
Ask YC: Profit: $25/user. Customers: satisfied. Competitors: none. Target market: huge. But... - tkiley
My startup's service:<p><a href="http://www.inquickersmyrna.com/" rel="nofollow">http://www.inquickersmyrna.com/</a><p>Customers love the service, and they say it's worth the price of $25 per use.<p>The bad news: Right now we're only serving about 1-2 customers per day.<p>My goal is to move the site from 1-2 users per day to 10-15 users per day; I think if we could pass 10 users per day, it would be easy to persuade other hospitals and urgent care centers to participate, and it's all downhill from there.<p>How would you raise consumer awareness for a service like this? I've tried a few things (mostly offline), but none successful so far.<p>(If you're still reading: So far I'm the only person working on this business. I'm looking for a person with strong ui + graphic design, seo/sem, and/or copywriting skills to work with -- initially as a contractor, eventually as a co-founder. Interested? E-mail me.)
======
dcurtis
Hmm. Interesting idea, but I see several extremely big problems.

First, you're relying on patients to triage themselves and determine if their
condition is life-threatening. You do not emphasize that the service is for
CLEARLY non-life-threatening problems. It should have a huge banner that lists
some symptoms and says to call 911 or drive to the ER immediately. Maybe there
should be a system for a triage nurse to monitor the "symptoms" of the people
who sign up and call them if he/she thinks it's serious.

Second, if someone signs up and doesn't think their illness is life-
threatening and then dies, you/your company can be potentially liable for
that. I have a feeling insuring yourself against that will be expensive.

Third, the brand is really horrible and the site isn't exactly easy to
navigate. But you mentioned you need a UI designer (I emailed you), so at
least you seem to recognize that.

Fourth, I would not pay 25 dollars for this service. Maybe you can work out a
deal with the hospital to pull this fee out of the flat ER cost. That would be
awesome and you'd have tons and tons of people use the system, especially if
it's well advertised at the hospital.

The idea is cool and for major trauma centers in metropolitan areas where the
wait can be greater than 7-10 hours, it could be extremely valuable.

------
joeguilmette
i dont think marketing to end users is the way to go. like someone said, no
one cares about an emergency until they are in one.

market to hospitals. get integrated into their website. when someone calls
their ER, make sure the nurse tells them to register on the website.

i think going white label is your best bet.

but yea, this is probably the best "Ask YC about my idea" i've seen since i've
joined. you're not selling ER software. you're selling software that helps
people wait in line.

think of other markets that could use these tools, and then sell it to them as
well.

~~~
iamelgringo
I moonlight as an ER nurse as I finish my Software engineering degree next
summer. I've worked in ER/Critical care for 15 years, and I've worked at over
25 hospitals as a contract nurse, and while your idea sounds good on paper,
it's a medical/legal nightmare.

How fast you see a doctor in to an ER is not about being on a wait list. It's
about how sick you are. If you're close to dying you get in right away. If
you're not, we see you as soon as possible. Even then, it's not first-come
first serve. And, if you're not here, you're not on the list, and there are no
reservations.

And, I can't tell you how many people _think_ they don't have something life-
threatening and end up dead. And, there are many people who think that their
illness is life threatening and it's not.

All it takes is for you to place one person on a wait list who ends up dead,
and you're having a number of long talks with a law-firm. I'm not trying to be
a hater, or flame you. I'm the last one to discourage an entrepreneur, but I'm
really concerned someone will end up dead, and you'll have a _big_ mess on
your hands.

Please, rethink your business idea.

~~~
yubrew
haha, iamelgringo, you beat me to bring up these comments. let me add on a bit
to what you've already said.

hospitals are not just run as businesses, but they also need to serve the
public. as such, you also have ethical and social concerns. there are a
several substantial problems with your idea:

-promotes inequality of care based on money. this will likely turn out to be a huge legal issue. 

-the decision of something being life threatening should not be determined by patients, but by health professionals.

