What Happens At Y Combinator

Re:What Happens At Y Combinator by pg on Monday September 27, 2010 @06:00PM (#1733650)

No others are quite as bad. We'd be dubious about startups building stuff for the government, for example, because there is such a horrible mismatch between startup culture and government culture. But we'd still fund a startup building stuff for the government if they weren't naive about what selling to the government would entail.

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Re:What Happens At Y Combinator by robg on Monday September 27, 2010 @06:13PM (#1733699)

Thanks and agreed. I'm surprised I haven't seen many (any?) medical applications from YC companies given the margins available over consumer applications. Do you think it is the uncertainty of the FDA regulations or just a space that Silicon Valley doesn't tend to mine as frequently? Make something patients want is particularly alluring to me.

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Re:What Happens At Y Combinator by aaronblohowiak on Tuesday September 28, 2010 @02:34AM (#1734794)

Many medical plays require large capital investment. Regulations, bizdev, and long sales cycles are all huge barriers to entry. Advertising to Doctors is incredibly expensive, and it is hard to monetize consumer applications that will scale (some people are trying their hand at medical compliance, but I haven't heard of a great business model yet.)

23andme is a great medical startup, but it is a capital-intensive business that has to spend time and money on Washington.

We (Epocrates) are working on an Electronic Health Record system as an additional product. Our core team is small, but we have the resources and brand of a midsize company. We have 40% of US physicians using our existing reference software and we are going to leverage our brand to provide a usable and moden system that increases the level of patient care and effectiveness of Doctors. We're a mixed RoR/Java/Mobile shop. We're currently hiring RoR developers, so please feel free to contact me if you are interested in this space and want to make a real impact on US healthcare.

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Re:What Happens At Y Combinator by pg on Monday September 27, 2010 @06:37PM (#1733780)

I would guess the reason is that such applications are foreign to most potential applicants.

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Re:What Happens At Y Combinator by HeyLaughingBoy on Tuesday September 28, 2010 @09:09PM (#1737954)

I'm a software dev. for a medical device company and when I read pg's comment about the mismatch between startup culture and government culture, the first thought I had was "add medical to the list."

The medical device/software field is certainly interesting, exciting even at times, but it progresses at an absolutely glacial pace for the most part. You're dealing with slow, conservative institutions (hospitals, etc) and government agencies. Unless you hire people specifically to deal with those soul-crushing interactions, you'll probably want to shoot yourself.

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Re:What Happens At Y Combinator by yoden on Monday September 27, 2010 @09:13PM (#1734219)

I think it's mostly just not something typical YC applicants are interested... which is really weird, because health issues are going to be a huge concern in the western world for the next 50 years at least.

Part of it may be that you need medical connections to do the much of the work. We work directly with a ton of different doctors/hospitals (for a team of only ~15 devs), and still have issues with building the right things, 510k submissions, etc...

But yeah, medical applications are getting neglected by the startup community at the moment.

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Re:What Happens At Y Combinator by skowmunk on Tuesday September 28, 2010 @04:00PM (#1737035)

That's true, the health care industry is a massive opportunity waiting to be tapped. Not just in the western world, even in the developing world, where the incidence of insurance is increasing.

Many developing countries have had none or next to nothing health insurance till recently. But the market penetration of the healthy insurance is increasing (but still very low now). Because of that more people who could not afford advanced diagnosis or treatments earlier are able to afford them now.

Imagine the potential size of the industry when 1 billion people in India and 1.4 people in China (not to mention a billion or more in other developing countries) can afford as good health care as the 300 million in US, the 450 million in Europe, etc

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Re:What Happens At Y Combinator by aaronblohowiak on Tuesday September 28, 2010 @10:52PM (#1738169)

Telemedicine, decision support and more favorable regulatory environment could be a VERY interesting mix for 2nd / 3rd world (and rural medicine domestically.)

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Re:What Happens At Y Combinator by _delirium on Monday September 27, 2010 @11:29PM (#1734461)

I don't know of any successful medical startups that didn't have strong involvement (usually as founder) of an MD, usually with some experience and connections. Perhaps it's possible for a group of twentysomething techies who are complete medical-industry outsiders to produce a new disruptive product, but it's at least uncommon and makes things harder (especially to get regulatory approval and buy-in among physicians). And I'd guess the overlap between YC applicants and MDs with significant experience is quite small.

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Re:What Happens At Y Combinator by Mz on Monday September 27, 2010 @07:16PM (#1733906)

Make something patients want is particularly alluring to me.

I am curious as to what you have in mind. (I tried to find an email address for you and couldn't. Sorry to junk up this thread. You can email me -- from one of the websites in my profile -- if you don't want to post it here.)

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Re:What Happens At Y Combinator by robg on Monday September 27, 2010 @09:53PM (#1734290)

I added the email to my profile. Specifically I'm interested in analytics platforms to help patients manage their health stats. I'm working on something specific with a great team, but I think there are a lot of opportunities in this space. Let data determine health status, where possible.

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Re:What Happens At Y Combinator by sbowles on Monday September 27, 2010 @08:45PM (#1734152)

I get the concern about inciting the wrath of music labels. However, can you elaborate on your comment in footnote 5? Is there an unofficial policy of avoiding music startups, or just an extra special sanity check? What if the startup pre-clears (or is in the process of clearing) licensed use of label catalogs before the program?

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Re:What Happens At Y Combinator by InclinedPlane on Monday September 27, 2010 @08:58PM (#1734185)

The copyright problems related to music labels are nothing compared to the legal shenanigans of the contracts between labels and groups. They are horrific. The closest analogies would be share cropping or indentured servitude, though at least there is an out if the band fails.

The way a lot of record labels work is that they will give a band a cash advance. The band uses that advance to pay for living expenses. They are also forced to use it for various costs such as studio time, recording, producing a music video, etc. The band earns a percentage of the gross revenue for album sales (say 7%), the label earns a larger percentage. The band pays back their advance using their share of the earnings. Stop me if it seems like there's something a bit off about this arrangement.

Sending a fledgling startup company to work amidst that hell is not a smart move. Even billionaire multi-platinum bands have trouble.

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Re:What Happens At Y Combinator by sbowles on Monday September 27, 2010 @09:54PM (#1734294)

I agree it is tough to be a band in the era of digital music. I’ll have to respectfully disagree about whether or not our venture is foolhardy. We are early days, but the multiple discussions we’ve had with one major label have been respectful and encouraging.

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