

Ask HN: Non-hacker doctor wanting to start a health startup. What should I know? - drthrowaway

I'm a physician who's always had the desire to build a startup and really shake things up. With the huge rise in iPad usage amongst my colleagues and myself, and the growing realization within the hacker community that the health sector is in desperate need of disruption, it's safe to say that health/medicine is going to be an extremely hot market in the coming decade.<p>As a physician at 35 with no technical background, I cannot help but feel powerless and useless; I do not have the skill set to cause disruption by myself. However, I'm not letting that stop me and am willing to dive head-first into developing my technical side. I should ask, though, whether doing such a thing would be feasible at my age (learning to code, etc), and whether my current educational background and training would be sufficient a contribution to a founding team. If yes to the former, what technical skill-set do you suggest I begin developing? If not, what would be the most feasibly attainable, yet valuable, skill-set a physician like myself could acquire to supplement my domain knowledge that you, as hackers, would find most helpful? I think it's the perfect time to try my hand at the startup game, and I don't want to miss this boat.<p>Thank you for your time.
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arn
Hi,

Former physician (nephrologist) here. I quit medicine in 2008. I find your
question a little confusing. Like others I question why you want to learn how
to code. I mean, I guess it comes down to what your plan is. I realize we are
on hacker news but startup doesn't always equate software company.

Uptodate was started by a Burton Rose, a nephrologist. I don't know the
history of that business, but I doubt he sat down and coded the website
himself.

Presumably, the value of you working on a startup is related to your medical
background, and the expertise that entails. Not spending long hours of not-
much-free-time trying to learn how to become a mediocre programmer. I don't
see how your changing the world is going to be based on your programming
skills.

The converse situation would also make little sense. "I'm a skilled programmer
of age 35 who wants to create a medical record start up. I'd like to learn how
to diagnose patients in my free time..."

~~~
drthrowaway
My interest is in more tech-based medicine (iOS, web, practice software, etc).

The consensus seems to be that I focus on deepening my domain-knowledge and
forgo getting involved in the technological side.

Thanks for your response.

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2mur
I'm a physician also (pathologist). I would encourage you to learn how to
code. I decided to learn python about 3 years ago. It took me about 6 months
before I really understood a lot of things (object oriented programming, in
particular took a long time to grok). I mostly started with the goal of being
able to knock together some little gui fronted databases and other things that
would make my life a little easier. Now I mostly fart around with Django,
javascript and Java (Android). I'm also learning C because I realize that I
have a lot of holes in my fundamentals.

I don't want to discourage you, but I think that there are a huge number of
roadblocks to creating a disruptive start-up that we usually see on HN in the
medical world. Firstly, doctors are not the folks who are making the decisions
about health care IT. The hospital IT depts are running that show, and in my
limited experience they have no interest in supporting open-source or services
that don't come with a big support contract. They would like to be able to
point the finger to an outside company if things go south. Secondly, HIPAA and
HITECH are going to be a big problem for small medical startups. A single
breach or unauthorized disclosure or security hole is going to potentially
sink your business.

I would encourage you to learn to code. It's definitely accessible for tech-
oriented physicians and the wealth of community resources in the open source
world makes it pretty easy to ask questions if you get into a bind.

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gharbad
Do you want to create a product to serve a market, or do you want to learn to
code? These, while related, are very disparate problems.

I would suggest you find a technical founder that shares your vision for
wanting to help make people's (hopefully the niche you're aiming at) lives
easier.

You have experience that many (almost all) hackers lack: you have real
experience working in a field and have identified a product/market that people
want/need. Focus on that. Build user stories on what you want to create. Make
diagrams of the interactions. Feed your vision to someone you respect that can
make it real.

Unless you are extremely interested in the core of technology, you will likely
find writing up a completed product exceptionally difficult. Writing code can
be difficult, but it can be even more tedious. I'm not sure I have any way to
express exactly how tedious many of the tasks that go into a release really
are. This is why shipping a title is so important in some fields (eg: games).
It is also why it is so important to find a technical founder who deeply cares
about the market segment you're after.

~~~
drthrowaway
Thanks for your reply.

I ultimately would like to create a product/service to serve a market;
although, I can't say I don't have an itch to get into code.

One reason as to why I posted this is because I wanted to hear from hackers
whether a physician with nothing more than domain-knowledge would be able
enough to provide significant contribution to a growing startup. I've lurked
about for some time and have noticed a stigma against non-hackers looking to
start up.

