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In Search of Silver Linings: Opportunity in Chaos

By: Tim Gordon, Managing Partner, Aequitas Partners

“Work wherever you feel safe and comfortable.” That’s what I said to our team over a month ago, and I haven’t seen any of them in person since. We didn’t mandate anything because this was before New York City effectively shut down, but everyone understandably opted to head for more square footage and stocked kitchens in the suburbs. Overnight, the world changed. It felt…sad. There was a solid week of culture shock and change management as we adapted to being a distributed company, but as we adjusted, I encouraged everyone to change their perspective. There is opportunity in here somewhere – let’s find it. What’s the silver lining?

I believe strongly that there also remains tremendous opportunity for companies in our space. Organizations have raised capital over the last 6-9 months, and there is an unprecedented amount of talent available, motivated, and looking to make an impact. Well-capitalized companies might be revising their hiring plans and sales forecasts, but they still need to grow. What if this environment isn’t temporary? What if much of the country remains remote through the end of the year, or longer? It’s unclear when sales leaders will be hopping on planes to go see prospects or existing customers. If more business is being conducted remotely, is there an advantage to building an interview and hiring process that can achieve success virtually, knowing that those hires might be conducting most of their work that way anyhow?

Just this week, someone on our team spoke to a VC who had just done two things that excite me and give me hope. First, they led and closed a Series B round for which the entire deal cycle was virtual. They never met in person. Second, they are running a search for a CFO of a portfolio company, and doing it remote, end-to-end. They will hire someone they’ve never met into a C-suite position. Most wouldn’t have fathomed either of these things in the middle of Q1, but I think this is where opportunity lies. That being said, in order for this to work, two things need to be executed on with relentless precision – your interview process and your onboarding process.

On a good day, a lot of companies struggle with constructing and adhering to a well-defined interview process. And one of the staples of that process has always been the “in-person interview,” where a person is brought in to meet the team, or taken to lunch or dinner where you can be in a more casual setting. Most will tell you that the in-person interview is integral to determine cultural fit. But it’s much more than that – it’s a way for you to determine what that person’s presence does to your already-existing gut instinct on whether they should be hired or not. So in a world where in-person interviews no longer exist, how do you fill the “Intuition Gap” that results?

This new world is a reality check on that, so it’s critical that a new process be thoughtful, creative and acknowledging of the difficulty and vulnerability of our various situations.

  1. Communicate your process clearly to candidates. It’s imperative that someone entering an interview process right now, with all of the unknowns, gets a sense of confidence that a hiring company has their act together. Lay out the steps on the front end.
  2. Get creative on your video interviews and calls. Sure every interview can easily be turned into a Zoom call, but so can social interactions. If you’re hiring senior execs, get the candidate and their spouse together with you and yours for a virtual happy hour, and make it last longer than 60 minutes. Have a virtual dinner meeting, or a “working virtual lunch.” Try to replicate the time you’d spend in person.
  3. Turn off your computer notifications during the interview. Frankly a good reminder for any interaction, but particularly interviews. If you’re distracted with emails, text messages and Slacks , you’re missing valuable opportunity to pick up on non-verbal cues that will help you close that Intuition Gap.
  4. Over-rotate on references and backchannels to fill in the gaps created by a lack of in-person face time. These are always important, but need to be done in greater quantity and depth if they’re going to successfully close your Intuition Gap.
  5. It’s also a strong argument for a collaborative “deliverable.” Not free work, but something that allows you and a candidate to really unpack the way you’d work together, and seek strong alignment before a hire is made. It’s a good opportunity to involve more team members in an efficient way, and will likely be required, as candidates try to get comfortable with the prospect of joining a team they’ve never sat in a room with.

Figuring out the hiring process is only half the battle. Where things get really interesting is onboarding. Onboarding remote hires – when it’s not your traditional method – is difficult. We just lived through this, bringing our most senior hire to date on board on March 16th – the same day our office effectively closed because of COVID-19. We benefited in a few ways: first, Polina is a total pro, and has worked all over the world remotely, second, we all had spent time together planning for her onboarding before she started, and third, she and I have a nearly decade-old relationship. Bit of an unfair advantage.

That said, similar to the hiring process, many of the same principles apply to onboarding:

  1. Fully schedule out the entire week. It’s a bit odd working from home when you don’t know what your work actually is. On that first day at 9am, what happens? Maybe it starts off with a virtual team breakfast, or with someone doing a demo on how your Slack account and CRM work. Did you even set up those logins in the first place?
  2. Create some internal accountability. Write out clear weekly goals for progress, and they should be tracked somewhere centrally with a great deal of transparency. Have proactive check-ins with the individual that are more than “how are you doing today?” There are few new hires that will tell you exactly where they are having trouble, so make sure your check-ins are tactical and include training.
  3. Recreate osmotic learning. Because you’re not in an office together, there is no way for your new hire to learn passively by overhearing conversations. So have the person shadow and listen in on as many calls as possible in the first few weeks. Proactively explain why you responded to an email in the way you did.
  4. Make things extremely high touch, but with a purpose. Leverage Slack to communicate throughout the day, and make yourself and your team available to folks that are trying to learn your ways and culture. Do as much of it as possible over video, trying not to leave a new hire with long periods of solo work without interaction.

Organize virtual team happy hours much the same you would if you were back in the office and taking the new guy out at the end of his first week. And please cut the newb in on the jokes / watercooler Slack channels so they can experience and subsequently add to the culture of your team.
With the wave of layoffs happening, many employers who are still hiring have fallen into a false sense of confidence that it’s a “buyer’s market.” Meaning that they’re going to have a plethora of candidates to choose from, and they can also take their time. That is a big misconception. The onus is much more on you to meet the candidate (and hopefully your new team member) halfway. Let me be clear – an unfocused hiring and subsequently uncoordinated onboarding process are the first and second impressions of how things work in your company. And a stellar candidate – which let’s be honest, you’re not out there trying to hire mediocrity – will take immediate notice and appropriately socially distance themselves from you.

Ultimately, there’s three choices. You can build a process that gets you right up to finalists, and then wait out the travel ban to see when you can get them on site. You can build an even better process, that allows you to get conviction and make a hire in a virtual format that’s uncomfortable, but might not be changing any time soon. Or, you can do nothing. It’s clear that many organizations and their investors are seeing a great deal of opportunity in adapting to the situation on the ground. The silver lining, if you’re searching for it, is that a process forged under duress stands to perform exceedingly well during happier days.

The Shift to Value-Based Conversation

Interview by Polina Hanin, Principal, Aequitas Partners

For the better part of a decade, I’ve had the unique privilege of working with 300+ companies and 500+ entrepreneurs to solve some of the biggest health challenges of our time as the Portfolio Director at StartUp Health.

In that same time span I had the opportunity to work with Tim Gordon, who as the readers here know, is the Founder and Managing Partner of Aequitas Partners, a firm that builds leadership teams for high growth health companies. Entrepreneurs find themselves in a vulnerable spot when they’re bringing in senior execs – you’re putting your trust, and your company, in the hands of someone new. And in my humble opinion, there are few who understand and empathize with that position better than Tim.

Example? It starts with the company name. Stemming from Latin, Aequitas stands for fairness and integrity. In fact, it’s where the English word “equity” comes from. It is these values that make Aequitas a great partner for not just new folks like me, whose first day was literally the day NYC announced its shelter-in-place order, but for each of the entrepreneurs with whom we partner.

This is why I am particularly excited to have sat down with Tim virtually and reflected upon the last month together.

Polina: Tim, you have a lot going on. In the two week span of when shelter in place in New York City was instituted, you kicked off a number of brand new searches, brought in a brand new team member (hi!), moved your family, and then celebrated your son’s first birthday. Explain yourself.

