

Ask YC: What would you do? - jyu

Background:  I'm 25, I am about 4 months from eliminating all my personal debt.  I have operating experience in the real estate industry, and I studied biology and engineering in school, focusing on designing, programming, developing three different medical devices from concepts to working prototypes.  BTW, I hate programming, but I know how tech can be applied, love crunching numbers, playing with different business models and cashflows, marketing/selling products that solve meaningful problems, and think consumer web apps and most web 2.0 "start ups/businesses" can go to hell.  Yes, I am a fan of uncov.<p>It appears to me that healthcare and real estate are both industries that are ripe for change and have many problems that could really benefit from technology solutions.<p>I have several ideas for real estate that have generated interest from people willing to pay.  Best case, this could end up in a start up or highly profitable company, netting several million in profits in several years time.  I have a good team in place, with great software experience, distribution experience, sales experience, and extensive experience in the particular market and problems I am trying to address.  In healthcare, I do not have as strong a network, and would probably need to join a start up and get ops experience before I gained sufficient credibility and insights to start a start up of my own.  Problem is, I am not particularly fond of the real estate industry, and it is not as sexy as solving anything in healthcare.<p>Question: Should I take advantage of the immediate opportunities in real estate, or develop myself for a potentially larger set of opportunities (in both personal satisfaction and financial incentive) in healthcare?  What other factors would you consider?  Having not worked much in healthcare, could it be that I'm suffering from "grass is greener" syndrome?
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pg
Based just on this info I'd take the real estate route. Healthcare has
bureaucratic constraints that make it a tough world for startups-- at least
startups that aren't founded by older people with tons of money and
connections.

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Spyckie
The biggest problems in healthcare are bureacratic, but something has to be
said about the mindset of doctors, too. They seem to hate change, and right
now it seems like the only way the healthcare space will change is through the
passing of generations.

No offense to any doctors out there.

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danw
I'm in healthcare and it's hard. At least here in the UK the NHS is big annd
slow. They prefer large vendors like Microsoft and Philips over smaller agile
startups. Our users (Doctors, Nurses, Pharmacists) are not our customers (Bean
Counters, Management) and that makes getting good products that can help hard
to get into the users hands.

But the possibilities for improvement are huge and you will make a real
difference to the lives of people which makes getting your product adopted so
much of a sweeter victory.

My advice is do what makes you happy, and if possible improves the world in
some way.

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yummyfajitas
Another thing to consider: in the US (assuming you plan to market in the US),
2/3 presidential candidates have proposed variants of socialized health care.
The "conservative" candidate is a "maverick", who is not averse to doing
similar things.

This doesn't bode well for long term planning. In 4-5 years time, who will the
buyers be? Doctors, hospitals, or some American version of NHS? What
regulations will you need to satisfy?

If the healthcare system is taken over (in any sense) by the government,
expect major rent seeking from various special interest groups. M$ may
purchase a "M$ software only" law, or hospital administrators may purchase a
"don't let software steal our jobs" law. (Such laws will, of course, go by
such names as "Helping Children not Die of Cancer Act").

In short, I'm saying that unless you are a lobbyist, stay away from this
market for a few years. Do your real estate thing, come back to healthcare
once the market settles down.

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nkohari
Wow. Pretty cynical take on American politics. :) Not saying that you're
entirely wrong, but every industry has regulatory burdens to deal with. Real
estate has their own challenges, including predatory lending laws, etc.

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yummyfajitas
I'm not saying to avoid it because of regulatory burden, but because of
_unknown_ regulatory burdens.

You can plan for known regulatory burdens. For instance, in the automotive
industry, just add millions of dollars worth of safety testing to your R&D
budget. If the business plan still works, run with it, and calculate odds. In
the defense industry, make sure you hire lots of lobbyists.

It's the unknown unknowns, not the known unknowns that will kill you.

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mixmax
Do what you love.

Money is only means to an end, the end being happiness.

If you spend 8 (or 12) hours a day doing something you don't like you won't be
happy.

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jyu
How do you know what it is you love? (Maybe by asking that question, I don't
really know?) How do you go about finding what it is you love to do? On the
same token, as long as I'm doing and learning a bunch of new information
constantly, I can usually find interesting problems to solve.

