitioned from practicing full-time primary care to eating, drinking and breathing start-up life. It was a crash course in product development and machine learning at a company that was in stealth mode. My family and peers had know idea what I was working on, but they were curious about the transition.
The first question people ask when I say I closed my practice to work at a startup is “Are you glad you’re working less hours?”
Let’s rewind. I was a young female Internal Medicine doctor working full-time in a large multi-specialty physician-owned Seattle practice, on call for my own patients every night except for weekends, when call was rotated. (I became more and more aware of this being a rarity when the jaws of those I relayed this to – primary care doctors themselves – would gape in shock.) I had good access, a fairly streamlined flow, and a great group of office staff (every doctor knows how critical and valuable this is). My physician-owned multi-specialty group gave the top floor of a beautiful new building in Seattle to the Internal Medicine Department. We Internists felt valued.
No doubt, the work was hard. The paperwork and messages were never-ending. I worked at least an hour and a half almost every night. But I knew what else was out there and how doctors in other health systems worked. I also explored concierge practice and felt the model didn’t align with my values or primary goals at the time. Direct Primary Care (DPC) was a strong consideration. Still, despite moments here and there of wondering what else was out there, I felt I truly had a pretty good thing going and appreciated the organization for which I worked.
It was, thus, serendipity that I came across a job description for a primary care doctor needed for a Seattle startup early in 2016, when I was neither burnt out nor actively searching for something else.
No, it was not about the hours.
Making the leap
Being observant of technology that came out of Silicon Valley, and mostly disenchanted with the leadership in the area at the time and the apparent values – I had been following the Theranos story closely – I was skeptical but curious. Would a healthcare startup based in Seattle have a better culture? Would it last?
In residency, one of my attendings had said that it took about 15 years of practice for doctors to really feel they’ve got it down, hit their stride. 15 years. Imagine hearing that now. By the time I answered this unusual start-up job description, I was already at 10.5 years of full-time work (and roughly twice the experience of colleagues working 0.5 FTE). Taking this new job was a risky move. Yet, I was always drawn to the tech side of things, particularly how it relates to usability in multiple areas. I had been dismayed by the way product after product was being developed in ways that kept missing the mark on being actually useful in the healthcare ecosystem or being short-sighted to the point that primary care doctors have to pick up the pieces.
So, after multiple talks with the CEO of the startup and verifying that both of us had an aligned vision, I went from running codes in the hospital to running code….or so I like to say fully tongue-in-cheek ever since a couple of our engineers showed me how to do a little of that.
Not breaking things
I learned firsthand what “moving fast” really looked and felt like, and more importantly, when to quickly hit the brakes on a plan and what to anticipate. Moving fast thoughtfully without breaking things is paramount to changing any system that touches people so intimately. This absolutely applies to healthcare, but not solely healthcare.
Failure is the best option….for learning
Though we are careful not to “break things” as a company, one of the most valuable parts of my experience thus far is learning how to fail. It turns out, trying not to fail 100% of the time is time and resource-intensive and unproductively aspirational, particularly when the path to doing something new has not been paved yet. I was forced to keep the risk-averse side (ubiquitous among doctors) in check. There are many articles and books that emphasize the importance of failure. Nowhere has the learning curve around this been as steep for me as in a startup.
We’ve made big strides since we were a small company of 17. I am looking forward to what lies ahead in 2019 and beyond. No doubt it will include some uncertainty and some failures, but it will be mission-driven and exciting all the way.