Tim: It turns out I’m a glutton for punishment. The crazy thing, too, is that it seems like a long list, but there were actually even more things than just what you mentioned going on at the same time. I think historically I do better when I’m busy, but even I can admit that this was kind of bananas. Ultimately, it was about rising to this challenge on two fronts: do whatever it takes for your family, and also at the same time do whatever it takes your other family, for the company. I probably blacked out a little bit for the last two weeks of March, but we made it through all that and got the team distributed, and got you up and running very quickly, which I don’t know that we had as much to do with that as you did. But I’m grateful, frankly, that March is behind us.

Polina: It literally was a light switch of Aequitas being a team that was in one office, always together, to all of a sudden being dispersed across the entire country. As a founder, how was it for you to make that transition?

Tim: To be honest, it was hard. It was hard for everybody. It was very abrupt. To your point, one day we were all sitting together and getting ready for you to join us, and by the next day, no one was there, and everybody was in these unfamiliar working environments or trying to adapt their living environment to also be a working one. In New York City, me included, I was living in a one-bedroom apartment with my wife and a one year old…that’s not optimized for work-from-home. So the first week of that was an exercise in change management, and managing the distractions that came with it. It took us about a week, and then it felt like we were all settled. I think we were all sad, but optimistic that we could all be back together in the not-so-distant future, and in the meantime, there was work to be done. I was really proud of the way the team came together, and how much of an impact frankly you had on that in light of your experience working remotely from all over the world over the years. I think we benefited greatly from that.

Polina: Adaptability is key for any organization, coupled with a bit of reflection. Almost a year ago, you penned a great retrospective on the lessons that you learned along the way to Aequitas turning five. And one of the first ones was “always be selling like you’re going out of business.” You wrote about the nuance of selling a service, and the urgency with which you need to approach dialogues and relationships. In light of what’s going on today, has your perspective shifted?

Tim: In some ways it’s changed completely, and in others it’s exactly the same, but there’s some weird irony probably buried in that bullet from that retrospective. For now, if you take the thesis behind “always be selling like you’re going out of business,” we’re really swapping “selling” for “adding value.” That’s not to say that adding value isn’t always one of our primary objectives, but I think traditional “business development efforts” are – I won’t go as far as to say inappropriate – but not conducted the way they were on March 1st. And so, we’re a little bit less worried about selling like we’re going out of business, and more interested in driving value for our partners like we’re going out of business. It’s not really about new business and new clients right now, as much as it’s about being great partners to our current clients and making ourselves and our expertise available to virtually anybody that needs it.

Polina: In this environment, how do you define “value”?

Tim: In some ways it follows over a longer period of time what our search process follows over a shorter period of time, which is that sometimes you need to go back to the beginning based on whatever market forces you’re dealing with. I have, in some ways, dusted off the playbook from when it was just me, which is that you’re not going to win everything, and the best you can do, the most important thing you can do is be there for people, with no strings attached. The way that would apply to an existing client would be counseling them on how to run virtual interview processes, or giving them guidance on whether or not it even makes sense to follow a search through right now or whether they should sit and wait, or ‘hey, don’t rush this through because you’re afraid you’re going to lose somebody, trust the process.’ That’s the client side. The candidate side is the same as it’s always been: have a conversation with anybody who wants to talk to us and needs our help. More people than ever probably need our help, and that could be market intelligence on who’s hiring, it could be how to think through a transition when you’re laid off, it could be how to rewrite a resume, whatever that might be, just help people. Similarly, something I’ve done for as long as I’ve been doing this, is continue to connect. Make connections for people that don’t come with any expectations other than “I hope someone benefits from this.”

Polina: One of the things that initially attracted me to Aequitas is the dignity that you bring to the hiring process for both the organizations and founders with whom we work, and the candidates. It seems like both sides of that equation are in a really vulnerable position. In such an uncertain time, how does dignity and choice play itself out today?

Tim: I truly believe that we’ve infused a different kind of ethos into the way we partner with clients and candidates. And so, I hear integrity – which is effectively the translation of our company’s namesake – defined as ‘what you do when no one is looking,’ which for me translates into doing the right thing even when it’s the hard thing. It’s easy to second- guess when and how you’ve done that in hindsight when we’re all under siege right now, but I wouldn’t change a thing. That’s exactly why we’re launching the Health Talent Exchange – it just seems like the right thing to do. It’s not about us right now, it’s about everyone. People are struggling, relationships are being stressed, there’s a lot of fear, and if building something like this helps some people get back to work, put food on the table for their families, get health insurance, that’s a big win. As a team, we’ll feel like we’ve done our small part, and it’s the least we can do because there’s just a bigger picture goal now. This is a humanity thing and if we do those things and if we focus on those things, it’s why we’ve built the company the way we did and built the culture the way we did. If we stick to that and stay true to that, everything will be fine when all of this is over.

Polina: Can you describe the Health Talent Exchange?

Tim: What we’re creating is an intellectually honest and democratized platform to connect people. The underlying principle for this exchange is what we’ve all been doing for a living as Aequitas Partners for so long, which is connecting. Connecting people. None of this will cost anybody a thing. It’s completely free, pro bono, and we just hope that it helps people. There are a few things at play. Firstly, certain companies are still growing and hiring right now, but they’re hard to find, or harder to find than they should be or would be under normal circumstances. We want to elevate them. We want to make them more visible to people who are looking, because they have growth objectives and they’re making an impact on healthcare. How do we help facilitate that? The first part is to aggregate the real opportunities that are out there, get them all into one place, and make them very searchable and very easy for people who are looking for new things.

The second piece is that there are a lot of people who have been displaced. And unlike other times, many of them are total rock-stars and their performance on the job had absolutely no bearing on being a part of a reduction of force. There are also lots of people who might see the writing on the wall and are worried that that’s coming for them too, and are starting to think about how they get out in front of that. There’s going to be an opportunity for those folks to announce themselves.

The third piece is that there are a lot of companies that are going to get squeezed here. They were getting ready to raise capital, or were in the middle of it, and those raises aren’t happening. But they still need to invest in certain things. Maybe they need marketing, and were going to hire a VP of Marketing with their Series B funds, but those aren’t available any longer.  What we want to create is a place where either volunteers or contractors or consultants can offer up their capabilities. So maybe the near-term solution for that Series B company is to grab a three-month consulting engagement from a really strong marketer and it bridges the gap.

Polina: As a veteran in the health-focused, executive recruiting space has your perspective on hiring processes and the recruiting industry changed?

Tim: I think if it’s changed my perspective, it’s changed it at a higher level. Maybe less specific to those things, but on the way we think of work, life, and family. I lived through the 2008/2009 recession as a twenty-something and I was laid off because I was in financial services. In my mind, I thought well, I’m glad that that black swan event happened when I was young, single, had no kids, and frankly had very little responsibility. This feels an order of magnitude worse, and only a decade has passed. So to me, this is a stark reminder that we really only have the illusion of being in control of anything. Mentally, the best thing for my general perspective through all of this has been to take a couple minutes every single day and think about what I have vs. what I don’t, and to be very, very grateful – out loud – for those things, because a lot have way less. That’s been one of the more acute impacts on my general perspective. I don’t think that there was a way to prepare for this. Shit happens sometimes. But what’s unique here is that this is happening to everybody, and I don’t know that there have been many events in the world where you can say that. The general empathy that this has created in the world is something that I hope we can hold on to when this is over.

Polina: It’s Rahm Emanuel’s “never allow a good crisis to go to waste” quote, right? I like that we quickly instituted “Silver Linings” happy hours and saying the things we’re grateful for out loud. And while there’s no way to plan for any of this, we can plan for the next time if something like this happens again. What are some of the other methods that the organization is implementing to come out of this stronger than we went into it?

