Dr. David Berman is a career Gastroenterologist, with over 30 years in practice, and is also the Founder and CEO of Slingshot Health. Slingshot Health is a marketplace that connects patients and providers directly, allowing individuals to bid on a physician’s time, leading to convenience, decreased cost and increased price transparency. Slingshot already serves the Greater New York City region, and is rapidly growing nationally.
Tim: David, you’ve been a practicing physician for over 30 years – entrepreneurial in your own right – but you’ve plunged headfirst into a health tech startup, as the Founder of Slingshot Health. Why now, and why Slingshot?
David: Those are questions I’m still trying to answer, believe it or not. I think a lot is just destiny. Having always dedicated my life to making the world a better place, through what naturally constitutes taking care of people – human beings – one person at a time. And I am just now transitioning to hopefully helping millions at a time. So why Slingshot Health? Well, it took 30-some-odd years to learn how to practice medicine – to get me to being a real doctor – and then, I think that the same reason I went to Medical School – that quest for knowledge – has always led me to exploring different parts of the world, not just medicine, but economics, politics, religion, history – and you acquire a certain knowledge base over time, and you may be presented with that ‘aha’ moment, where you combine all that knowledge over decades of life experience, and that’s what happened. In the space of a second, an idea was born. Actually, I think I was shaking – saying ‘wow, this is it, this is it!’ So it was a combination of life experiences and just an operating system of always having your eyes wide open and trying to be the best person you can be.
Tim: Tell us a little more about Slingshot. What are you after and what’s the mission?
David: It’s a relatively very simple concept. The mission is to put people back in control of their Healthcare destinies. Whether that’s patients or providers – that’s the goal. After having spent 30+ years in Healthcare, I saw people on both sides with less control, less affordability, less accessibility and less transparency, and living that nightmare day-to-day. If you think it’s bad as a patient – which it is – try living it as a provider. Try running your own practice, seeing patients, and then having all of these other things forced upon you that are unrelated to the patient’s visit or their problems, in order to justify somebody else’s existence – somebody else’s fix for Healthcare. And we get all these newsflashes that “Healthcare is broken, but we have a fix for it!” All we really get is another acronym, another few trillion dollars in debt for my kids’ generation, less transparency, less affordability and less accessibility, because nobody comes at the problem – or the solution to the problem – from the way that makes sense: the provider.
Tim: So what does Slingshot do? How does Slingshot solve that problem? Tell us about the platform itself.
David: The concept is really very simple: You should have complete control of your Healthcare destiny. The same way I want to have complete control over my professional destiny as a provider, the same way my plumber charges me a hundred and fifty bucks an hour, and sees me when he wants to see me – the marketplace is fully in effect there. The only place that the marketplace is not fully in effect is in Healthcare. Instead of the current system where patients beg for what they need, we provide them with not only what they need, but what they want. At the same time, we present providers with the freedom to practice the way they thought they would going into medical school.
We’re an unfettered, dual-sided marketplace. We don’t charge anybody anything. We’re free for patients, we’re free for providers.
A patient comes to our homepage, they tell us what they want, when they want it, and how much they want to pay. We tell them the average price for that service. That bid goes out to all the providers that can provide that service for that patient, and they have the freedom of either ignoring it, accepting it, or counter-bidding. And because when a patient joins, they use their HSA/FSA account, credit card or debit card – it’s a cash payment – so from the provider’s perspective, they are saving over 50%. There’s no co-pay collection, there’s no balance billing, there’s no administrative costs, there’s no MACRA, no MIPS, no claw-backs – nothing. So they know what they’re going to be getting paid, because we tell them within 24-48 hours that they’ll receive that from us. They get the freedom from the administrative burdens of having to try to collect that dollar, and having to satisfy different requirements imposed by insurance companies and government, and having to check off different boxes during that patient visit. If you haven’t gone to the doctor recently, they spend half their time with their face in the computer screen, making sure those boxes are checked off. What a waste.
Tim: Any big wins that you can share with us so far?
