Ethan Weiss, a cardiologist at UC San Francisco, spends long hours at the hospital treating patients. But between shifts, he takes calls with health-technology entrepreneurs to offer them advice and feedback.
As Weiss explains, it's not about the money. He does the majority of this advisory work for free or in exchange for a tiny chunk of equity. It's also not about prestige: He doesn't speak publicly about the startups he's consulting with. So why does he bother?
For one thing, it makes for a stimulating break in the day. "I have an intense curiosity and I like novel things," says Weiss.
It's a challenge to quantify the exact number of doctors moving into health tech; even if a large physicians' group like the American Medical Association (AMA) tried to keep track, it would need to determine whether to include doctors that advise startups but still practice one or two days a week, or just those who have left medicine altogether. I suspect that the former category is much larger. Suffice it to say, though, that Weiss is far from alone—the migration of doctors into the health tech space is noticeable.
It is now fairly common for well-funded health-tech startups to have medical directors, physician founders, or chief medical/health officers on their team. Some high-profile examples include Collective Health, Sherpaa, Startup Health, Doximity, Aledade, and AthenaHealth. And the AMA tells me it is proactively forging partnerships in Silicon Valley and beyond to help doctors "work in tandem on the innovative tech solutions that promise to change health care."
To understand why doctors are dabbling in startups or even changing careers, I recently polled MDs involved with startups (very informally) on Twitter to gauge whether they were motivated by money, prestige, fun, or altruism. Of 45 respondents, 44% were motivated by "fun." But it runs deeper than that. Weiss, for instance, has other motivations. He is concerned that much of the $4.5 billion in venture capital raised by digital health companies in 2015 will be spent on the next "Uber for health care," or the 10th next-generation stethoscope, rather than on solving patients' most pressing needs. "A lot of startups are peddling really cool technology in search of a problem," he told Fast Company.
I recently spoke to a half dozen other physicians based in San Francisco, Boston, and other tech hubs to understand their motivations for working in the space. Here's what they said.
New online communities have popped up to cater to doctors with an interest in health tech, and they shine a light on some of the problems in the medical field. A handful of California-based doctors started a private Facebook group called "dropout docs," which includes Rebecca Coelius, a UCSF medical school graduate who worked as a health director at Code for America; Amanda Angelotti, a fellow UCSF grad who works in clinical systems design at One Medical; Sean Duffy, a Harvard Medical School dropout who cofounded Omada Health; and Connie Chen, a practicing doctor who cofounded a chronic disease-management app called Vida. Much of the offline and online discussion is centered on the struggles of being a young doctor today, as well as the guilt associated with leaving medicine after years of education (and in many cases, a massive accumulation of student debt).
Other groups, like U.K.-based Doctorpreneurs.com, The Modern MD, and the Society for Physician Entrepreneurs are also spreading the word about alternatives to clinical medicine via blog posts and job listings. "There is an increasing acceptance that doctors will leave clinical medicine and do something in the startup world," says Vishaal Virani, one of the founders of the Doctorpreneurs group.
As Chen from the "dropout docs" group points out, some physicians don't see a clear path forward, career-wise, especially if they want to strike out on their own. As the industry consolidates—and small physician groups get gobbled up—it's harder than ever for doctors to start their own practices. That had traditionally been an entrepreneurial outlet for them.
Other doctors are simply burned out after years of grappling with (often onerous) technology systems for documentation and billing, which hospitals have rapidly adopted in the past decade—a key reason that doctors today have less and less time to spend with patients (the average interaction these days is about 8 minutes). As one physician recently put it on the blog KevinMD.com: "The ratio of time spent on doctor-patient interactions compared to physician-computer ones appears so horribly skewed that it has reached the point of complete dysmorphia."
"Doctor burnout and dissatisfaction is most definitely a factor [for why doctors are looking outside of clinical medicine]," says Daniel Kraft, a pediatrician, startup adviser, and the faculty chair for the medicine and Exponential Medicine program at Singularity University, a Silicon Valley think tank. "We see inefficiencies every day that are hurting patients."
Some doctors are actively looking for ways to work hand in hand with entrepreneurs to fix these problems. They see problems with the industry, but they also see an opportunity to make a major impact. "Most physicians are desperate to help patients, especially when they keep seeing the same pain points," says Kraft.
For Atul Butte, a doctor and researcher in biomedical informatics at UCSF, there's plenty to be excited about. Butte, who advises about 50 health tech startups, is optimistic about a range of new initiatives that offer ways to diagnose, treat, and care for patients. He is currently digging into the growing pool of open data from both failed and successful clinical trials, which he sees as vitally important for the development of new therapies.
Most of the Bay Area doctors I spoke with had focused on one or two pet areas of health tech, ranging from mental health apps to sensor-based medical devices. And many of them, like Weiss, were working to divert the flow of money into health tech into the areas that would make a real impact. "I see a lot of companies that aren't picking the right problem," says Butte.
Moreover, health tech also offers young and ambitious doctors an opportunity to make a name for themselves. "You talk at conferences, you are on panels, you do things that academic medicine would expect you to do when you have another couple of decades of experience," says Harvard Medical School-based physician Arshya Vahabzadeh, who is also a director at a neuroscience startup called BrainPower. Vahabzadeh believes that startups can help him make a more immediate impact.
For entrepreneurs, physicians' growing interest in health tech is a huge boon for their businesses. Having a well-respected doctor on the team offers legitimacy (and a path to funding), and it is paving the way for them to tackle bigger and more complex problems. "I see too many entrepreneurs steering clear of the real medical challenges," says Weiss. "But I say now is the time. Don't think about the market in a year. Think about what can be accomplished in the next 10 years."