Tim: Right from the get go – and most of the folks on the team would tell you – while also taking a real view on what was happening, I tried to harp on the fact that even though these are kind of crazy and wild times, there’s opportunity here. Obviously we have to keep delivering for clients, but we’re using any available time that’s not already dedicated to that to unpack, refine, and institutionalize our process, our workflows, our database integrity, general company infrastructure – the things you tend to kick the can down the road on when you’re growing and busy delivering for clients. I think it’s forcing us to think about how we communicate with each other. There are some illusions too, when you’re in an office. It’s open, you sit right next to people, and you think you communicate well, but it’s not always the case. We’re revisiting that and we’re being forced to be better communicators because without that, we’d be in trouble. And then obviously we’re thinking through how we train and onboard people. If we use this time to level up all of these things, the new versions of them that perform under duress will perform exceedingly well when we’re back in an office together, and I think that’ll be powerful and I’m really excited about it.

Why We Do What We Do: The Health Talent Exchange

By: Nina Mermelstein & Jessica Horn

As a team whose daily work revolves around building teams for high growth healthcare companies, Aequitas Partners has been closely tracking the effects of the Coronavirus pandemic across the digital health industry. We’ve watched our clients step up and do incredible work during this crisis, quickly responding by adapting their technology to address patient needs and the larger healthcare community. Unfortunately, we’ve also seen this pandemic result in budget cuts and layoffs for healthcare organizations regardless of whether they are established businesses or new startups.

Not surprisingly, the health startup space is amongst the many industries suffering a wave of recent layoffs. Founders and CEOs who are at the precipice of growth had to reverse their plans and make difficult decisions, team members who’ve been committed to big causes are asked to make impossible sacrifices, while others have been galvanized to roll up their sleeves and join the fight against a looming pandemic. Through it all, our team speaks daily to people who share a unified purpose in health, as they remain vulnerable to uncontrollable forces. In each of the conversations, the first question is the same – How do I even begin?

We recognize that the job search process is overwhelming during normal circumstances and that it is only further exacerbated given the current state of the world. At the same time, we know there are many healthcare companies that are still actively growing, and therefore hiring, to fuel that growth. As a team of people who pride themselves on being “professional connectors,” we were inspired to leverage our expertise to launch the Health Tech Talent Exchange.

This intellectually honest and democratized platform is built on Aequitas Partners’ principles of bringing authenticity and integrity to the job search process. This will serve as a real-time hub for positions that are actually open today, connecting organizations that are actively hiring with people who are committed to making a meaningful impact in the health industry. We hope that this pro-bono initiative will support people who might feel uncertainty during this time, help them recognize the breadth and choice of opportunities available to them, give them dignity during this next step, and ultimately find that perfect role that fuels their purpose.

We invite all companies involved in the healthcare industry to participate by sharing their active hiring needs. Participating companies can range in size from 5 to 1,000 employees, seeking talent across the US market. We understand the time and resources necessary to find the best talent, and our hope is for healthcare companies to leverage this exchange to help support their growth. For job seekers, we encourage people who are looking for full-time or part-time work to share this resource with their larger professional network. Whether you are committed to staying in the healthcare industry or you feel mobilized by a sense of urgency to enter the field, we hope this exchange presents you with opportunities to take that next step.

AQP Book Club Being Mortal: Medicine and What Matters in the End, by Atul Gawande

By: Jessica Horn & Emily Bak

We are so excited to make our first contribution to Aequitas’ quarterly newsletter! As the newest additions to the team, we’ve spent some time over the course of our first year here trying to further educate ourselves on our industry to add value to our clients and candidates alike. Both avid readers, we decided to choose a healthcare related book to book-club internally. We settled on Being Mortal by Atul Gawande. For those of you who are unfamiliar with the book, first of all, READ IT! It’s excellent. Atul Gawande is a general surgeon, and the CEO of Haven, and does a deep dive into the evolution of our country’s approach to treatment and care for the elderly and dying population. As science and medicine have advanced, people are living longer, but more often than not, suffering more. Treatment has become very institutionalized and he illustrates what care looks like today through personal stories and those of his own patients and peers. Needless to say, this sparked a lot of interesting dialogue between us and our team. We talked a lot about our own healthcare journeys and realized how fortunate we are to be exposed to so much innovation in our work. We feel grateful to work with companies that are striving to create opportunities for the future of healthcare and we want to open up the conversation to all of you.

Emily: As an intern, I always thought that what we did was really interesting, but now working here full time, I realize how applicable and valuable what we do is to the real world. While in college, whenever I got sick or had to go to the doctor, I would hand them my parents’ insurance card and never see a medical bill, getting the care I needed and thinking that this magical little card made going to the doctor easy and free. Post-graduating college, I’m realizing how challenging navigating the healthcare world can be. I no longer have the flexibility I did in college, a relationship with a doctor I trust, or the convenience and time to wait an entire month to see a doctor. One of my first weeks after moving to the city, I felt sick and went to the Urgent Care near my apartment. After waiting for a couple hours, getting to see the doctor for only ten minutes, and then getting prescribed medication, it led to me receiving a $1,000 bill in the mail, with charges for things like “going at night,” something that seemed ridiculous to me as the only time I could have gone was after work. When I came into work the next day upset, one of our coworkers reminded me that I should have used Slingshot Health. The platform allows individuals to see doctors in a low cost, convenient way. This creates the balance of getting treatment even with time constraints, something that would have been great in that situation, and pretty much any time, as I adjust to professional life. He told me that he’s met doctors that he now sees regularly and interacts with directly rather than going through admin to book appointments. I’m excited about this option of building more trustworthy relationships with my doctors, having the reassurance that if I do ever get sick, the process of getting better won’t be a burden.

Jess: I totally remember how overwhelmed I felt when I first graduated from school and experienced similar pressure when it came to prioritizing my budget, health, and time, no longer having the luxury of free time like I did in college. I think I’ve finally started to figure it out. As I’ve moved through different phases in life and career opportunities, it has become more and more important to me to find a balance, especially living in New York City. While New York is charged with energy and much fun to be had – it’s also crazy and overwhelming. A few years back I completely hit a wall, finding myself pulled in many different directions, and an opportunity to move to Denver presented itself. I love to ski, spend time in the mountains, and felt that living in another city could give me some perspective. After living there for a couple of years, I walked away with a greater sense of self and a better understanding of what I need to incorporate in my life to make me feel healthy. Now that I am back in New York, I’ve carried these lessons with me, and make it a priority to create time for myself, allowing me to be efficient at work, manage my time, and be the best version of myself for the people I love. I try to say “no” to things that don’t serve me, spend time with the people who share the same values, and create opportunities to leave the craziness of the city and spend time outside. I’ve learned that the times when I have low energy or stress, it’s often because I’m burnt out and not fully supporting my well-being and mental state.

Emily: There were a lot of examples in Being Mortal that demonstrated exactly what you’re talking about. When people are treated in a way that serves them as individuals, they find purpose and meaning in their lives, ultimately changing their overall wellbeing. In one example, animals, plants, and even a children’s daycare were placed into a nursing home. Just these few additions did more for the residents than the antidepressant drugs they were given prior. According to the book, compared to an average nursing home, the total cost of drugs fell by 38%, and deaths fell by 15% of the control facility. By bringing personalized care and attention to these people, and surrounding them with things that brought them joy, the overall desire to be alive and present increased. Whether it’s spending time outside in the mountains of Denver or caring for a bird within a nursing home, it’s important to consider that healthcare isn’t solely about the physical body, and that finding that greater sense of self increases overall happiness. As exciting as the city can be, it can feel lonely if you’re not taking the time to stabilize your mental health and do the things that make you feel connected to others. Purpose, meaning, and connection can be more valuable to quality of life than taking a pill.

Jess: I love that part of the book. It’s such a simple concept – to encourage individuality – that it’s hard to believe how revolutionary it is. I guess it is easy for us to take this for granted because we are exposed to people and organizations that are trying to instill this mindset every day. In our universe, we’re constantly speaking to execs or working with companies that are working towards elevating the human experience when it comes to taking control of our own health and having transparency. Even the most general form of care is being revolutionized. We see it with companies like Eden Health, for example, that is building a Primary Care platform to help people seamlessly navigate through their healthcare journeys. Not only do they make it easy to book appointments and make insurance costs more transparent and less stressful for patients to understand, but each person is assigned to a designated care team that will learn about his or her individual health and is available to them at any time. I imagine it’s such a relief to talk to a clinician that actually knows you and your story. I feel like I’m constantly having to explain my medical history over and over again or having to gather my past records. I never know whether I’m painting an accurate picture. This emphasis on building a relationship and having an option to speak to my own team through an app on my phone or even see them in person if I need to is so valuable.

