• by William Mougayar
    Venture advisor, 4x entrepreneur, marketer & strategist. I live in Toronto, curate a lot, blog a bit, and help startups.

Startups are like Patients. They Need Doctors and Hospitals.

hospital image

I interact with a lot of startups on a daily basis, while they are in various stages of evolution. Often, it feels like being a doctor or running a hospital.

That led me to think that startups are a little bit like patients.

Some are in the Intensive Care Unit. We’re not sure if they will survive. They need intensive care in order to make it.

Every other day someone will come into the Emergency Room, with something urgent that needs to be looked at, either because they had an unexpected accident, or because a problem erupted and they are bleeding.

The ones that are fit come for a regular check-up, and that’s all they need. Maybe they could lower their cholesterol, or lose a few pounds, but there is nothing critical.

In some cases, there is a lingering tumor, and we’ve been trying to convince them to have that surgery, but they are delaying the intervention in the hope that it will go away. Or maybe they don’t see the problem, although to the trained eye, the ultrasound shows it. Some prefer to wait for the operation until it really hurts and the pain is untenable.

Not entirely a medical analogy, but some are low on energy, so they need to gas up, i.e. raise more funds. But I try to suggest if they could start running on alternative energy that would make them more self-sustainable, like solar panels, i.e. generate revenues.

In general, the ones doing well just need a diagnostic exam. The ones who are still figuring it out need to be monitored more closely, remotely via data, or in person.

Sometimes, a specialist will be called to diagnose a specific issue, so they need to go deep into a particular area to isolate the problem, and prescribe a specific solution. Example, fix marketing or sales or scalability or a user experience issue. A few might need cosmetic surgery, so they work on improving the looks of their website or App.

And in some cases, psychological help is needed. Being a startup is not easy, and some entrepreneurs hit the depression doldrums or need a mental toughness workout, so they enroll in executive coaching, join a CEO Bootcamp, or a peer-to-peer support group to help them bounce ideas with others who are in their shoes so that it feels less lonely at the top.

In some cases, the startup is still young, and they need to go to puppy school to learn some good habits, so they join an accelerator.

Then, suddenly they go from being patients to becoming champions, running on their own.

If I were a doctor or running a hospital, my goal would be to get my patients to not need me again. I want them to be fit enough so they don’t come back, so I have more time and room for newer patients who need the help.

Of course, few of them will get snatched and get married to another company (exit), and then my involvement going forward will vary, depending on the situation.

  1. Guy Lepage

    Great read William. One thing that stood out to me was “But I try to suggest if they could start running on alternative energy that would make them more self-sustainable, like solar panels, i.e. generate revenues.” I think this is a great idea but only in certain circumstances. I feel as though a lot of startups, in places like Canada, just don’t raise enough money to survive the long haul. If you haven’t raised enough capital to survive 2-3 years on a realistic budget, your chances of survival decrease significantly. Then someone suggests generation of revenue. Then the real problems begin as they are scrambling to think short-term instead of long-term. They end up focusing on the money instead of building a great product and death becomes them. I’ve witnessed this time and time again.

  2. William Mougayar

    Sure…I didn’t imply to start generating revenues prematurely. At the right time, of course. But thanks for the note reminder.

  3. Martyna Janowska

    This is superb, well said, and totally true one, start ups need doctors and hospitals because they are patients that are needed to take care of. We introduce Prepluy here with its CEO w start up’ie program http://www.kluczdokariery.pl/twoja-kariera/rozwoj-osobisty/samoocena/art,12,czy-nadaje-sie-na-ceo-w-start-upie-10-cech-dobrego-managera.html

  4. astadon strategy

    Awesome 3 minutes of reading. To evoke a series of thoughts.

    Keep up the posts William.
    They really help us young bidding entrepreneurs. By allowing us the mindset shift to help ensure we enter the doctors room with a clean bill of health.