-substantial change to hospital behavior. the act of creating and incorporating reservations to the ER system will likely be a shock that hospital administrators will not appreciate. (just look at how long it took for doctors to move from beepers to PDA's and cell phones, and also look at the adoption of electronic medical records which is still less than 18% of all doctors) making hospital staff jump through new hoops will increase the resistance of using your technology.

please do not take these comments the wrong way. your idea could work, if you
tweaked the business model around hospital constraints, and nothing specific
is popping up right now. perhaps other areas where waiting in line is a pain
that people will pay for?

~~~
cstejerean
Try to sell this service to government agencies where usually the wait times
are ridiculous. Personally I would feel weird registering online for a visit
to the ER. I'm either sick enough and I want to go there NOW or I'm not that
sick and I can just see my regular physician when he has time.

------
corentin
> How would you raise consumer awareness for a service like this?

I'm not sure that "diluting" your message in the press will be very efficient.
I may be wrong but I guess people don't really care about emergencies unless
they need it.

I would instead spend a day (or a few days) in the emergency waiting room (or
ask a doctor there) to see if there are "typical" cases of non-life
threatening emergencies. Then I would directly bring the information to those
people (e.g. skaters).

edit: your domain name really sucks. There's no way someone will remember this
or even type this with a broken hand.

~~~
tkiley
Great idea. I've done some limited research, and it seems that this site would
appeal very well to people who have some type of infection that has worsened
over a period of days. I've spent some dollars on adwords for "fever" and
related terms, but that hasn't been terribly effective so far.

Right now I'm working on a plan to market the service to schools, hotels,
amusement parks, retirement centers, sporting arenas -- basically any place
large numbers of people are gathered. It seems promising so far (fingers
crossed, nose to the grindstone :P)

Thanks for the input.

~~~
shiro
It might be also useful for parents with small kids. If you got a 104F fever
on Saturday night you just take some pills and sleep over next day to see how
it goes. If your kid get 104F you don't want to wait for your pediatrician to
open their office on Monday. (Or, if your kids put a pill in his nose and it
won't come out at 9pm; that happened to us).

If you can put your brochure in the "packet" the new parents receive from
pediatricians or hospitals, that might help.

~~~
jimbokun
Seconded.

Don't remember the last time I went to the ER for myself. With 2 boys in the
house (now 3 and 5) we had a stretch of 3 visits to the ER in one year.

------
bmaier
What a great idea.

The way I see it, there are a couple ways to work with it.

1) You've found a size hospital that it works well for and you get resistance
when trying to go to bigger hospitals? The forget the large hospitals and find
hospitals that match this one's profile around the country. Interesting niche.

2) Use the technology and apply it to any place that you have to wait in line
(for a table at a restaurant, public golf courses, etc...)

What else am I missing?

~~~
paulgb
Agreed. Lines are a waste if you look at them from an economics point of view
- people willing to wait for something would almost always be willing to pay
more to have it right away. but businesses are throwing that opportunity away
because they don't have the technology to fix it or they don't see the
problem. It is cool to see someone solve the problem with software.

I wish I owned a grocery store, because I think it would be a neat experiment
to post a different markup rate for each cash register, and see what would
happen. For example, one cash register charges the advertised price (+0%),
another +5%, another +10% up to 40%. At certain times the +0% line would be
the obvious choice, but what would happen in the rush hours?

~~~
mechanical_fish
I have no data, but let me make some off-the-cuff predictions about your plan
to create "premium" supermarket checkouts:

Customers who understand your novel scheme will tend to queue up in the line
which has the lowest prices, because people do not consciously understand what
their time is worth.

Then other customers will see the long line at the discount aisle and
subconsciously decide to leave your store without buying, because the lines
are too long.