Overall, you’re right, Em. There is a clear shift in mindset industry-wide in care delivery. Companies like Eden are emphasizing the benefits of primary care to prevent problems before they begin. Another one of our clients, T1D Exchange, is building a platform to help individuals living with Type I diabetes better manage their disease by leveraging real world data to improve outcomes for this population, along with educating the people that are caring for them. After reading Being Mortal, we’ve learned that there’s even a shift in what treatment looks like for terminally ill patients.

Atul Gawande talks about how very sick patients are gravitating towards living out their days in their own home and choosing hospice versus opting for treatment (whether it’s chemo, radiation, a new drug trial, or surgical procedures) where there is no guarantee that it will extend their lives and more often than not the treatment will decrease the quality of life.

There’s a study conducted in the book where researchers compare patients with stage IV lung cancer receiving two different approaches to treatment. One group received the usual oncology care (chemo), the other half received the usual care plus visits with a palliative care specialist. The group who saw a specialist stopped chemotherapy treatment sooner, entered hospice earlier, suffered less, and lived longer (by up to 25%). I think that this increase in awareness and move towards allowing people to make decisions about their own health, helps them figure out what is most important to them, no matter how scary. I’m witnessing this firsthand as I see how my parents and their siblings are approaching care for their parents who are sick. As my grandmother’s health is declining in her old age, it’s hard not to hope that a new drug or treatment might prolong her life. I doubt that when she was younger and healthier she was asked how she’d like to live out the end of her life. Despite how uncomfortable this conversation probably is, I can’t help but think that I would like to learn from this and broach this topic with my own parents. I would rather hear what’s important to them. We should all be able to make these decisions for ourselves.

Emily: I completely agree, and also felt that I would want to have this sort of conversation with my parents sooner than later. I think painful situations could become more tolerable if we educate ourselves and talk about what matters while we still can. Atul Gawande shows us how educating patients has become extremely important, we see evidence of this in some of the solutions our clients are building. Doctors are putting more of an emphasis on offering options, not just delivering treatment. Providing a well-rounded education on the consequences and options in treatment is necessary for the patient to make informed decisions. In Being Mortal we see many examples of how patients have better outcomes when their doctors spend time giving options rather than giving orders. When working with a client like CarePort Health, it isn’t difficult to convince people of their mission, as most people have come into contact with a situation where they, or someone close to them, feel lost and uninformed within the healthcare system. CarePort collects data to allow patients to make more educated decisions about post-acute care facilities. The product suite helps patients to understand that they can make choices and have more control over their own care rather than being handed a list of rehab centers at discharge and expected to choose at random. With a patient’s ability to see all of the options and information laid out, they have a say in their care journey that will lead them to making decisions that align most with what they hold valuable in their lives. It’s important to recognize that more people want to have a voice in their care, which is why so many companies like CarePort are creating innovative products to change the traditional system.

After reading this book, and coming into contact with different innovative companies everyday, we see healthcare moving towards people customizing their own healthcare experiences around what matters most to them, which in turn is affecting the doctor-patient relationship. Doctors have to take into account the whole person, and recognize that there isn’t one right way to treat or care for someone. For example, I want the convenience and low cost way of seeing a doctor, knowing that when I get sick, I can easily see someone I trust to give me the care I need. What’s important to Jess is a doctor who sees the whole person, encompassing everything from physical to mental health. People want a say and options in their care journey, a major theme in the book as well as in the companies we work with everyday. When you have a say in your healthcare experience and are being listened to and cared for in more of a holistic sense, your health and wellness can drastically improve, experienced through two New Yorkers and through the stories told in the book.

Coffee Chats with Nina: Understanding the Entrepreneurial Mindset – Part IV

Part IV of an Ongoing Series – Heavily Caffeinated & Highly Enlightened

Two years! I truly can’t believe that I’m already approaching my two-year mark as a member of the Aequitas Partners team. It feels like it was just yesterday that I moved into my first closet-sized NYC apartment and received a phone call from Tim Gordon. He offered me an opportunity to join his team, that I now consider family. To some people, two years might not seem like a long time. However, upon reflection, I can confidently say that this has been the most transformative timespan for my own personal and professional development in my life.

My skilled colleagues, our innovative clients, and the thousands of impressive candidates I’ve interviewed have all contributed to my development in this field. But I must attribute an important part of my recent growth to the insights I’ve gained from the highly-driven healthcare technology entrepreneurs who have opened up to me during my Coffee Chats. Last year, I set out to better understand the entrepreneur’s mindset and hear stories straight from the source about what it takes to build a digital health business from the ground up – and that’s precisely what I got! I was gratified by these leaders’ willingness to participate in my Coffee Chats with Nina series and the level of genuine authenticity in their shared stories. I had the chance to dive into some pretty touchy subjects and they didn’t hold back one bit. I heard unfiltered accounts of their experiences including all the ups and downs; everything from the first moments when they knew they had novel concepts to the times they thought they were going to fail.

For this final article of 2019, I’m taking a look back at some of the key insights and highlights from my discussions over the course of this past year. I’ll also share some thoughts on what 2020 might have in store for this series.

Wrapping up 2019

Since we are all focused on this complex, highly regulated, and emotionally charged industry we know as “healthcare,” we’re also familiar with the challenges that confront us in attempting to innovate in this space. Instead of developing solutions for industries such as retail or consumer goods, the founders I met with all chose the convoluted world of healthcare technology. On top of the typical challenges facing all entrepreneurs such as fundraising and team building, these leaders have many added obstacles, spanning HIPAA regulations to longer than average sales cycles. In my first article of the series, “Taking the Leap,” I dove into what it took for these founders to actually take that first big step to build their respective companies in this trying industry. I was shocked to hear about how often they felt ill prepared to enter these life-changing journeys. Despite spending years working as venture capitalists or practicing clinicians, all of the executives shared the common sentiment that they had to do most of their learning on the job. While the path to growing their businesses has been difficult, these leaders all refused to accept the status quo and they continue to be driven by the notion that there must be a better way of doing things.

Since there is no all-encompassing playbook for the obstacles faced while growing a startup, I heard stories of some tremendous roadblocks that these founders have overcome. They told stories ranging from how they bounced back after hiring the wrong team member to how they were forced to completely change direction after losing an expected investor in a major funding round. I also heard firsthand accounts of times when founders were offered advice from people whose only intent was to get something in return and instances where there were challenges in working with relatives and close friends. In my second article, “5 Things Entrepreneurs Wish They Knew Before Building Their Companies,” I shared some of the biggest lessons they’ve learned as well as some pointers they wish they were given prior to starting their businesses.

My last article, “What They Don’t Teach You in Business School,” covered the different aspects of being an entrepreneur that you can’t train for ahead of time. While most of the executives I’ve spoken with have earned advanced degrees from the most highly regarded institutions, they all noted the aspects of being a founder that you can’t study. Many of them underscored the difficulties they encountered in assembling their teams. I heard stories about overcoming communication barriers, discovering the best ways to motivate employees, and making tough decisions around hiring and firing team members. I also had the opportunity to dig into another key topic I was curious about – time management. They offered insights on how they’ve attempted to manage competing priorities across their work and personal lives. Finally, I learned about the different resources (i.e., books, podcasts, networks) these professionals often leverage to become better leaders.

