A Trauma Surgeon and Entrepreneur on Healthcare, AI and What's Next | Niral Shah, Ep 44
Episode Summary
Niral Shah, a trauma surgeon and serial entrepreneur, discusses his journey from starting a search engine startup during the dot-com boom to returning to medicine and now investing in healthcare innovation. He shares lessons from shutting down his first company responsibly, explains why healthcare represents 18-21% of US GDP with poor outcomes, and identifies opportunities in AI-driven biotech, disintermediation of healthcare delivery, and multiomic drug discovery targeting aging as a treatable condition.
Pull Quotes
On why healthcare economics are fundamentally broken
“In healthcare, the end user is not the buyer. You go in, you've got a coronary blockage. You're the end user and the doctor decides which stent to put into you. But even the doctor who's not the end user isn't the buyer of the stent. Those steps remove the economic buyer from the end user. And the further away you go, the less you kind of care about what the end user experience may be.”
“What people get wrong is they think that it's about pushing through some barrier. I would argue it's like being Neo where you're just dodging bullets. The biggest risk you should take is saying yes, I'm going to start this company. But then every subsequent thing that you do is try to derisk it.”
On shutting down his first startup
“We had money in the bank. We're under no obligation to give it back. But we decided to do chapter 7. I thought about it as a fiduciary to my shareholders. That company was going to die no matter what. Why don't we give some of those organs, i.e. the money that we had back to the investor so they could put it in something that was going to potentially change the world.”
“In the US healthcare sector, it comprises 18 to 21% of our GDP. The next OECD country is clocking in at about 10%. We have no better outcomes. We have a lifespan that's about equivalent to Albania. At some point there's going to be a reversion to the mean when you're so far off the curve.”
“I am a physician. I also have health insurance and I've navigated it for my family and I don't understand it. And if I'm in the system, I don't understand it, then something's gone wrong.”
Transcript
Hi, welcome to Tales from the Sky Lounge. It's a podcast about business, consulting, and venture investing. We get out there in the world, we talk to people who are making it happen, and we get their stories. And if you like and subscribe, makes producer James super happy. Today's guest in the Sky Lounge, Nural Shaw. Hi, Nural.
Thank you for having me, Todd. We've gotten a chance to meet up at various meetings and happy hours, but it's always fun to see you and interact with you this time virtually. Very excited to spend a little time with you. So, Nural, who are you and what are you working on?
Great. So, I'm a physician entrepreneur. I've had a couple of startups. I am a trauma surgeon by trade. Now, I am going to put a little asterisk on the physician entrepreneur. Which one comes first depends on the day that you may see me and more importantly over the last 25 years of my career, shall we say.
Yeah. So, I mean, you've had a really cool arc through your career as most people in the Sky Lounge here have. Let's talk about your early career. How did you get started? And maybe bonus points for talking about your mother.
Well, I actually have a very circuitous background. I started med school when I was 19. I'd always had a keen interest in entrepreneurship. I come from a business family background. I was a micro entrepreneur as a child. I always had that thirst of thinking about things a little bit differently. But I loved biology. I loved life sciences. I liked the aspects of health care with the betterment of society. And so I went to medical school pretty early on. I then decided to take a sabbatical to do my own startup, much to the chagrin of my Indian mother. My friends and I had an idea for a search engine. If you'll remember at that time, search engines were governed just by keyword. So my mother had breast cancer. If you looked up things for breast cancer, often pornography pages showed up and we were like, "Hey, there has to be a better way." And so we started working on it. We moved out to Silicon Valley, ultimately got hooked up with an incubator, got some funding, did a reverse takeover, and I know we're going to go into that a little bit more, but I took some time back and I said, "Hey, you know what? What still drives me?" I went back to medical school. I love surgery. I became a trauma surgeon and then in 2018 I realized hey healthcare is really going to have a reckoning and it's better for me to get a seat at that table especially because I can speak both languages and more importantly thinking about how can I make an impact and as Steve Jobs would say make a dent in the universe and that was sort of what drove me to go back to business school and since then I've been helping life science companies, startups, and my favorite role is an ad hoc entrepreneur in residence.
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