Or perhaps, instead of abandoning their attempt to buy anything, frustrated
customers will notice an apparently empty checkout line with a cashier
standing there. They'll approach that line, and be told that that it's a
"premium lane" which will cost them an extra 5%. Then they will become
enraged. Nobody wants to pay extra for a service that they're accustomed to
get for free. And when they're told that they can always stand in the long,
less expensive line, they will continue to be enraged at the sight of one or
more cashiers standing around idle in the premium lane, waiting for premium
customers, when those lazy cashiers _could_ be helping out in the discount
aisles! What do we pay those bums minimum wage for, anyway?

Inevitably, unless you are on-site breathing down their necks, your cashiers
will give in to popular pressure and go to work in the discount lanes. At
which point the premium lanes will have no cashiers, and nobody will use them.

Of course, if grocery stores were more like emergency rooms -- scarce, high-
margin businesses which routinely force you to wait two to _eighteen_ hours
for service -- things might be different.

For info on shopper behavior from a guy who actually _does_ have data, I
recommend Paco Underhill's _Why We Buy: The Science Of Shopping_.

UPDATE: I have the answer! You could invent a scheme where customers who want
to avoid waiting in line can trade their own labor for a shorter wait -- by
scanning and bagging _their own groceries_ at an automated kiosk. Suddenly,
via a series of psychological tricks, your idea works well. I should patent
this amazingly original variation of your idea. :)

~~~
froeber
So re-label it as a discount line. People who are willing to shop at odd hours
or are willing to wait during peak times can save 5-10%. Meanwhile mark the
rest of your stuff up 5-10%.

Not sure whether people pay enough attention to their grocery bills to tell a
5% increase, but I hear grocery store margins are terrible (like 2-3%) so
maybe they would. It's tough to tell without some data.

Good idea though.

------
DanielBMarkham
Interesting comments!

I thought I'd post again, because I wasn't so clear the first time. Let's try
again.

1) You DO have competition. Almost nobody has NO competition. Competition #1
would be "do nothing". There are other competitors.

2) This has probably been done before -- many times in many venues. You should
find out where and why it did/didn't work out.

3) I hear you say you want to generalize to all kinds of things: doctors,
grocery stores, banks, etc. Take a pill on some of that. If this has been
tried before and failed, then you're going to need to grow organically inside
one vertical -- then spin out. Waiting in line at an ER is just a different
problem (both business and technical) than waiting in line at a car wash or
something. Learn how to sell into one market well, first. Dreams are grandeur
are probably a little premature. Mind your knitting.

Hope that helps some.

~~~
dcurtis
"Do nothing" is not called a competitor, it's called a barrier of entry.

~~~
tkiley
There is a distinction between competitors and alternatives; "do nothing" is
the latter. I'm not foolish enough to think there are no alternatives, but I
do believe there are no competitors to my service right now.

~~~
DanielBMarkham
Look, I'm not trying to argue with you. I've been in a spot with ideas that
didn't have competitors too. First thing I was told was that there's always
competition.

Now you can look at it as alternatives, but if you are competing with these
other alternatives in the mind of the prospect, guess what? They're your
competitors. Alternatives that people have to doing your thing is called your
competition, even though it might not have a logo and an office.

You can split hairs and try to call it something else, but that's the way I
was taught. And I don't think splitting hairs will help much. You are in
competition with the status quo, with inertia, with the tried-and-true. Your
main goal is to get people to try something new. As far as I know this is a
well-established piece of sales and marketing knowledge.

[http://ezinearticles.com/?Sell-More,-Make-More-by-Knowing-
Yo...](http://ezinearticles.com/?Sell-More,-Make-More-by-Knowing-Your-
Competition&id=393169)

<http://www.businessknowhow.com/marketing/knowcomp.htm>

[http://opinionatedmarketers.blogspot.com/2006/12/other-
day-f...](http://opinionatedmarketers.blogspot.com/2006/12/other-day-friend-
and-i-were-discussing.html)

I think you've got a good idea. Good luck with the implementation.

~~~
tkiley
Interesting. I'm starting to see a lot of business-related terms that mean
different things to different people in different fields (for instance,
"securities" means "bonds" to a tax accountant, but "stocks+bonds+etc" to a
financier). I'll certainly be careful with such distinctions when talking with
investors, clients, etc.

Thanks for the input.

