May 11, 2024 • 52 mins
Ever feel like you're standing at the edge of a precipice, about to make a decision that could change everything? That's where Dr. Johann Malawana found himself as he made the audacious leap from the security of medicine to the exhilarating world of startups. On today's show, he bares his soul, revealing the internal battles, self-doubt, and the resilience required to navigate such a life-altering transition. His candid reflections on the pressures of entrepreneurship, juxtaposed with his experiences in obstetrics, make for a compelling narrative that both aspiring and seasoned founders can relate to.
As we weave through Johann's story, the conversation gets into the challenges of leading two mission-driven healthcare organisations, The Healthcare Leadership Academy and Medics Academy. His insights on the importance of focus and the similarities in decision-making between medicine and business leadership are eye-opening.
Johann provides an inspirational roadmap for those contemplating a foray into startups. He encourages aligning one's personal convictions with their career choices, emphasising that the true measure of success is deeply personal and unique to each individual. Embrace the doubt, harness the passion, and carry forward the mission—Dr. Johann Malawana's reflections are a beacon for anyone seeking to leave a mark on the world through their work.
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Episode Transcript
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Speaker 1 (00:02):
If you're a founder, honestly, the idea that you have
no self-doubt about what you'redoing I cannot imagine the
level of psychopathy you mustactually suffer in your head.
That's right.
The level of crazy you must beis just enormous, right?
So if you don't have thatself-doubt, then like okay, I
(00:22):
don't know what to say to you.
But if you do like you've gotto live with that self-doubt,
then like okay, I don't knowwhat to say to you.
But if you do like you've gotto live with that self-doubt, if
that makes sense.
Speaker 2 (00:28):
Dr Johan Malawana.
He is, in addition to being amedical doctor, is also a
startup founder.
Speaker 1 (00:37):
And actually it's incredibly exhilarating that
once you realize that actually alot of medicine, a lot of that
type of medicine, is patternrecognition, you just have to
recognize patterns right andmake instinctual decisions that
are really, really basic, likedo the safest thing, always stay
safe, right, always do what youneed to do In startup land,
(00:58):
it's stress.
It's like really stressful.
Okay, let me put it this way Ifeveryone tells you to stay and
then you decide to leave, youmay have made the right decision
for you, right, but if peopletell you to stay and it makes
you stop and think, should Istay?
You probably shouldn't leave,right.
Speaker 2 (01:15):
Interesting, just incredible actually listening to
you.
You really are a real source ofinspiration.
Speaker 1 (01:21):
Yeah, I tend to be a kind of all or nothing kind of
person, so when I'm working onsomething I try and just be
really focused and get on withit.
Speaker 2 (01:31):
Hey everybody, it's Greg Sheehan.
Welcome to my podcast, whereyou will hear from a range of
guests, including those from thestartup world and those that
have had incredibly interestinglives and some stories to tell.
I would really appreciate it ifyou could hit the follow button
and share this amongst yourfriends, but, as you know, time
is limited, so let's get on withit and hear from our next guest
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Now back to the show.
My guest today is Dr JohanMalawana.
He is, in addition to being amedical doctor, is also a
(02:57):
startup founder, and there'ssome pretty interesting
contrasts that we'll pull onthere.
He's also a bit of a politicianin and around medical politics
and governance and I understandactually at some point was even
the organiser of the juniordoctors strikes, or certainly
you know massively and behindthat.
So, johan, welcome to the show.
Hi, how are you, greg?
(03:18):
It's very, very cool to haveyou.
So you are the ManagingDirector of the Healthcare
Leadership Academy and you'realso the founder and CEO of the
Medics Academy.
But before we get to that,let's sort of start off a little
bit about your origin and thekind of kid you were.
Were you the sort of kid thatwas always destined to be a
doctor, or were you alwaysdestined to be a startup founder
(03:39):
?
Speaker 1 (03:39):
Ooh, that's a good one.
I don't really know.
I think I found my passion formedicine relatively late.
I enjoyed the sciences, Ienjoyed maths and things like
that, and I wasn't too botheredabout what I studied because as
a kid I was probably a bit lazyin terms of unless I found it
(04:00):
interesting, I didn't reallyapply myself.
And so I went into medicalschool and I think I only really
it's interesting because Ithink a lot of people like
describe this deep seatedpassion for medicine that from
when they were like six.
I can't pretend that that'swhat I had.
I come from a Sri Lankan familyand in Asian, especially Sri
Lankan, culture medicine is likea thing right, it's like an
(04:22):
aspirational goal you aim for,and so I went to medical school,
probably with some of the wrongreasons.
The interesting thing isactually, after I got to medical
school I actually discoveredmedicine is quite an interesting
subject and so I actuallyreally fell in love with the
subject of medicine, like thescience of it and the aspects of
it that were just not alsoscientific, that were quite
(04:45):
artistic.
I quite enjoyed that.
I loved the kind ofcommunication and the human
aspect of it, and then I endedup in obstetrics primarily, and
I always said to my studentswhen I was practicing that
basically obstetrics is one ofthe most interesting bits of
medicine, simply because it'sthe only time you go and see a
doctor for a happy reason, andso it was again.
