Newbie Founder/Entrepreneur trying to find his way

'Fresh-meat' here...

I appreciate the comments, (especially the tip about color.com). I realize it's difficult to give meaningful feedback, not knowing which domain I'm referring to, or understanding the business I'm entering. So here it is, PhysicianReferral.com. The domain is currently redirected to my twitter page...

The reason I'm going into the healthcare space with this startup is this...

BetterDoctor raises $10M more for health-provider referral platform

http://venturebeat.com/2014/06/27/betterdoctor-raises-10m-more-for-health-provider-referral-platform/
Doximity raises $54M to bring its network to every US physician

http://mobihealthnews.com/32523/doximity-raises-54m-to-bring-its-network-to-every-us-physician/
Grand Rounds takes another $40M for expert doctor referral service

http://venturebeat.com/2014/06/24/grand-rounds-takes-another-40m-for-expert-doctor-referral-service/

Physician Referrals account for nearly 40% of the $500 billion in doctor's visits that occur every year. They are the life-blood and currency of America's healthcare system. It's what puts patients asses in doctor's waiting rooms...It's what keeps America's $1400 per night hospital beds occupied. It's how general practitioners and specialists market their services to one another...

Why am I going into the healthcare business? Really...?

Now you know...

I'm sorry, but your domain name is not worth anything. physicianreferrals.com (with an s) is active. physician-referral.com (with a hyphen) is available. I could buy it right now, like anybody else and become your competitor...

Your domain name would have a little value if and only if you owned absolutely all variations on the theme. And even in this case, the owner of referral.com and referrals.com could create a physician.referral.com site. Of course, doctorreferral.com and doctorreferrals.com are already in use, by different owners. Variations with hyphen are also reserved. This is totally hopeless.

You are the only one who think there is any value in this particular domain name, because you own it. Maybe you could sell it a few thousand bucks if you find the right client for that, but that's all. I'm afraid you only own a pipe dream...

BetterDoctor has Ari Tulla, former head of Game and App Studios @ Nokia plus Tapio Tolvanen, chief architect for Meego platform, plus $12.6M in funding to date.

Doximity has Jeff Tangney, former founder of Epocrates which turned a $35M series B into a $293M acquisition and has raised $71M between Series B and C thus far.

Grand Rounds has Owen Tripp, founder of Reputation.com and $41M (+$10M prior to renaming) in funding.

So we have a play with a strong tech founder competitor, another with a strong medical startup background/SME plus a large exit, and a third with a large successful internet company.

How do you compare with these founders?

Do you expect to get any technology, operational, or subject matter credibility whatsoever when you put these comps up before prospective investors?

Have you done any research whatsoever?

I dont understand how what you are suggesting you are doing is a "startup", let alone any form of business, at best its an investment move you made.

You're right...and I understand the need for assembling the best team possible, to make this project successful. I am certainly open minded regarding the possibility of going the accelerator route. But I intend to guard my equity in this project, like a fat kid guards a piece of cake. Simply because an opportunity like this doesn't come along every day. Maybe once in a lifetime...for someone like me. I can't afford the luxury of being stupid about this. That's why I came here...to tap into some entrepreneurial expertise. And it's not a $225 million dollar market...it's $225 billion per year, that changes hands due to Physician Referrals. I think there's room for a modest revenue stream to help facilitate that process, don't you?

Look its like you own a land in the middle of two towns and you want to start a railroad company. I really don't think it will end up well.

Before you make the leap on starting a business you have zero domain knowledge in, I suggest spending sometime on something that you have at least "some" idea of and that's domain monetization.

You don't have to sell your domain to make money. You can simply set up a website and serve as a referral traffic for hospitals, medical schools etc. I'd recommend starting there, THEN maybe one of the people you partner with on the deal side might want to do something with you and you go that direction.

Here's a decent article (I just googled domain parking monetization):

http://symbolics.com/domain-buying-investing-and-monetization-basics-part-i/

Good luck... but yeah, DON'T START A HEALTHCARE COMPANY. You will regret it.