Looking at 2020

In speaking with such a wide variety of digital health entrepreneurs over the last year, I’ve heard many different perspectives on what it takes to build a business. I’ve spoken with both clinical and non-clinical executives. I also met with a number of first-time founders in addition to leaders who’ve had experience from previously growing other companies. Heading into 2020, I’m excited to have some more pointed conversations with this eclectic group of ambitious individuals while also adding new executives to the mix who will offer other fresh perspectives on entrepreneurship.

While I’ve had the chance to cover a number of interesting topics, I feel that there is a lot more to explore. Moving forward, I’m planning to tackle a host of new topics such as the challenges specifically facing female founders and the impact of major healthcare policy changes on these entrepreneurs’ business strategies. I’m also hoping to learn more about the dynamics of working with a co-founder versus going at it alone. Additionally, I’ve been increasingly curious about investors’ perspectives on many of these topics and would love the chance to connect with a variety of leaders in that space.

Moving into this next year, I welcome feedback from our readers on things you want to learn or questions you wish I had asked. Please send any thoughts directly to me at nina@aqpsearch.com. Looking forward to sharing more insights in 2020!

An Interview with Kevon Saber, CEO of GoCheck Kids

Kevon Saber is the CEO of GoCheck Kids, a digital health platform designed for the advanced screening of vision impairment in children globally. The company is based in Nashville, and is currently screening children on 4 continents. We sat down with Kevon to talk about the business, his vision, and what it’s like to scale a global digital health company.

Tim: GoCheck Kids is on a pretty incredible mission. Why don’t you tell us a little bit about the company.
Kevon: The company was started by Dr. David Huang who actually invented the most widely used diagnostic in all of ophthalmology. He recognized that most children in America weren’t being screened for the most prevalent disability in the country – vision impairment – because of the absence of an affordable screening tool. He decided he was going to leverage his expertise in biomedical engineering and ophthalmology (he’s got four degrees in those two areas) to invent a product that is actually affordable. GoCheck Kids is a third of the price of the competition and as a result has made vision screening affordable for pediatricians in the U.S. and globally. Our goal is to catch every kid with vision impairment (that’s one in five kids in the U.S.), so that they can see and learn, and ultimately fulfill their potential.

Tim: You were brought into the company as the CEO a little over two years ago from a career outside of healthcare. What drew you to this business?
Kevon: I had said to myself and to my friends for years that I wanted the rest of my career to focus on elevating human flourishing. And I hoped to bring together my background in technology and entrepreneurship for a cause that ultimately would make a big difference in the lives of many people. Preventing the most prevalent disability for children in many countries, GoCheck Kids fit my first criteria. I was also really impressed with the quality of the team. They were the kind of people I would hope to recruit to found a company, but they were already assembled, which of course makes everything go a lot faster. Thirdly, I talked to twenty of their customers, and their enthusiasm for GoCheck Kids’ affordable impact on seeing, learning, and the rest of life was galvanizing. Those three factors were intoxicating and I couldn’t help myself.

Tim: Being new to healthcare, what was the biggest challenge in navigating the healthcare landscape for you early on?
Kevon: I had many steep learning curves, but the biggest thing I underestimated was the increased complexity associated with regional variation in payors, regulatory requirements, and customer preferences. This diversity in the operating environment is also a positive – it encourages a company to practice managing change – which of course is the only constant, and especially in healthcare.

Tim: In your view, what makes GoCheck Kids different than the alternatives available for the advanced screening of pediatric vision impairment?
Kevon: There are a few pediatric photo screeners that have been available for ten years or twenty years, and they are actually very effective. The challenge is that they aren’t affordable, and they increase administrative burden due to their lack of, or negligible EHR integration. We are a third of the price, without compromising on clinical efficacy. That’s probably the biggest reason, in addition to the prevalence of vision impairment that we have skyrocketed. We have grown from about 1,700 pediatricians in the U.S. when I joined just over 2 years ago to over 6,500 today.

The second big way GoCheck Kids is different from other photo screeners that preceded us is that we are a fully digital product that is in the cloud on a modern operating system, enabling us to very easily integrate with a hospital system’s electronic health record. We are already integrated with the EHRs representing most of the market today and every quarter we add additional EHRs. Ultimately, a hospital system isn’t just saving money and impacting outcomes while using GoCheck Kids but they’re also saving a lot of time. This means clinicians can spend more time with patients.

Tim: You mentioned a bit of it already but how has the company grown under your leadership, and are there some wins that you can share?
Kevon: We have grown from 1,700 pediatricians to 6,500 pediatricians which has also represented about a tripling of the company’s revenue. Our burn rate has been cut by eighty percent without any layoffs, driven purely from the growth of the business and our investments in efficiency. More than the numbers, what’s really fulfilling for us is the impact that we see. We look at a lot of big numbers around screenings and referrals but what we love, of course, is hearing the actual stories from pediatricians. Those stories fall into three different but equally fulfilling categories:

First, every day we discover children who are not seeing the chalkboard or whiteboard very well. Their learning, their confidence, even their relationships were compromised because they had vision impairment. Once this impairment is addressed their whole trajectory is changed, because seeing is learning and learning is potential.

The second category consists of kids who are actually losing their vision permanently (this isn’t just a benign issue that glasses can fix); those kids are also not learning. Stories like these are fulfilling because these are children who are going to lose twenty percent or seventy percent of their vision in one or both eyes if it weren’t for GoCheckKids.

And fortunately, this last category of issues is much more rare: retinal cancer. This disease usually spreads from the eye to the brain and will not only cause a child to lose their vision in both eyes but also their life if they aren’t caught very early. The magic of GoCheck Kids, is that we enable pediatricians to catch these issues early and while they are still treatable, which saves a child’s learning, vision or life. We believe every child deserves to see what they’re capable of.

Tim: You mentioned impact here and there’s been talk about GoCheckKids’ ability to make a global impact. Has that begun, and how do you see that evolving overtime?
Kevon: We received our CE mark, which is the FDA equivalent in Europe last year. And already about 15% of GoCheck Kids screenings are in Europe. We actually have a few pilot customers in Asia right now. We’ve also just landed our first customer in Africa, so now GoCheck Kids is being used on four continents to protect the learning and vision and potential of children. We are definitely excited to expand our global footprint and impact which of course is being made possible by the portability and the affordability of the approach we are taking: putting a proprietary advanced technology on a smartphone which has a significantly lower cost of manufacturing and distribution than a traditional medical device.

Tim: Very Cool. How do you think about company culture as the leader of an organization that you weren’t the founder of?
Kevon: You know, when I was in Belgium a few days ago, a candidate who was applying to work at GoCheck asked me what single characteristic is true for everyone in the company. We were having lunch and I didn’t even have to drop my fork, it was obvious. Everyone at GoCheck Kids is passionate about our mission. They are passionate about protecting the potential of the kids we serve and as a result, elevating human flourishing.

When I joined the company, it was tempting to take my business and life principles and kind of impose them on the company and the culture and the people. But I realized that probably wasn’t going to be as effective as just taking a more patient approach. What I did was just observe and listen to see what the principles were that people at GoCheck Kids already had. My job was actually more of a scribe as opposed to an agent of things. And then to create a discussion with the team to see ‘what are the great aspects of the culture already existing and where we can improve.’ Our work here is never done, but I feel like taking a more patient approach ultimately has resulted in a commitment to principles and a culture that is broadly shared by the company as opposed to the likely resistance that I could have experienced if I was imposing my own principles.

Tim: So with all that in mind, what keeps you up at night?
Kevon: The one thing I’m thinking a lot about right now is how to provide a product that’s disruptive (not to hospital systems or doctors): radically changing affordability and access to care. However, that’s really hard to do if hospital systems put vastly more affordable digital products through an unnecessarily long decision cycle. If so, digital health companies can’t reap the full cost advantages of being digital because they have to spend a lot of money on sales and marketing, on these really long sales cycles. That’s not something that I think GoCheck Kids or any hospital can figure out in isolation, but as we sit across the table and talk about our mutual desire to advance outcomes and lower costs, we have to find a way to compress the sales cycle if we plan to both boost outcomes and lower healthcare costs for the whole system.