~~~
DanielBMarkham
Yeah it's a biz term.

Perhaps non-intuitive, but the point is that you have to figure out how you
are getting customers, whether that is changing their mind from "option X" to
your service, or changing their mind from "doing nothing" to your service.

Some businesses don't bother to do that work, instead just saying "I have no
competition" -- I'm sure you know that you don't want to go there.

As a side note, I'm really curious as to why I was down-modded up above there.
I was simply trying to share stuff I know. Don't know why it would tick
anybody off. People are welcome to have different opinions, and I'd like to
hear about them instead of getting down-modded. If I'm wrong, I want to know
about it! (That's kinda the point of commenting to begin with)

------
jdavid
Get an add for it on the automated answering machine at the hospital, clinic,
and or local physician offices.

i think the best way to do this is, via negotiations with ppo groups, hmo
groups, and insurance companies. I could see someone like Allstate being
interested in this, in regards to their current ad campaign about safe
driving. Insurance is a really competitive market place, and I could see this
as a feature add on sell, for a monthly fee. say 10$ a month to auto fill your
paperwork, when you arrive in the emergency room.

you also need to consider that information is so often filled in wrong, and it
makes the billing process hell for doctors and hospitals. if you could
validate someones payment options before they arrived, then the hospital/
doctor might pay for that service just to get more accurate billing info.

medical health care billing is a dirty business and doctors get paid less than
1/2 the time. increase their payment percentage and they will jump at it.

when someone calls in, they will be given the option to fill in the data on
the web via a website.

------
buss
I can't find anything about it online, but going from the word of my adviser
while I was studying in China, there was a woman there who did something
similar to this and is now very wealthy. IIRC, she paid people to wait around
in lobbies and sell their spots when they got called, so people could bypass
the rest of the line. What you are doing, I would say, is more ethical because
instead of skipping the line a customer is just reserving a spot. I wish I
could find some news article about this, but I have nothing. Either my adviser
was lying to me or my web search skills are diminishing. Anyway, good luck, I
think it's a good service.

Go after the big city hospitals where there tends to be a really long wait
time, like Chicago, New York, and LA. Also, try to work in text message
notifications for 15 minutes before the scheduled time.

~~~
dyu
They have that for housing in China too. Usually when a new building of condos
is for sale, only the first 100 (or however many there are) customers can buy
it, so a few days before they open the office, a lot of people would line up
and sell their spots to real potential condo buyers.

------
nostrademons
This is an absolutely brilliant idea, and I'd certainly use it if it were
offered at a hospital near me and I needed it. (I hope I don't, for obvious
reasons.)

I'd try two things to raise awareness. One is a local news story, as mentioned
elsewhere on this thread. The other is to work with the emergency room staff
at the offering hospital - I'd imagine they appreciate something like this
too, since it means fewer frustrated patients when they finally do see them.
Have flyers available for emergency room visitors - they'll be frustrated from
the long wait time, which is the perfect time to offer them a solution. Put up
posters around the waiting room. Try and get on the offering hospital's
website.

~~~
tkiley
You're right -- the ER staff love the service, because patients are in a
noticably better mood when they haven't been cooling their heels in the
waiting room for 3 hours.

The hospital's web site has a link to us on its front page, but this hospital
hasn't invested much in developing their web presence. I'd like our next
partner hospital to be one that has a stronger, more high-visibility web site.

