In Our Thoughts

We can all agree that for today’s internet startups, customer acquisition is one of the biggest issues they face. The world is so crowded with apps, things to do, things to grab your attention and waste time – it’s one of the hardest problems to solve to break through the noise and get someone to notice you AND download you or try you out. Consumer startups face this problem the most, but B2B startups also face this problem. There are enough B2B startups now hitting up the IT managers of companies big and small that they are slowing down in their decision to implement a new product or service. And as I’ve always said, if it takes too long to gain customers and get to sustainable traction or great metrics, you will die because your bank account won’t last that long.

However, there is a similar and IMHO worse problem for today’s health related startups. But it’s not quite a customer acquisition problem – you can spend money to get people to download your app or get to your website – it’s more related to conversion and I call it a customer adoption problem.

First, I want to clarify that when I say health startup for the purposes of this post, I am leaving out the “health” startups which don’t really have definable, definite, repeatable health impact – I would put fitness trackers, GPS watches, workout apps and hardware, etc. into this category. They provide data, but you need to figure out how to use it OR, there really is no definable, definite, repeatable health benefit – by this I mean, you can’t tell someone exactly how many steps you need to take to lose 10 pounds or to prevent a heart attack. It’s just not possible.

I would also leave out the traditional biomedical device startup, whose path is generally not direct to consumer (some are, and more are needing to go to market first before some kind of exit happens), they create a great device, take it through FDA trials to prove efficacy, and then sell to a large biomedical device company. The biomedical device startups who are going direct to consumer, however, can be placed in my category of health startup.

So leaving out those kinds of “health” startups, what are we left with? Some pretty cool startups that are applying technology to solve some really sticky health problems. However, there is a HUGE hurdle towards success – the culture of the consumers highly tilted against adoption of these kinds of products and services.

These hurdles are:

1. People have been trained for decades that they should never pay for their healthcare. Insurance should pay for all of it. If it’s not reimbursed by insurance, they won’t pay for it out of pocket and avoid treatments of any sort that makes them pay.

2. We are in a “curative” culture of healthcare and not a “preventative” one. We would rather wait for something to happen (and lead crappy, self-indulgent, unhealthy lives to get there) and then do something about it.

3. Along with 2., we don’t see the value of something we haven’t experienced yet, or have no experience with. Why should I worry about my thyroid? What the heck is that? My heart beats so why worry ahead of time about it?

4. We hate hearing something might be wrong with us. So any product or service that would tell us that is avoided as well.

5. Inaccurate, outdated information on health hampers the ability of new information, packaged into products and services to gain traction. The illusion of knowledge exists in health; knowledge seems to be eternal but it is not. Every year new information comes out and old information is discarded, but people stubbornly hold onto information they learned years ago and they erroneously think it’s permanent. Still this means that they are resistant to adopt new information or methods due to thinking they already know enough.

As you read through the above, I’m guessing that you can relate to each one of those points. To me, these are nearly unsurmountable issues that are deep rooted in the culture of our society. These are issues that are top of mind for me right now in looking at today’s health startups (by my previous definition). Finding a believable, reliable solution to the customer adoption problem that circumvents these issues is critical to their success, and whether I will invest in them.