Tim: Awesome Kevon, that was great.

Reflecting On Our First 5 Years: 5 Things I Wish I Knew At The Beginning

By: Tim Gordon

It doesn’t feel like five years. In fact it feels like just yesterday I was sitting down at my  kitchen table to figure out how to start a company. So much has happened since then, and without the support of my now-wife-then-girlfriend who apparently missed the memo that being an entrepreneur basically means you’re unemployed, none of this would be possible. I’ve watched in amazement as we’ve grown – bigger offices, new website iterations, the launch of this newsletter, new clients, new investments, and most importantly – more team members. The impact of adding
each and every one of the people on our team has reverberated through the entire business, taking it somewhere I never could have even flirted with on my own. Through all of that, I’ve learned countless lessons – many the hard way – but on the whole have found these challenges far more rewarding to power through than those that came before. In honor of our 5th Birthday, here’s five things I’ve learned that I wish I knew at the beginning.

  1. Always Be Selling Like You’re Going Out of Business

    This sounds obvious enough, but things are tricky in a services business when you’re an army of one. We don’t sell widgets, and we didn’t invent a better mousetrap. We don’t cold-call CEOs, suggest it’s time that they replace their CFO and offer to help them with that. Sales cycles are all over the place. The shortest has been 1 week, the longest – well I’ll know the answer when we start doing work for companies we started building relationships with the year I founded the firm. In the beginning, I was worried that I’d sell too much and not be able to deliver on the
    work without having a team to support me. In hindsight, this was bananas. This would have been a wonderful problem to have. Alas, it was not the problem I had. After some reps, I quickly learned that I always needed to have the same urgency around our business development efforts as I did around our delivery. This got easier once our team grew and I could split my focus more evenly, but the reality is, no revenue, no business. Even when things are going well, get your ass out there and sell more.

  2. Hiring The Right People is Transformational

    Duh, right? Shameless plug for a search firm? Maybe. But if you want to trace the first inflection point in our business, there’s an exact date that just happens to match up with our first hire. You have to white-knuckle your way through the productivity dip that follows, but when you come out the other side of it, the return on investment is huge. When you get it right, you see the early formation of your company’s culture, you get freed up to focus on other things (see Lesson #1), the next hire gets incrementally easier to on-board via shared institutional knowledge, and, it gets a little less lonely. Just a little. There’s a chicken and egg element to this when you’re bootstrapping the business and haven’t raised capital, but there hasn’t
    been a single thing that we’ve spent money on that has a better return on investment than our people.

  3. Understand Why People Say No To You, But Even More Importantly, Why They Say Yes.

    In the beginning, I heard “No” a lot. A lot. Turns out, starting a company is an exercise in getting your teeth kicked in every day, and coming back for more. Good thing my dad’s a dentist. When we wouldn’t win an engagement, I very infrequently knew why. I could take a good educated guess, but rarely would a prospective client tell me straight up. One-man shop, track record, etc. Over the last year, a number of our clients have told me why they said “yes” to us, and it was a strangely profound realization that that was probably more important for me to understand. I should have asked every damn client we had why they picked us, because some of the unsolicited feedback surprised me. It highlighted that they cared a lot about the
    things about us that I thought they should care about, but feared they didn’t. They chose us because of our size not in spite of it, our clear focus, and the belief that we would do anything to deliver for them. It showed me that the story about us that I wanted to tell, was in fact the one that people wanted to hear. Who would have thought? Which leads me to my next lesson…

  4. Trust Your Gut

    You know. You know you know. But you zig when you knew to zag. At what point do you start to listen to that feeling that clearly knows better than you? I should have listened more often. I’m happy I listened when I did. Instinct led me to make some bold (for me) calls over the last few years at times when all the evidence said not to. A number of those moments represent huge inflection points in our business, and frankly are why we’re still here. Other times I didn’t trust my gut, and I really should have. This one requires constant awareness on my part, because I still miss it sometimes, but I’m getting a lot better at paying attention. I think the brain subconsciously does a phenomenal job of cataloguing experiences in the form of data, and when it’s trying to tell you something based on all of that computing power, you should listen.

  5. Balance is A Key To Longevity

    I say “A” and not “The” because there are others, but this one has been hugely important for me. In the beginning, at that lonely table in my one bedroom apartment, 10 feet from my bed, it was hard to figure out when the work-day started and ended. Even sitting on the couch in the evening, being able to see my “office” led to pangs of guilt. I’m starting a company, shouldn’t I still be working? I think the answer was no. This is a marathon, not a sprint. Finding time to get above it, rest, reset and come back ready to go made a big difference. Taking the occasional vacation to realize that I could and the world wouldn’t come to an end was really important. We just aren’t meant to keep going without taking a break, and I’ve got to set a good example. Happy employees make for a happy company and happy clients, and they need to know that it’s not only OK to rest and reboot, but that it’s an expectation. As a founder, I had to be deliberate about placing boundaries (with some flexibility) for the benefit of everyone, not just me.

What I’m Working On

I, like our company, am a work in progress. I find that when I share what I’m working on out loud and with others, it helps keep me accountable to it. There are two things that I’m trying to improve on daily. The first is patience. And not the “I’m an impatient person and that’s a weakness masquerading as a strength” type of a BS answer to an interview question. I mean impatience in a form that I’m not proud of. It’s something that I’ve been working on for a long time, and probably always will be, but it’s important to me, my team, and my family that they get the best, most patient version of me so that we can continue to do amazing things.

The second thing, is stopping to celebrate the wins. I think we’re like most growing companies, in that we spend a lot of time unpacking the things that we mess up, or fail at, and very little time patting ourselves on the back for a job well done. I’ve been guilty of this my whole life, but I’m making a concerted effort to focus on our wins – big and small – because we should and it’s important. I worry that if we don’t we may forget how to have fun doing this, and if we’re not having fun, what’s the point?

An Interview With Carolyn Witte, Co-Founder & CEO of Tia

Carolyn Witte is the Co-Founder and CEO of Tia, a New York City based modern gynecology  and wellness practice designed to personalize and integrate a holistic approach to omen’s healthcare. Designed to be a one-stop-shop for female health, Tia opened their first clinic in Flatiron in the Spring of 2019, with plans to expand in the coming months.

Tim: Tell us a little bit about how Tia came to be, and what inspired you and Felicity to found the company in the first place
Carolyn: Tia really started out of my own and Felicity’s frustrations with the healthcare system as patients. We very much approached the space from a patient-first point of view, having gone through our own really frustrating diagnosis process in our early twenties that exposed to us everything that was fundamentally broken about women’s healthcare – specifically the fragmentation, lack of personalization, and, something that we talk a lot about: lack of soul in healthcare. It’s been quite a journey over the past two years taking our patient experience and marrying that with the provider reality, and really saying, ‘well, what would healthcare really look like in design, with the female experience at the center of it?’ That’s what Tia has been really about.

Tim: And for those that don’t know, what is Tia?
Carolyn: Tia is a lot of things. We are not a clinic with an app, or an app with a clinic, but at our core: the next-gen women’s platform fundamentally changing the way women interact with the healthcare system at large. What that means in practice is we build all sorts of products, tools, and services, from our personal private women’s health advisor app to our first brick and mortar Tia clinic here in New York City. Everything we do or build is designed to help women be their own patient advocate and get meaningfully better healthcare.

Tim: Women’s health is having a bit of a moment right now – and sensibly, as depending on where you get your stats, upwards of 78% of women are the primary healthcare decision-maker in their household; what do you attribute the explosion of companies focused on the space to?
Carolyn: Yeah, it’s interesting. I think there’s a tension between this realization that women spend 80% of the healthcare dollars and therefore are “a niche market,” as this market used to be described as. With the other side of the coin, which says that that women have – we believe whole heartedly at Tia – fundamentally different, distinct healthcare needs than men; and therefore, necessitate their own product experiences and healthcare offerings designed with them at the center of it. As we say at Tia, ‘women aren’t small men,’ and the healthcare system at large has all too often treated women as such.