+10000

If you are lucky, you will get $10m per year. Now I'm asking you now, would.you rather earn $5m per year... Or see $110k per year because you wanted to guard equity? Hint: 110k is you being greedy... Either way, if you're so concerned about your precious equity, just make sure you retain 51%. It means nothing until you exit anyway.

I appreciate the comments. I don't agree with all of them, but I do appreciate them. These are some of the very same issues I've been dealing with since I started this company.

"All you have is an idea, and a domain name/brand..." Well, yes...and no. I've also assembled a database of all the Physician referral sites I can find. And while the idea may not be unique, (i.e., every hospital, medical association, and insurance company also offers a database of affiliated physicians). I do have the luxury of being able to offer all of these entities, an additional outlet, where they can market their services further.

And I agree, I do need to assemble a good management team; and refine my business model. But these things are doable. I don't have to know every single nuance of finance, IT, marketing, etc...to build an effective company. I just need to find the right people, who are able to grasp how important physician referrals are, to the healthcare market space.

One competitive advantage I do have, over the 3 companies listed above, is the relevance of my brand. I disagree with the comment that I need to own every single iteration of this domain. (plural and hyphenated versions, .net .org. .info?) Give me a break. The relevance is there, a simple Google search, will tell you this.

As far as my track record goes, of not having led a previously successful startup, followed by a $200M exit? Well, you got me there, brother...but everyone has to start somewhere. I'm starting right here...

How do I compare, with those other founders? Hell, I'm a nobody...but that can change. I have to believe that here in America, there is still room for someone like me. If a janitor with a high school education, can take an idea and turn it into a profitable healthcare company? That means something. That's an accomplishment I can be proud of. It's the American dream, baby! And that, my friend...is a selling point, not a disadvantage. It's a media angle that I intend to utilize, because it has the distinct advantage of being the truth. (Everybody loves a Cinderella story...) And that equates to free advertising for my company. It's David and Goliath man, and that makes for some compelling copy.

Hell, I can hire incredible managers, and marketing gurus, and cats with IT genius. And I know there's capital out there, to help me hire these folks. Angels that want to take advantage of the current disruption in healthcare. I just need to find them, by getting my story out there. (See the previous paragraph).

But I'm not above bootstrapping this project. Hell, I've been living that concept, my entire adult life. It forces you to be frugal and creative. I've got the data...and there are many excellent companies now, who focus exclusively on building websites for doctors. There's no reason I can't strike a deal with one of them, to build me a site; in exchange for sending them a flood of new business, while taking a cut? There's my MVP...creating a space where doctors, dentists and hospitals can market their services to one another.

There are also about 1400 companies out there who design EMR's (electronic medical records). These are potential customers as well. In fact, every company that sells a product or service to physicians, is a potential customer. Hospitals, software vendors, pharmaceutical companies, insurance companies, not to mention people just looking for a doctor. There's no lack of a market here.

As far as this business being too 'industry-specific'? Well...I guess I can live with that...a $225 billion per year market, is big enough for me.

Once again, thank you guys for all your insightful feedback...I appreciate it.

The issue with being a nobody isn't that you cannot accomplish something, the issue is that you don't have instant credibility which translates into hiring people, raising money, etc.

Absolutely, it is very possible that anyone can do anything. However, the reality is that doing anything is a hell of a lot more difficult when you're trying to do it in the face of multiple well funded, strong technology, and/or SME competitors.

If you believe that you can build sufficient traction such that you can make more money operating your domain name as a referral business as opposed to just selling it for cash, then best of luck.

Trying to build sufficient traction to be purchased by one of the above companies is a perfectly legitimate business model, but you'll have to flesh out the team, the operational plan and budget, the fundraising, etc.

Thanks for insightful comment. I totally agree...

"Brand" really doesn't mean anything. Execution and relevance of the business mean everything. The words Uber, Starbucks, Spotify, etc. don't mean anything...the companies they built created the brand, not the other way around. Figure out the business concept, align it with the domain name if you can, start collecting data, an then you'll be on your way to something.

revenue ? Will you ask him that ?

Your desire to create the Google or Yahoo of medicine is admirable.

