How not to lose your integrity when running a fast-growing health startup
At the time of writing, a very well-known mental health telemedicine platform is getting a lot of heat due to an exposé by a former employee. They are shutting down major operations in response to a claim that they were overprescribing potentially addictive substances. This can happen at telemedical companies who rely on frictionless prescriptions to generate revenue.
Most people start health companies for good reasons. I’m sure there are a few companies out there who were like, “Hey let’s just get rich quick by becoming a pill mill for XYZ,” but I’ll bet there’s an equal number of founders who start off well-meaning and end up lost as they chase success.
Most people start health companies for good reasons…they start off well-meaning and end up lost as they chase success.
Growth and scaling pressures mean founders are constantly trying to follow the users, the metrics, the money. At the same time, doctor founders like myself remember we have an ultimate mission to do no harm.
So how do you prevent capitalistic demands from destroying your mission of helping people?
It’s very hard to deny a sick patient who is demanding antibiotics for what is almost certainly a viral cold, and even worse when they start leaving you bad reviews and demanding their money back. It’s also really hard when you advertise “ADHD meds for all” to then turn around and say, “Nevermind, maybe stimulants aren’t actually the best thing for you right now because you haven’t solved your underlying anxiety.”
So how do you prevent capitalistic demands from destroying your mission of helping people?
The answer isn’t easy, but it is simple. You remove incentives that promote harmful prescriptions. You refund people who are demanding specific medications that are more harmful than helpful. You help them get the intervention they actually need, even if it means referring them to a different clinic/business for a second opinion. You educate each and every person on the team that there is, in almost every single case, a non-pharmacological option that needs to be presented to the user.
By doing these things, you’ll find that you can make a positive difference and build a big company without destroying the high standard of healthcare. And you will end up with a stronger company for it.
So practically, how do we do it as a psychedelics platform? Yes, we’re trying to increase access to psychedelics via clinical routes. No, that doesn’t mean we want to end up in a death spiral of refills. (Side note: we are trying to get people away from medication dependence, not towards it.)
The key is to focus on the comprehensive process, and to drive revenue generation towards non-pharmacological means. Does that sound counterintuitive? After all, aren’t psychedelics pharmaceutical substances?
Does that sound counterintuitive?
Psychedelics are powerful, but not in the same way traditional medications are. They aren’t most useful as a daily medication. They’re most useful and powerful as catalysts for positive change. And positive change is not a straightforward chemical process like healing a bone (see my prior post here). Positive change is a process that requires support, such as from a coach or therapist.
The solution is to form a business model and protocol that optimizes the complete process of psychedelic-assisted coaching and therapy (PACT), rather than simply promoting refill upon refill of medications. We help people understand the value of a structure, process, and experience in lieu of endless prescriptions. Yes, we also make money doing it, which is important, because companies should be incentivized to offer a complete solution, not a runaway piece that can drive them away from their ultimate mission — to help people.
Not so easy, but simple enough to understand. Set up your incentive structures upfront to satisfy both capitalistic demands as well as humanistic ones. After all, we only live once and the ultimate point is to love and be fulfilled by what we do.