David: I think the biggest win from my perspective is being able to grow a team centered around our culture of humility and love and kindness. And those are just immutable values. The fact that we’ve controlled that and maintained that and have people who are part of the team who share that operating system and the vision, is everything to me. It’s easy as you grow quickly, to kind of let go of that culture – and that happens I think very frequently. It’s very common to gain more business success, at the price of ethical and moral imperatives. You can build a lot of things, but if you don’t build it with the right people and the right operating system, it’s not worth it in the end. At the end of the day, I look at life in lots of ways. One of the ways is that I have an existence and I have a life, I am going to die eventually, I want to make sure that my life lives on beyond my body, that I am a positive value proposition that lives on beyond my body; that I can do good for people, do good for the world. So if I can do that, that would be a huge win. Being able to wake up in the morning and participate with the people I do during the day – whether it be in my medical practice or with the people at Slingshot, that’s a huge win. A huge win is going to the Slingshot offices in the morning, and being able to give everybody a high-five or a hug, realizing that they voluntarily come and join me on the island every day. That they do that with a smile on their face, and a sense of urgency and vision and mission – that’s really spectacular and special. When people go to the office and you can see that, it’s energizing and invigorating. That’s a win. The fact that I’ve attracted people who have helped me – including you – from the beginning, makes me believe that God works in mysterious ways.
Tim: How about on the Investor, Customer and User Adoption Front?
David: The fact that we have two billionaires in our $8M Seed round is pretty exciting. The fact that we have former Tiger Management execs, and the head of M&A at Goldman Sachs and his associates on board is personally a huge win. So, on the investor side, we were able to raise a lot of money at a very nice valuation, and attract people from all walks of life.
The other wins that we’ve had in the marketplace are with the providers. We were able to sign up 1,000 providers two summers ago, with little difficulty. We now have contracts with major Healthcare systems, including Hackensack Meridian Health.
On the user side – we’ve now booked our 6th month of 50% growth month-over-month, in terms of bids. We now offer 90 different specialties, and 1,000 different services on our website. At the patient level, today I had a Slingshot patient that walked in, a gentleman that was being treated for Hypertension. He said to me, because he had just started a new job, and had no insurance, ‘This is the most amazing thing! I was able to see a doctor – someone to take care of me – at a price I could afford. How can I help you?’ And we get that all the time – “How can I help you?” The fact that we’re putting people back in control is really very heartwarming.
Tim: What surprised you most in the first two years?
David: The amount of acceptance that we get across the platform. We have never heard that “this is not scalable.” We have never heard that “this is not going to work.” It’s always about execution. So, the surprise was – and I don’t want to say it’s really a surprise, because providers are patients too; I’ve been a patient, I know how terrible the system is, because I’ve been on both sides of the marketplace… the surprise was, I didn’t think we would be at this point in our team’s trajectory that we are today. We have 30+ full time people, and growing. I knew it was going to work, there had never been a doubt in my mind, from the first second, that this is going to work – but I guess the surprise is that so many different people from so many different walks of life agree with me. We’re able to get our message across in under 60 seconds, and people get it, no matter what they do.
Tim: The benefit of having a relatively simple story.
David: Yeah. Well, I’m a simple guy (laughs).
Tim: The simpler the better, especially in Healthcare.
David: That’s not a usual term for Healthcare – simple.
Tim: No, it’s not. So you’ve talked about this a number of times – your quasi-day job is your medical practice. You’ve successfully built a time-tested practice. How has this venture been different than that, for you?
David: There really is not that much of a difference – the only difference is the subject matter. Building something is building something; people that are successful at building things are going to keep on doing it, and they can just change what they’re building, as long as it is in their wheelhouse, or leverages their skillset. Building a medical practice is not easy, in fact it’s pretty hard. I was employee number one, 25 years ago, and now we have several dozen people. And what you do is you learn… there’s always learning, every day. There are several advantages in being a physician that comes into play when starting a business. The interesting thing in Healthcare is that we approach things very differently than MBAs and business people. We’re trained in a collegial way – we like people around us, we don’t think in an adversarial way. If we did, people would die. We are quick to admit what we don’t know. If we try to do something to the patient that we shouldn’t be doing, they could die. There’s nothing really life or death about business. Businesses do live or die, but nobody’s actually dying. We are trained to retroactively analyze everything. You examine a series of decisions that led to that outcome, trying to learn why. You can apply that to business too. And I think that’s very critical – people hesitate to find out what’s wrong with what they’re doing. It may not be wrong when they’re looking at it, but the trick is to find something early before it becomes a big problem. So there are lots of things you can apply from medical training to building a business.