As an investor, I'd be asking a large number of questions including:

1) what are the federal, state, and or medical industry regulatory issues that may be involved with advice to physicians?

2) how will you handle the potential civil legal implications of such practices? In particular, lawsuits arising from recommendations accessed through your service?

3) what is your operational experience and/or expertise in maintaining the availability, reliability, and security of medical records?

4) what is your experience/expertise in building relationships with pharmaceutical companies, hospitals, medical supply companies, and insurers?

Quite frankly, your desire to do something is admirable, but it is far from clear your ability to execute is proportionate.

1) what are the federal, state, and or medical industry regulatory issues that may be involved with advice to physicians?

Answer: The applicable laws involved include HIPPA, and the Federal Anti-kickback statutes. I'm not sure what you mean by giving advice to physicians, as I will merely be providing the vehicle for them to consult with one another, on a HIPPA compliant platform. I won't be making any referrals myself. That's for the physicians themselves, to decide. The intended service I'm wanting to provide, would simply make his/her job easier to accomplish that. Think of it this way...Let's say I'm a software developer who comes up with a new email program. Am I responsible for the content of those emails between my users? No. My job is to simply get those messages from point A, to point B...in a secure/reliable manner.

2) how will you handle the potential civil legal implications of such practices? In particular, lawsuits arising from recommendations accessed through your service?

Answer: This is what incredible attorneys are for. I intend to vet every aspect of this project through my legal team, before going public. (when I can afford them).

3) what is your operational experience and/or expertise in maintaining the availability, reliability, and security of medical records?

Answer: Zero/Zilch/Nada...Again, experts in secure Healthcare IT can/will be hired to provide that aspect of this service.

4) what is your experience/expertise in building relationships with pharmaceutical companies, hospitals, medical supply companies, and insurers?

Answer: I've worked in healthcare for 33 years. (As a janitor, mind you...) But I was there! No seriously, there are people out there who are a LOT smarter than me, who can fulfill those roles. I intend to hire the best, and compensate them accordingly.

Quite frankly, your desire to do something is admirable, but it is far from clear your ability to execute is proportionate.

Answer: Well, that remains to be seen..

I truly appreciate your input! It allows me the chance to think through some of the potential pitfalls, I'm bound to encounter on this journey. You had some legitimate concerns, and I hope I've answered them to your satisfaction.

Thank you again...

"Quite frankly, your desire to do something is admirable, but it is far from clear your ability to execute is proportionate."

Hey. I'm just going to tell you a little story about my job--I work in the online marketing division of a JCAHO healthcare staffing firm (not physicians, though, but nurses + allied health).

I was originally hired to take care of a nursing website that the staffing firm acquired a few years ago to generate leads. One of the founders of that website, who became the VP for Community after the acquisition, used to be a recruiter for nurses. As for the site, well, it was originally designed as a community portal for nurses--its original incarnation had a nursing job board, a forum, a nursing school guide, and a bunch of videos and articles about nurses.

So far, so good, right? You have someone with lots of industry knowledge at the helm.

Well, that was what we all initially thought.

Because she wasn't an IT expert, and she wasn't even into that aspect of the business (she'd often dismiss it as "I'm not a tech person, can you handle that for me?"), she got misled by the web development firm that were tasked to upgrade the site. We ended up with a half-baked site that didn't have the forums, which led to a lot of the old membership leaving the site. And in her efforts to stem the exodus of members, she went in haphazardly, requesting the in-house IT guy to implement various bells and frills that only messed up the site more.

In short, she lost sight of what the site was all about, and that hurt the site in the long run. Eventually, upper management had to let her go (and it became some sort of joke in the office: how can she be VP of Community--how can we be a community website--without any forum functionality???).

Now, I'm not saying you should forget your idea simply because you're a janitor.

What I'm saying is that yes, you will need to hire experts; but you will also need to 1) strive to learn more about the core business--enough to communicate well with the experts you're dealing with, at least, and enough to help steer the startup in the right direction--and 2) do a good level of due diligence before hiring people.