Tim: What was the biggest challenge that you faced in getting Tia started?
Carolyn: Where to start. That continues to be a challenge we face: We’ve always had a really big, bold, grandiose vision for building a new model of women’s care from the ground up. The question of where to start, sequencing and prioritization has always been the challenge. We started as building an information-only platform, and quickly learned that we couldn’t really achieve our goals, or our vision, without getting into care delivery ourselves, which was the next chapter. I think now the challenge continues to be what are the next, and the next, and the next chapters, and the right sequencing to really enable us to achieve our long-term vision?

Tim: Along those lines, how do you differ from other women’s health providers?
Carolyn: First and foremost, we’re not just a women’s healthcare provider. We’re a technology platform at the core. In many ways we’re three businesses in one: a technology platform, a clinical services business, and a direct-to-consumer brand. And Tia’s magic is really at the intersection of brand experience, technology, and best-in-class clinical care.

Tim: When you talk about that technology, what role does it play in your view in revamping the patient experience that you’re providing?
Carolyn: We view technology as the tool that’s not only about revamping the patient experience,but changing the provider one. I think the biggest realization for me as the founder, who approached the space originally from a patient-first point of view, was realizing that, to fix women’s health for women, you need to fix it for providers too. So we view technology as a bridge that can serve as filling the gap or the void between patients and providers, and build a new relationship-based model of care for the modern healthcare system that is missing today at a time when healthcare is becoming more fragmented, more transactional, and less human. And we use innovative technology to fill that void.

Tim: So what are your plans for expansion?
Carolyn: Big plans. Expansion for us looks like an array of different, sort of, chess moves, opening up more Tia flagship clinics in other cities around the country. It’s been amazing to see how in demand this new care model is that we’re building since we opened our first Tia clinic 3 months ago – expanding our scope of practice beyond core gynecology and basic primary care. We found that women want literally everything from Tia – from fertility to mental health to OB – and the challenge of where and how to expand our scope is a big one. And the third thing is scaling our technology platform through other providers is something we are starting to think through as a way to reach more women at scale and really productize that part.

Tim: At this point, what keeps you up at night?
Carolyn: Sequencing. The same thing that has always kept me up at night, and doing the right things in the right order. I think we have worked really hard to get where we are, and validate it a lot and prove that women and providers really want this new care model, and that they trust Tia, which is the ultimate thing we’ve earned. Their trust is hard to earn and easy to lose; and thoughtful scale, thoughtful sequencing, and expansion is the key thing to fix up here and what keeps me up at night.

Tim: Remind me, how far into this are you? How long have you been at this?
Carolyn: Two and a half years.

Tim: Which is kind of a lifetime in a startup, right? What’s one thing you know now that you wish you knew at the beginning?
Carolyn: Aligning incentives among all the different players in the healthcare system is key to success. You can’t just build for patients. You can’t just build for providers. You can’t just build for payers. You have to build for everybody. And figuring what that thing is that fulfills everybody’s needs and wants is the secret.

Tim: Hmm, that’s a good one. I like that one. Great thought to end with. Thanks Carolyn!

Coffee Chats with Nina: Understanding the Entrepreneurial Mindset – Part III

By: Nina Mermelstein

Part III of an Ongoing Series- What They Don’t Teach You in Business School (or startup summer camp)

We often applaud successful entrepreneurs for creating innovative solutions that are aimed at changing the status quo. Our culture prioritizes entrepreneurship skills so much that we now offer summer camps such as Biznovator and school programs like We Grow to empower young entrepreneurs. Where were these amazing programs when I was stuck sweating in the summer heat at tennis camp? By the time I attended university, my school offered a brand new minor that I was excited to partake in called “Entrepreneurship & Management.” We analyzed corporate case studies, developed business plans, and built mock marketing agencies.

I generally agree with the idea that it is important to instill entrepreneurial skills such as creative thinking and teamwork in children and young adults. However, I have also come to understand through my continued Coffee Chats with Founders and CEOs in the digital health space that there is a lot about entrepreneurship that we can’t learn in summer camp, college, or even business school. Below I’ve pared down my findings into three categories: honing people skills, balancing competing priorities, and leveraging available resources.

The “People Stuff”

Over the course of a business school education, you might dive into classes focused on finance, organizational behavior, management, or accounting. However, one entrepreneur who earned her MBA from one of the most prestigious business schools in the country noted that while her education was incredibly valuable, it didn’t exactly prepare her for all of the “people stuff” that came along with building her business. For example, she found herself embarking on new and exciting quests to better engage her employees and establish a strong company culture. This was what she called “the fun part” of learning on the job. She was also confronted with much more difficult predicaments regarding underperforming hires. No book or course had prepared her to determine when is the right time to let someone go or even how to fire an underperforming employee. She said that as a founder, “it’s important to gain more comfort in living in the grey area, rather
than in a world that is just black or white,” especially when working with and making decisions about your team members.

Another founder spoke about her successes and challenges while bringing together a group of employees with a variety of skillsets and work experiences. She knew early on that there was a great benefit in assembling a team that would offer a diverse set of perspectives. While she was proud of her success in hiring an eclectic team, spanning clinical researchers to software engineers, she was quickly confronted with a significant communication barrier. Since her team members came to the table with different specialized skillsets, they became frustrated when trying to speak and understand one another’s views and ideas. Her background as an investor never fully prepared her for this type of challenge. She found herself acting as a translator between a physician with 5+ years of clinical care experience and a product expert who had never worked in healthcare before. Once she made a more concerted effort to level the playing field by creating a company culture that invites people to ask questions and never assume that any concept should be immediately understood, her team began working well together.

The Balancing Act

As a millennial living in NYC, I often find myself struggling to strike a balance between my career responsibilities, social activities, and self care needs. If I find balancing these
priorities difficult, I was curious to know how founders and CEOs, who have more at stake, attempt to balance their work and personal lives. When I asked these entrepreneurs how they maintain balance, I often received a laugh and the response: “I don’t.” My Coffee Chats have taught me that the idea of a true work-life balance is unattainable for someone who is building a business from scratch. While striking a perfect equilibrium of work, self, and family needs is unlikely, I’ve learned about a number of tactics that these founders have employed in an effort to distribute their time in a way that leaves them feeling fulfilled.

I spoke with a second-time entrepreneur who shared that work truly was his number one priority while immersed in his first entrepreneurial venture. During the time that he built this first business, he also became engaged and got married. He found it difficult to create a separation between work and home life, as he was constantly thinking about the needs of his company. Since then, he and his wife have had children and he has further recognized the need to strive for more work-life balance in his new role as CEO of a different startup. For him, the key was to hire an energetic Chief of Staff with the bandwidth to juggle multiple projects and the ability to take things off the CEO’s plate. With this incredible new hire offering a safety net for any immediate work-related tasks, the CEO is now able to go home at 5pm and spend more quality time with his wife and children.

I’ve also learned about the concept of career-life integration rather than attempting to compartmentalize different aspects of work and home life. I spoke with another Founder, who in addition to her work responsibilities has two young children and two parents in need of care. She said that she is not striving for perfection in any one area, but instead thinks of ways that she can integrate her work and home worlds. For example, working in a startup gives her the flexibility to take her children to school in the morning and to be home with her family at dinner, although she will often sign back online in the evening to answer emails once everyone is asleep. Since her company has grown, she reminisces about the times she was able to get more hands on and involved in the smaller tasks associated with building the business. However, she has investors who say to her, “you can’t do it all, you really need to hire others who can help you.” By making the decision to shift many of her previous responsibilities to her capable employees, she is able to find more time for other aspects of her life.