Tim: What’s your grand vision for Slingshot?
David: The grand vision is to be the world’s marketplace. Next quarter – and I want to show you the new homepage – we’ll launch Slingshot Pet. Same coding, 98% compatibility, we just switched the provider from a physician to a veterinarian. And with 1.1 million cats and dogs in Manhattan, we could be a very successful company just with that alone. And you can change it to anything – it can be an accountant, a lawyer – hopefully we do that at the end of next year. So we are creating a prime membership that will encompass different marketplaces. The first one is human health. And we’ll combine that with Slingshot Pet, and hopefully we combine that with different marketplaces along the way.
Tim: So with all that in mind, what keeps you up at night?
David: Lots of things (laughs). There’s things that I always worry about. One is that as CEO, I have several responsibilities. One is about making sure we’re executing and allocating. The most important thing is to make sure the people on board the team are happy, fulfilled, have a sense of vision and mission, understand the culture and the operating system, and understand that I want them to be the best they can be. It’s a matter of making sure everything is in place, that there’s enough money in the bank, and that we’re executing on all these different fronts.
There’s a healthy fear of failure. And I mean more the big fail. I like to fail – it means I am pushing myself. But if you look at the org chart in our office, I’m at the bottom. And that keeps me up at night, because I know I have to answer to everybody, not just the people on the team, but the investors, the people we do contracts with, and everybody. But what’s interesting – I don’t feel pressure at all. It’s actually an honor to be where I am, it’s a blessing. The first thing I say in the morning is ‘Thank you.’ And the last thing I say is ‘Thank you.’ And it’s been that way for a long time. I just want to make myself the best person possible, to lead the best life possible, and make the world a better place. That’s what keeps me up at night – to make sure that I don’t fail myself, and in doing so, others.
Tim: So if you had a do-over on anything since you started the company, what would it be?
David: I look at every experience I have – good or bad – as a learning moment. So I don’t ever want a redo. What I do want is to make sure that I am cognizant of everything in the past, and that I am integrating it into myself, into my being. There’s a reason that thing may have happened, and the outcome may not have been what I wanted it to be. I have to understand why that happened. I think there’s a reason for everything that happens, so I have never in my life wanted a redo of anything. And there have been some moments where probably… (laughs)… where probably somebody else has wanted a redo… but I think things happen for a reason, and I am charged with trying to figure out why.
Tim: Anything you want to leave the people reading this with?
David: I think that no matter what you’re doing, it’s important to set your goals properly. Is it about getting wealthy, or is it about making you a better person, or is it about making the world a better place? I think if you put money or capital accumulation ahead of everything, that will create jaundiced lenses through which you will see your project or your company. If you’re key on monetizing something, that should be a natural result of very hard efforts solving a problem, that makes people’s live better. A lot of startups are formed around people having personal pain. They live through something that they don’t want to live through again or they don’t want other people to live through. And if that’s the reason you’re creating your company, and if you can make that operational and execute that, monetizing becomes easy. I think that’s important – I think it’s really important to put life in perspective. You have a very short amount of time on the planet. It may seem long to you… my advantage is that what I do during my day, I see things happen to people for unexplainable reasons. Because of chaos and entropy. I understand how precious every day is. Few people do, the way that I do, because I see what happens. And if you create the proper value proposition to each and every day, knowing it could be your last, and knowing what you want to leave behind, it’s a start. If you take each day and make it a tile in a mosaic, that mosaic out of tens of thousands of days of life can be spectacular. If you don’t have that many tiles and your mosaic is kind of small, it can still be amazing. Every mosaic can be special. And it depends what you want to paint with that mosaic, is it a dollar sign, or is it something that you want to last thousands of years, that somebody unearths and says ‘wow!’ And that’s what it’s about. That’s the way that I drive myself.
Tim: That’s a good note to end on, thanks David.