

Ask YC: How fulfilled are you with tech entrepreneurship? - kyro

It's time to dig deep within ourselves and get a little mushy.<p>I feel, well I know, that I have a passion for both entrepreneurship and medicine. Both passions are very time and labor intensive and to most people seem like two mutually exclusive passions, with no room to pursue both. Ideally, however, I'd be able to mesh the two and pursue an entrepreneurial project with a medical flavor.<p>I'm at a fork in my life's road right now. Look down one path and you see a long arduous road to M.D.-ship. I feel that being a doctor, you acquire an invaluable ability to help people directly, helping them retain, maintain, and improve the most precious attribute to human nature - life. Everyday, you're helping people grasp and grip onto their last thread. In my opinion, there's great fulfillment found in knowing that you're saving a brother, a son, etc., but it requires roughly a decade or more of your life, depending on specialty. Drive down the alternate path, and you get an exciting adrenaline filled life with extreme highs and extreme lows. You're out on your own leading a team to success during your youthful years. You're on the bleeding edge of tech, steering the ship into newly found waters with the hopes of finding untouched hordes of fish just waiting to get caught. And if you find yourself in dead waters, you refocus, and make way in a new direction full force. But zooming out, in the end, it's just a web page, a new widget, etc. Not to belittle the whole field, because God knows I love it all, but do you find fulfillment in that? Do you feel that you are using your life to fulfill an honorable purpose?<p>I feel that if I give up medicine, I'd be giving up a chance to truly help people, and have a direct and positive effect on others, yet if I pursue it, I'll be missing out on the young exciting 'I make my own rules' type of entrepreneurial life I've always dreamed of living. Hopefully, I can drill my way down the middle of the fork and forge my own path.<p>EDIT: I'm not just asking for advice. I'm curious as to find out what people in the tech entrepreneurship field feel towards the purpose they're working to accomplish.
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iamelgringo
I've worked in ER/Critical Care for the last 15 years of my life, and I'm
almost finished with my degree in software engineering. I've gotten a lot of
flack from people, because I'm leaving a "caring" field and pursuing "living a
life in front of a computer" or "making a better mouse trap".

So, I've had quite a long chance to think these issues through. And, I've
thought a lot about medicine and health care as well as it's limitations in
terms of being rewarding.

One of the biggest problems that I have with either nursing or medicine, is
that to get into the industry, it's tall barrier to entry. But after you're
in, it's hard to get kicked out. You pretty much have to molest someone,
recklessly kill someone or be on drugs to get booted out of the profession.
And, that leads to a large set of problems. There are personality disorders in
health care that simply would not be tolerated in the business world. I've
seen people yell at each other, physically assault each other, throw dirty
scalpels and charts. What other industry would tolerate that without involving
the authorities?

Another problem that I see this: as an individual committed to growth and
learning, is that there is no financial reward for becoming better at my job.
It essentially becomes a volume business, not a quality business. If I am
phenomenal at starting IV's or phenomenal at diagnosis or perform great life
saving feats requiring inhuman feats of physical endurance--my bank account
doesn't look any prettier. As a nurse, I'm rewarded for hours worked and more
to the point for overtime worked. This produces nurses who work tons of
overtime, especially during nursing shortages like we have now. And on the
medical side, doctors get reimbursed by diagnosis or procedure, not by quality
of work done. So, the doctors who make the most money are those who see the
most patients, or who perform the most procedures on patients. In fact, if I'm
not mistaken the highest paid doctors tend to be those who perform generally
needless procedures: dermatologists and plastic surgeons.

But, as an entrepreneur, I get to make things and build things. Perhaps I
don't save a life every day I go to work, but I can build something that can
make thousands or hopefully millions of people's lives a tiny bit better, and
that's pretty rewarding. Imagine how many people's lives have been improved
because of Google. How many people now can earn a living because they are
proficient at the Microsoft Office suite of applications? I know that I
certainly consider my life to be qualitatively better because of innovative
technology like the internet, cell phones, computers, better monitors, better
user input devices, web applications like Gmail, Twitter, Hacker News,
Slashdot, etc... How much financial benefit do you think that web apps like
Ebay or Craigslist have created for the nation if not the world? How many
people have been reunited with old friends because of Facebook or MySpace?

Those products don't get made without startups and entrepreneurs. Those
products all help people. And, the best part of all... If I can make a product
that a lot of people find benefit in, I get financially rewarded for the
benefit that I can bring to other people.

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menloparkbum
You have described a very romanticized and inaccurate picture of both medicine
and tech startups. I come from a family of doctors and most doctors are not
directly saving lives on a daily basis. Likewise, the work in a startup can be
incredibly mundane.