Money buys freedom, opportunities, and most importantly time. I don't want to
be a slave to my debts and habits, which is why I'll be debt free by age 25.
Money certainly is not everything, but it's definitely a factor.

~~~
mixmax
Good point.

There's a quote from an eccentric Danish Millionaire that says "Money can buy
almost everything, and the things that it can't buy are free anyway"

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iamelgringo
I've worked in health care for the last 15 years, and I really don't think
that it's a viable field for startups.

Any device that you'd develop that touches a patient has to get approved by
the FDA, and that takes millions of dollars and years of studies. I was
involved with a company that subcontracted studies for drug approval. Each
study was a couple of million dollars, and you had to do multiple studies to
get through each phase, before a drug could be released. It's a nightmare.

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aneesh
healthcare is definitely ripe for change. but it is one of the hardest
industries to solve problems in. the payment system is so complex, the
customers aren't the decision makers, and they're not the payers either. so
you have to keep lots of people happy.

so don't just go into healthcare because you don't like real estate.

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davidw
Real estate looks to be in a bad spot right now. Health care is only going to
grow, with aging baby boomers. Health care seems a lot more like doing
something that will leave the world a better place.

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Spyckie
I would be more worried if real estate was boring and stagnant. Real estate
looks bad right now, I'll admit, but oftentimes a shakeup is useful for
companies entering the market space. (Decouples people from old methods and
products, and also allows for new business processes).

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skmurphy
Do both. Start a business you understand and start now on educating yourself
more deeply on the issues in health care. To me the single largest opportunity
in real estate is to move away from the broker model to a fixed fee model with
guaranteed service levels. This would allow a focus on productivity and value
added service, but my experience is much more limited than yours.

The only place that a market current functions in health care is cosmetic and
other elective surgeries. Because the patient pays a number of incentives are
aligned that are disjoint in the third party payer (e.g. employer / insurance)
model. If you could find another medical practice that patients could pay for,
a lot of startup opportunities would flow.

Entrepreneurs work from available means to ends, start with what you know well
and work (assuming you have passion for it) and learn more about the aspects
of healthcare that energize you.

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dkokelley
Like what was said before, real estate is not doing too well, and if your
application would require a high market then it might not work too well. On
the other hand, it is entirely possible for someone to make money a few years
from now by taking advantage of the low market right now, so it depends what
type of market your application would thrive in.

If it were me, and I were only 4 months away from eliminating my personal
debt, I would go for the short term gain. I don't know what your financial
situation is like in terms of steady income or savings, but if you're still in
debt, I wouldn't recommend something that will take longer to pay off it it
does at all.

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edw519
"think consumer web apps and most web 2.0 "start ups/businesses" can go to
hell"

Fine.

I'm not going to challenge your opinion (you may be right).

I AM going to challenge your attitude.

You come to hacker news and insult (with profanity) that which is very
important to many of us here. And then ask for advice.

So here's my advice:

Maybe you just came across wrong to me in writing; it's easy to do - I've done
it myself. I should give you the benefit of the doubt, but I won't because
most others won't either. Before you consider any career move, I'd suggest you
seriously consider evaluating your people and communication skills. I don't
care what you pick, if you turn people off like you just did to me, you will
have problems succeeding. Maybe I'm in the minority here, but I suspect not.

Show me that I'm wrong about this, earn some trust, and keep asking for help.
Interesting to see how this turns out.

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jyu
You know, you're absolutely right. I was out of line with that comment, and I
see how people could pretty easily take offense. Thanks for your honest
feedback, and I will keep a careful eye on this type of behavior.

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edw519
Don't be a stranger. Let us know what you decide and how it goes. Always
interested in success stories from those who aren't chained to their terminal
all day (and night) long.

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ken
Talk to the Estately.com guys. If nothing else, you can hear how much fun it
is trying to change the real estate market via the startup route. They'll
probably also be happy to tell you about all the roadblocks the old-school
real estate folks put up just to prevent this. And they're all-around cool
guys with lots of interesting stories.

(No, I am not one of them, but I had a beer with them once.)

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jyu
Thanks, will do!

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ericb
I built an apartment rental listing site in rails for a now-defunct startup.
Maybe it could fit what you're thinking about. I'd be interested in hearing
your ideas (although I'm in the middle of a different project now). I'm
ebeland on gmail if you're interested in talking about it further.

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konsl
I think the fact that you lack insight into yesterday's healthcare industry
works for you -- it's an industry that's desperately in need of fresh
perspective. These "insights" can blind you from new opportunities that may
shape tomorrow's healthcare industry.

Both industries are ripe for change, but if healthcare's grass looks like it
can be greener, go for it. You have 4 months to explore its problems.

"When you're green you grow; when you're ripe you rot"

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tel
Healthcare, as many others here point out, is difficult, bureaucratic, and
potentially unstable do to the political climate; however, medicine is no so
bad overall. There are medical technologies growing constantly and while it
does involve a little more initial investment some of these areas approach
"startup" levels of innovation and risk.

I'd suggest there may be more variety on the "healthcare" side the real
estate.