The Resources Available

Making time for continued industry learning and professional development is difficult, especially when you are a Founder who can barely find a minute to eat lunch. A number of entrepreneurs voiced their tendencies, for better or for worse, to hunker down, trying to get everything done. However, they often forget to pick their heads up throughout the day to leverage the resources available to them- whether in the form of consumable materials like journals and podcasts, or in the form of people such as mentors and advisors.

One CEO mentioned that he started using a time tracking device to compare how he would like to be spending his time with an accurate assessment of how he is realistically spending his time. He discovered that he wasn’t dedicating as much attention to networking, mentoring relationships, and industry reading as he would have liked. He now has an hour carved out on his calendar every day to read the news, blogs, journals, and other relevant publications.

A first-time founder described how he immediately immersed himself in all the resources he could find online about starting a company and raising funding. He said that First Round has ggregated an incredible variety of resources for founders. Additionally, he mentioned how he was inspired by Nike Co-Founder Phil Knight’s book Shoe Dog and he spoke about the lessons he learned from the book The Hard Thing About Hard Things by Ben Horowitz. Other great resources that entrepreneurs shared included a number of different podcasts, such as How I Built This with Guy Raz, Masters of Scale by Reid Hoffman, and Reboot with Jerry Colonna.

In regards to human resources, many Founders have found wonderful communities where they can share ideas and personal stories with others who can relate. Some leaders I spoke with took advantage of networks built by unique co-working spaces like The Wing, while other leaders have joined what are effectively “business leader support groups” offered by companies like Venwise. I’ve also heard from some entrepreneurs that they enjoy seeking guidance from people in their existing network that comes in the form of family, friends, and friends-of-friends who can relate to starting their own businesses.

These coffee chats have deepened my respect for entrepreneurs and what they are juggling on a daily (or minute-by-minute) basis. They are constantly pulling different levers, continuously learning how to better manage their teams while making time for their personal and home lives, as well as their own professional development. This has also brought to light the psychological impact that many entrepreneurs feel when attempting to portray 100% confidence all of the time without showing any signs of weakness. Michael Freeman, a psychiatrist and faculty member at the UCSF School of Medicine found that Founders are 50% more likely to report having a mental health condition. I wasn’t surprised to read that statistic given everything I’ve learned about
entrepreneurs’ competing priorities and need to depict an impenetrable vision of leadership.

Mike Tyson once said, “everybody has a plan until they get punched in the mouth.” Many of the CEOs and founders I’ve spoken with have incredible educational pedigrees and work experiences, but there is only so much they can do to plan and prepare before actually building their businesses. At the end of the day, these executives are just people who face a lot of the same challenges we are all familiar with, whether it’s about maintaining some balance in our lives or overcoming difficult team dynamics. I believe it is important to continue to have an open dialogue about how we can best support and empathize with these driven Founders so that they can achieve success in their businesses while also maintaining their personal health and happiness.

How Starting My Own Company Made Me Better At My Job

By: Tim Gordon, Founder & Managing Partner

It blows my mind that we’re going to be five. Five! I’ve now officially been running Aequitas Partners longer than anything else I’ve done in my professional career. Five has me a bit nostalgic. Reflective. Grateful. I’ve tried to be mindful and celebratory of milestones that we’ve reached over the years as the business has grown, but I’ll be honest – I’m bad at it. In quiet moments I celebrate these things, but it’s usually fleeting and then it’s back to work. It’s something I’m working on. As we close in on our fifth anniversary as a firm, I thought it fitting to revisit the first thing I wrote when I was “giving content a try.” As I read through what I wrote, it felt more relevant than ever, and reminded me of how incredibly uncomfortable I was writing it the first time around. Now felt like a great time to dust it off, polish it up, and drag it into 2019.

Part of why I wanted to revisit this topic is because my belief in its impact hasn’t changed, and if anything has only gotten stronger. Empathy may be the most important, accidental thing I’ve gained from starting my own company. Friends and family would tell you that I’ve always been empathetic; tough but fair. I’m the guy that people usually came to with their problems when they needed someone to listen and maybe give advice. I’m a good listener, and was always good at relating to people. I’m talking about empathy in a different way here. It’s been nearly 5 years since I took the leap and founded Aequitas Partners. It’s been a wild ride that’s gotten more exciting each month, and I’m not kidding when I say it feels like a blink. Days, weeks and months disappear, and I regularly lament to anyone that will listen that if I had a super power it would be the ability to slow time down and live in moments longer. I’ve made what I view as an offensive number of mistakes (no one beats me up quite like me). These mistakes are different though; these challenges, stresses, missteps, screw-ups, missed opportunities – have actually taught me things. I’ve learned to separate that from the trivial. Interestingly enough, the one thing that quite possibly has had the most profound and unexpected impact on me is a simple byproduct of starting the company in the first place – building my own team. It was true when I wrote this the first time, and it’s true now.

The irony of this is not lost on me. I’m in the business of hiring, so shouldn’t this be easy? As an executive recruiter, I’ve been fortunate to work with some incredible entrepreneurs and CEOs across Healthcare in recent years, helping them identify C-level and leadership team members across every functional role. What I had yet to do when I wrote this the first time, was find team members for myself. It’s now a little over two years since we hired our first person – Steven Berman – and the subsequent growth of our team has given me a small glimpse into what each of my clients must be experiencing when they ask us for help. Something that seems low risk, such as hiring a summer intern, at the time felt like it came with the weight of the world. There were nights tossing and turning as I did the math on whether I could afford to hire that person that could be an absolute game changer, and when the right time to pull the trigger was. There’s that gut feeling that someone just isn’t the right choice, even though they look great on paper. There’s the realization that with a team comes a tremendous amount of personal responsibility – they need engaging work to do, a steady paycheck, health benefits, professional development, training, career growth, and general investment from me in them. And they deserve it. Conversely, I need them to be ambassadors for the brand; every person they interact with needs to walk away impressed and intrigued by our story. It’s scary as hell.

But it has also made me better at my job. I now have a level of empathy that’s difficult to recreate, having not walked a mile in a client’s shoes. I’ve never been a hard-sell search guy – not with candidates and not with clients. I try my best to shepherd both parties through the process, adding insight when I can, and pushing back when it’s required. I try to do all of this while not losing sight of the significance of the decisions that both parties are making. Our clients are investing a significant amount of money in this process, both in us, and the executives they hire. Mistakes are costly, potentially meaning lost clients, lost revenue, and unhappy investors. Add to that, that this is just one of their priorities on a list that never ends, and you gain some perspective. Similarly, the executives we recruit are making what most would consider life-altering decisions. Leave a good job for what might be a better one? Relocate their whole family for what might be a career-defining opportunity? Take a cut in their cash compensation in favor of a bigger equity stake in something that could create generational wealth? Living here in the middle, it’s easy to lose sight of the gravity of these decisions.

Hiring our first few folks was a crash course in how much time and energy needs to go into making someone successful at what we do. My perspective shifted dramatically from being a one-man shop and worried about providing for myself (and subsequently my wife), to include these other incredible humans who were willing to get in the boat with me. The loyalty I feel to them for taking that leap, and the tremendous effort they’ve put in to building this company with me is something I’m not sure I’ll ever be able to articulate. It also raises the stakes. Payroll gets bigger, offices get bigger, infrastructure costs grow, and the investment of time back into our team grows. To say it never keeps me up at night would be a lie. The gift it gives me though, is the good fortune to currently be working with the best people I ever have. The pressure to deliver for them, in that light, feels appropriate.

Spending time thinking about building my team has given me an immense respect for my clients that do it every day, and arguably with more at stake. It’s helped me be more patient as clients reach their own conclusions. It’s made me acutely aware of all the things that are probably going through their minds, even though they might not say them out loud. It’s made it more personal. I now know where they’re coming from, not just in theory, but in practice. In a business that is so intensely driven by relationships, I’ve come to appreciate that my internal challenges have given me a window into the minds of those who we aim to help. As I reflect on the last 5 years, this perspective and empathy has to be one of the most important things I’ve gained, and has unquestionably made me better at what I do.