If we could get on the first page of google for "<metro> hospitals" or
"<metro> emergency room" that would be huge, I'd think. (But again, it's a
local service, so getting link-fu is difficult right now)

~~~
nostrademons
Flyers & posters. Have the triage staff hand out a flyer along with the visit
forms. It's the kind of thing that people will take note of and use later, and
they may even tell their friends.

------
Alex3917
There is a lot of potential for really clever marketing. I'm thinking
something like bus billboards that read "Hit by a bus?" :-)

I'd definitely use this if it were available in my area.

------
rms
>How would you raise consumer awareness for a service like this? I've tried a
few things (mostly offline), but none successful so far.

This is the kind of thing with huge mainstream appeal which means you need to
market to the mainstream. PR is the best, do you know any reporters at local
newspapers? If you raise some money or have some money, you can also buy
advertisements in newspapers or magazines or hire a true PR firm to get you
press hits.

------
dfranke
Market the damn thing! Buy advertising! I'd definitely use this service, but
there's no way I'd know to go looking for it.

------
rokhayakebe
This is a great service. I do not have much advices as I do not know about
your industry but I can clearly see the value. Too bad I just moved from
Smyrna ( I lived on Paces Ferry & Cumberland) or I would use it. Good luck,
It's always nice to see startups from the ATL

------
DanielBMarkham
I like it. Keep bootstrapping.

I wonder about scaling past that first hospital, though. Kind of a catch-22
situation -- the hospital has to be small enough to not care about having part
of its records online yet large enough to support a growing business.

~~~
tkiley
Good point. We've had to do some interesting data gymnastics to satisfy the
lawyers at our first hospital, and the bigger hospitals we've talked with seem
even more concerned.

I think it needs to be a compelling service from a financial perspective in
order to get the hospital's legal and financial departments to approve. If we
were able to move 10-15 patients per day to a partner hospital, it could be
adding $1 million/yr in profit to the hospital, easily. Hence the need for
volume before we can partner with more hospitals.

Thanks for the comments.

~~~
DanielBMarkham
Perhaps do a little thinking about who your customers are. Just guessing, but
I would think they are people with a) not a immediately threatening problem,
but one they want to see a doc about, b) have $25 or a credit card or
something and are willing to use it to prevent waiting around, and c) are
internet savvy.

So I'd go looking for a hospital that has a lot of these folks that use their
ER and see if you can't set up a partnership based on the work you are
currently doing with this hospital. Better yet, get a list of 50 such
hospitals and work your way down :) With a high-enough density target market,
you can move to things like radio, doorhangers, or newspaper ads. The
interesting question is whether or not to use SEO, because of the geographical
limitations.

Neat idea. I was just talking with a guy a couple of weeks ago about this
exact thing, except for doctor's offices.

------
andreyf
"Competitors: none" won't last.

This seems like a situation where raising tons of funding and scaling like
hell is your best move. Settle questions of legality in different
cities/states now, before you have competition.

------
mikesabat
rev split with hospitals + terminal in the waiting room. Get biz dev and sign
up hospitals. I'm sure that someone is saying this already in the comments,
but don't have time to read all.

Find the person in the hospital that is having pain (figurative), whoever
deals with the ER scheduling. Start by giving offering the hospital 15-25 %

------
gscott
It is a unique story, try pitching it to the local news, worst they can do is
say no.

~~~
tkiley
Good idea, I'll give that a whirl.

PG and others tend to talk a lot about how PR firms and offline marketing are
irrelevant to online startups -- I think this may be one particular instance
where that's not true. In a way, this is a very web1.0 idea, but hey, it's
something people seem to want, so I'm running with it.

Thanks for the thoughts.

~~~
ed
"Our startup spent its entire marketing budget on PR: at a time when we were
assembling our own computers to save money, we were paying a PR firm $16,000 a
month. And they were worth it. PR is the news equivalent of search engine
optimization; instead of buying ads, which readers ignore, you get yourself
inserted directly into the stories."

<http://www.paulgraham.com/submarine.html>

------
Arrogancy
"Keep away from people who try to belittle your ambitions. Small people always
do that, but the really great make you feel that you, too, can become great"

\- Twain

