Gautam Sivakumar may have tinkered with design and programming since he was a high school student in Northern England, but he always knew what he wanted to be when he grew up--a cardiothoracic surgeon or an oncologist. 

So how did he end up at Y Combinator, the king of the accelerators, at the head of a startup? And how did he make the transition from hospital ward to Silicon Valley?

After medical school, he quickly discovered that though medicine can accomplish some mind-blowing things, when it comes to IT, many hospitals are relying on old-fashioned pen and paper for crucial tasks like transferring notes of the physicians going off duty to the ones taking over.

"I was always frustrated with the lack of good technology in hospitals," Sivakumar says. "It was completely insane to me that within a couple of minutes of my friend falling over in Australia, I could see an HD video of that on my phone, but I can’t access my patient’s blood results from a hospital 20 minutes down the road. And even scarier than that, I can’t even access some critical bit of information my colleague wrote about my patient 12 hours ago."

Each day, Sivakumar recalled, he would come in and grumble with colleagues, until one day he had a thought: In 20 years time, I’ll have a lovely house and a nice car, and I’ll get into my nice car from my nice house on the way to my great job, and on that drive, I’ll think, Awww, man, if I had just gone for it 20 years ago! "I could live with failure, but I just couldn’t live with not having had a go," he says.

So he took the plunge, selling his flat and moving back to his family home to devote himself full time to his idea of developing a tech solution for the problem of doctor handoffs. Medisas was born and attracted attention, getting accepted into Silicon Valley’s most prestigious accelerator, Y Combinator.

But how was the transition from doctor to founder? "Initially, I thought there were going to be lots and lots of differences, and it’s true, I had to learn a lot of stuff, but what really surprised me were the similarities between being a founder and medicine," says Sivakumar, who listed at least three ways being a doctor was good preparation for starting up.

The ABC Methodology

Deciding what to do first under a lot of pressure is key in medicine. “For example, in medicine, when we see a patient," says Sivakumar, "we do things in what we call the ABC methodology. A is for airway. B is for breathing. C is for circulation. Now why is it, when the patient in bleeding all over the place, you go and check his or her airway first? You check the airway first because that’s the thing that’s going to kill the person the fastest.”

Though you hope that no one will end up bleeding at your business, it turns out this is a useful skill in startups, too. "In medicine, we are extremely focused on prioritization," Sivakumar says. "That is absolutely 100 percent true in startups because you don’t have enough resources, and you’ve just got to pick the things that are most important and do them in that order. We try to employ similar tactics when we make any kind of decision at Medisas. Learning about prioritization in a [medical] setting has definitely helped me prioritize tasks with the company."

Bedside Manner

"In medicine, we’re taught a lot about being empathetic and communicating complex medical terminology in a simple way," Sivakumar says, "and that’s become very useful when hiring and talking to engineers and people who don’t really know about this very nuanced workflow that we’re trying to improve in hospitals. Trying to explain things in a way that is not too esoteric is really, really important." The doctor’s well-honed ability to gently break bad news comes in handy as well, he reports.

A Team of Experts

"In medicine, we have this multidisciplinary team approach to looking after patients, because you might need a surgeon, a physician, a dietician, a physiotherapist, a nursing team," Sivakumar says. "It’s about working with all these disciplines to achieve a common goal, and the same is absolutely true in startup land, where you have engineering, product, design, and sales."

These parallels between the worlds of medicine and entrepreneurship are fascinating, but is there any overarching lesson here for the great majority of us who are not headed to Y Combinator by way of the oncology wards? The deeper lesson, according to Sivakumar, is that having a deep expertise outside of entrepreneurship is increasingly an advantage.

"Marc Andreessen has this saying that software is going to eat the world," says Sivakumar. "And if software if going to eat the world, which I definitely believe is happening right now, the chefs that prepare that meal have to have an expertise in technology but also the domain that they’re trying to tackle." (Not incidentally, YC partner Jessica Livingston recently agreed with him in an interview.) "What if you imagined two doctors getting together and saying, 'Let’s go build this great programming tool'?" Sivakumar adds.  "It’s a ridiculous idea, but when you flip it around, this happens all the time."

Which isn’t to say making the switch to founder was entirely smooth sailing. "In medicine, you have this team," says Sivakumar, "and there is less reliance on you to do everything. There’s this net around you, but in startup land, that’s really, really not the case. It’s you or nothing, and that was definitely a big switch. One day, you have all this support, and the next day, it’s just you and an old laptop."

The final takeaway then may be that entrepreneurship is a hard and lonely road for everyone, but it’s not necessarily harder if you’ve traveled far down another professional track already--in fact, it may be easier.




Published on: Feb 6, 2014
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