I could paint an equally distorted portrait of both fields: Do you want to be
stuck at an HMO, explaining to crabby hypochondriacs that you can't just give
them a script for oxycontin based on website printout they are waving in your
face? Or would you rather stay up until 4 am every night restarting the server
while your business partner tweets about doing shots next to Arrington at 111
Minna?

Anyway, that was mainly an exercise in creative writing. The only real advice
I have is that if you have any inclination to do work in a medical related
field, it is a good idea to have an MD. I've worked on biomedical software
projects and was always just a paid lackey.

I knew a kid in boston in medical school who ran a successful web-based
startup part-time while he was in medical school. He was a "kid" too, I
believe he was 18 or 19 years old. Thanks for bringing this up, I should see
where that guy is now.

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kyro
I am fully aware that both fields have their dry/monotonous/painstaking
moments. Hard work and consistency is pretty much required to succeed in all
fields. I was just mainly looking at the idea of fulfillment, and the fact
that you can give up a decade for one type, or jump right into real life as a
younger individual in pursuit of a different type.

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menloparkbum
It depends on what your actual options are. If you have a great startup plan
that you are putting on hold, maybe it is worth avoiding med school. If you
plan on being an entrepreneur anyway, you don't have to give up a decade, you
just give up 3-4 years - you don't have to do a residency.

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skmurphy
Modern medicine is in desperate need of entrepreneurial approaches. Finish
your training and practice for a few years so that you understand the issues
deeply and can address them with authority. If you are entrepreneurial you
will find a way to blend it into your practice. It's not too late to start a
company in your 30's once you have gotten a thorough exposure to the issues.

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ardit33
My current company that I work for, was started by three people in their late
30s early 40s. 6 years later, it has 230+ employees and it is doing pretty
good.

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jsjenkins168
Would you be content studying medicine while others were running around
creating successful startups? Or would you feel a bit like a grounded child
having to watch his friends play outside?

If you love helping people then medicine can be a good choice. But practicing
medicine has changed considerably in the last 10-20 years with managed care.
While I come from a family involved in medicine, I was always encouraged to
pursue my passion for computers instead because the rewards of being a doctors
are just not what they were. You might be painting a picture a bit too pretty
for the lifestyle of the average doctor.

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davidu
Do both, like my doctor:
<http://www.nytimes.com/2008/04/15/health/15well.html?8dpc>

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monological
You can look at it this way...

Taking the entrepreneurial path will equip you with a multi-faceted skill set,
kind of like a swiss army knife, and if all goes will, some money in the bank
too. In my opinion, you can use the skills and capital to develop a product or
service that could help people on a much larger scale. However, in the end, we
still need a doctor in the house. God knows you love it all...I suggest you
start asking Him what you really should be doing.

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sonink
It seems like entrepreneurship is what you are really excited about, but
medicine appeals more to your altruistic self.

Clearly, you should go for entrepreneurship - also there are going to be ample
opportunities in entrepreneurship to truly help people - possibly have a
bigger impact then you might have by studying medicine which will take care of
your altruistic leanings.

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hpvic03
If you are successful as an entrepreneur you could do much more good with the
wealth you've created than you could as a doctor, even if you spent the rest
of your life helping people one on one.

That said, success is far from guaranteed.

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iloveyouocean
Have you also posed this question to a Medical Forum? Of course the people
here are going to advocate entrepreneurship.

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LPTS
You can probably have a bigger impact on health as an entrepreneur than a
doctor.

I'm working on a start up addressing the medication adherence problem. I think
a solution to a problem like that helps more people then an MD in most
circumstances would and represents the exciting lifestyle you love. I think
you got yourself a false dichotomy set up.

It sounds to me like you have a passion for technology and a guilt issue
around helping people with health care. You're saying "on one hand, I feel
obligated towards A, and on the other, I've dreamed of B."

From what you said, I think you should stick with tech and find a way to work
on a start up that could produce equal health benefits to an MD. I
particularly think you shouldn't get an MD. You sound like you really don't
want to get one.

Feeling like most of web 2.0 would be a waste of your life bodes well for you.
It means you have high personal standards and clearly perceive the big picture
when most people are distracted. You should feel fine belittling almost the
whole field. Most of them are wasting their lives on completely frivolous
things. Especially the ones who get by on ads. If you don't feel comfortable
clearly criticizing people without sentimentality, you will never be able to
manifest your high standards.

But the frivolity and lack of moral vision common to most start ups are not a
prerequisite to starting a company. It's false that giving up medicine costs
you a chance to truly help people. Apply technology in such a way that it has
medical import, with high standards, and you can have your dream and help more
people than you would as an MD.