Also, speaking of HIPAA, you should read this:

http://www.nursetogether.com/what-constitutes-a-hipaa-violation

"Within the care continuum, HIPAA makes it clear that PHI should be shared with as few providers as necessary, and only to the extent required for each provider to fulfill his or her role, so nurses may have access to a different portion of the patient record than physicians have access to. It also strictly prohibits using PHI or making it public for marketing purposes without a signed release form from the patient.

[...]

We’ve all heard stories about hospital employees being fired for looking at the charts of people they did not directly care for, perhaps out of curiosity regarding a celebrity or local public figure, or through the temptation to “just browse” to pass the time. One nurse wrote on a forum that she thought this behavior was okay because she wasn’t sharing that information with anyone. Yet it is still a violation of the minimum necessary standard, which dictates that PHI should not be accessed or shared at all unless it is necessary to satisfy a particular function of care. Some healthcare facilities take this standard so literally that they consider it grounds for dismissal if a staff member looks at his own records, or that of his child."

This is also the kind of threat you'd have to guard against - http://www.wsj.com/articles/health-insurer-anthem-hit-by-hackers-1423103720

Fresh Meat here...

I share your concerns regarding HIPPA, and I am keenly aware of how serious of an issue this is. I may end up revising my business model at some point because of these concerns. But rest assured, my site won't even open it's doors, until all of the (i's) have been dotted, and (t's) have been crossed with regard to patient privacy.

Like I say, I'm still fleshing out my business model, at this point; but I still think it's possible to accomplish.

Your advice to familiarize myself with all the different aspects of my company, is well taken. I've been doing so, for awhile now.

Thanks for sharing your insights and experience!

With respect to HIPPA (and/or whatever other laws there might exist, which by the way are likely to vary from state to state), your answer is basically the Uber answer: I'm just a platform. However, <em>when</em> a malpractice suit arises due to communications on your platform, you <em>will</em> get pulled in. Uber has the cash to fight this type of thing, do you? What percent of fundraising or absolute value is set aside for this eventuality? Who will do the defense, and what is their track record?

Your answer would not satisfy me as a potential investor.

On the expertise side: how will you know who is expert in regulatory, in delivering the service, in coding the platform/website/whatever? Believing that top notch people are just sitting around waiting for your call is naive in the extreme. Again, as an investor, I'd want to see the team first - not as an action item down the road.

You also said you will hire the best and compensate them accordingly. I very much doubt any investor will be interested in putting out tons of cash to pay multiple $250K/year employees, equally the risk in giving out tons of equity is that it both dilutes your control and makes it much harder to do the same for the next employee.

I really don't think you've put enough consideration into this, but at least you're making a start.

I'm not sure gaining a patent is even possible, for my line of business. I assume you are referring to securing the copyright, for any of the software that I need to have custom built to run this business. This can be covered under a simple work-for-hire agreement, when I negotiate with the software development team.

And for the record...I don't view my having worked as a janitor, as any type of Achilles heel. It was honest work. And I'm secure enough in my abilities to captain my own ship, (given the right advisers and crew). If potential investors have a problem with that? They are certainly free to invest their money elsewhere. If that ends up being the case...then say hello to the mayor of Boot-strap city! Because either way...this site is going up.

You know, it may come as a surprise...but even though someone comes from a humble background...that doesn't mean they don't have a brain cell or two, to rub together? Some people simply can't afford to go to college. Know what I mean?

Thanks for your comment...

Fresh meat, check these out:

Dropping the Baton: Specialty Referrals in the United States - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160594/

Need better care coordination? There’s a toolkit for that - http://www.kevinmd.com/blog/2014/11/need-better-care-coordination-theres-toolkit.html

Will A New Market For Better Doctors Arise In 2015? - http://www.forbes.com/sites/nicolefisher/2015/01/22/will-a-new-market-for-better-doctors-arise-in-2015/

Making physician referrals more efficient has become a launch pad for health IT startups - http://medcitynews.com/2013/07/making-physician-referrals-more-efficient-has-become-a-launch-pad-for-health-it-startups/

Go for it!!