But your post is reassuring and encouraging.

~~~
baltcode
So short answer -> you will be able to provide significant contribution! I
would recommend also trying to get your head around things that are possible
in code rather than coding itself, so you are able to analyze scenarios. e.g.,
keep a table of patients and medications on the server, serve reminders on the
doctors smartphone, call up best rated doctor, or whatever. Also, try to
understand what is not possible, e.g., automatic algorithm to diagnose (too
complicated).

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freerobby
If you're reasonably strong in mathematics, you can learn to code basic
concepts pretty quickly. Unfortunately, there's not shortcut to learning to
code _well_. But that's okay - at a super early stage, being able to assemble
a prototype that will never go live could still be very valuable.

That said, I'm not sure learning to code is the best use of your time. Given
how murky health care is, an inside knowledge of the industry should be
immensely valuable to a startup, especially when it comes to demonstrating
formidability and landing early biz dev relationships. You might be better off
working on on the ins and outs of daily business, inbound marketing and
fundraising, so that you can support your team while they build whatever it is
you set out to build.

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malandrew
Focus on user experience and interaction design first. Learn to code not with
the intention of building the app yourself, but with the intention of becoming
familiar with what is possible with today's current technology and
technologies which will become commonplace in the near to mid term.

Why?

Because as Wayne Gretzky said, you need to skate to where the puck is going to
be and not where the puck is.

Where the puck is going to be is eliminating a lot of what doctors routinely
do today by putting the tools in the hands of consumers.

90% of what general practitioners do today is simply glorified pattern
matching. And they do an imperfect job at that. Computers are much better at
pattern matching than humans for most tasks. The problem in the field of
medicine is that we lack the tools to take the input from patients and put
them in a form that is usable for most patients.

iPad tools designed by doctors for laypeople to use are going to be the single
most disruptive force in medicine IMHO. Creating iPad apps for doctors will be
a far second or even a largely temporary category of apps. What I would be
skeptical about is apps made by doctors for doctors. There are certainly going
to be good ones out there, but I expect many to suffer from the "designing it
for me and the way I work instead of the designing it for doctors and the way
all doctors work" problem.

Start looking at everything you do as a doctor and start asking the possibly
painful question: "How could what is possibly with today's technology possibly
replace the work I routinely perform?"

You want to learn to code to learn what is possible.

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xm1994
Forget learning to code, it's probably a waste of time and you'll miss the
boat. Your medical background is by far your strongest asset.

I suggest you find yourself a technical co-founder or someone that would be
willing to work on a prototype with you. Even if you have the means and are
willing to pony up some capital having someone technical that cares about the
idea and end-product is pivotal to your success. Additional capital can speed
up the process of course.

Why you shouldn't learn to code? The medical field is one that a hacker alone
can't crack. Sure we can figure out what a user is looking for when we're
designing a flight search interface - but if the end customer is a physician,
being an actual physician is a huge advantage, both in designing the product
and in speaking the same language as the customers (assuming they are also
physicians).

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geekam
>>__whether doing such a thing would be feasible at my age (learning to code,
etc), and whether my current educational background and training would be
sufficient a contribution to a founding team__

Last time I checked, this field had no age bar. Honestly, you're most welcome
to shake things up. If you have the vigor, which your post says you do, you
can do it. Also, the support from communities like HN is amazing and worth
giving a try.

HN also has a contractor list
[https://spreadsheets.google.com/ccc?key=0AlD_6iEb8Ed9dGs3clV...](https://spreadsheets.google.com/ccc?key=0AlD_6iEb8Ed9dGs3clVJYi0yYVBka181Z0ZKRW9kQ0E&hl=en#gid=0)

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znt
Try learning at least a bit of coding so that you can communicate clearly when
you find a technical co-founder. Also preparing a document or something
similar to introduce domain specific terms to the potential technical co-
founders should be useful.

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petervandijck
You won't be coding it yourself, you'll be showing it to fellow doctors to get
feedback.

Learn the basics of user research, usability testing etc.

I would also dive into the existing apps, existing industry and analyze its
weaknesses/strenghts.

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keeptrying
I just quit my job to work on my startup ideas. I'm very interested in the
area of Health. Email me at railsnoob at yahoo dot com - I would be interested
in hearing where you think the pain points of the industry are and your ideas.

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imechura
I would recommend you pair up with someone technical who will help build the
solution and provide guidance to learn the technology if that is what you
want. If you are located in the Dallas area email me.

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mw63214
A strong relationship with someone who knows every bit of the regulatory
system involved with health care would be a good idea too.

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bhousel
Are you in the NYC area? If so, email me using the contact info in my profile.
We may be able to work together on something.