(05:07):
I actually didn't really enjoyobstetrics at medical school,
but when I did a placement as ajunior doctor in obstetrics I
thought it was just amazing likegetting to deliver babies and
being around that and seeinglife come into the world and how
vulnerable little babies were,and so I absolutely fell in love
with that part of it basically.
So I really enjoyed that and soI absolutely fell in love with
that part of it basically, so Ireally enjoyed that, and so
(05:30):
that's how I ended up inmedicine basically, how long
were you a frontline clinicianand obstetrician?
About 10 years.
I really enjoyed the obstetricspart of my job.
I would say the other thing Ikind of talk about whenever
anyone asks me about that careerand the switch is that
essentially, when I made theswitch from medicine, the switch
is that essentially when I madethe switch from medicine, I
often find people are oftenrunning away from something,
(05:51):
whereas I very much runningtowards something and that was a
slightly different reason.
So I really loved my job, Iloved obstetrics, I loved
delivering babies.
I found something I was, Ithought I was quite good at and
I was passionate about.
But I was also very aware ofother things I really wanted to
(06:15):
solve and enjoyed and andgenuinely challenges I found
that I thought were challenging.
I thought that were reallyinteresting and so yeah, like I
say, I think I was runningtowards something as opposed to
away from something else.
Speaker 2 (06:31):
It's a massive change , though, to go from delivering
babies to delivering companiesand, before we get into the
startup nature, when you're aclinician and an obstetrician
and involved with obstetrics, isthat when you got involved with
the politics of medicine, ifyou like, and the governance
issues?
Is it true that you wereinvolved with the junior
(06:51):
doctor's strikes?
Speaker 1 (06:52):
So, no, I was always involved with student politics.
I was the president of mymedical school at Barton in
London, which is one of the fivemedical schools in London, so I
was the sabbatical president.
I held leadership roles inmedicine and healthcare
throughout, pretty much from themiddle of my medical school
career and then all the waythrough.
So I was always involved insome aspect of governance and
(07:15):
leadership and so, yes, itwasn't like a completely
different scenario and, yes, I,for there was actually two
periods so I was involved withthe.
So I was the lead for juniordoctors at the time when the
doctors went balloted and wentout on strike in 2015, 2016.
So that was the first time thatthat happened in, I think, 40
(07:35):
years in the UK.
But prior to that, I'd alsonegotiated a whole series of
aspects of the education spacein about seven, eight years
before that, when, again, therewere lots of difficulties within
the British medical system andI was appointed I was elected at
the right at the end of that toresolve some of those and
(07:58):
negotiate some of those and comeup with various policies.
So, again, it was quite a longperiod of life that I'd been
involved with that stuff.
It wasn't like something whereI got involved like very quickly
and or I'd spent a short timein it.
It was quite something.
I'd been basically workingalongside or around my medical
career for quite a long time.
Speaker 2 (08:20):
And you're still involved with the political
aspects of medicine.
Speaker 1 (08:23):
No, not really.
I mean I haven't been when.
No, not really, I mean Ihaven't been.
When I say not really, not atall.
Actually I haven't really beeninvolved in that side of the
professional work, probablypretty much since I left the
role as the lead for juniordoctors in 2016.
I did a couple of years kind ofsupporting the just being
(08:44):
around and kind of beinginvolved very much in the
background, but I pretty much mywork has been so full on, as
you can imagine, in a kind ofstartup, that I always tend to
throw myself fully into whateverI'm working on.
So, yeah, I tend to be a kindof all or nothing kind of person
.
So when I'm working onsomething, I try and just be
really focused and get on withit and do that, and so that's
(09:07):
basically what I've been doingfor the last eight years now.
Speaker 2 (09:10):
I'm really intrigued to dig into that sort of
transition from medicine acrossinto startups.
Now I can imagine that you know, when you've gone through all
of the hard work to get into medschool, you become the
president of your medical school, you know, president of the
student council, if you like ofthe medical school.
You become an obstetrician.
(09:31):
You are involved with medicalgovernance and politics.
The idea of essentially almostleaving that behind to go into a
startup must have had a bit ofI'm not even sure what the right
word is here some tension there, like there must have been
expectations that you wereputting on yourself or even
others were putting on yourself.
(09:52):
How did that go?
Take us through that process.
Speaker 1 (09:54):
Yes, I remember when I was early on in the process.
I remember a lot of, quite afew people, some very, very
prominent people, giving me,yeah, very um, interesting
advice about what was I doing,throwing away my career and my
life and and going and doingthis and given everything I'd
(10:16):
done and all the stuff I'dworked on, that I'm throwing
away a very well, in some ways,a secure career, so lots of
security in that career, butalso there was other aspects of
it which would have beenrelatively, I'd achieved certain
things and it would have beenmuch easier and to do other
things.
And so, yeah, it was.
(10:37):
It was an interestingtransition, I have to say.
I again it goes back to thisidea of running towards
something as opposed to runningaway from something like I think
that the weird thing was thatwhen I was heavily involved, I
mean, obviously, in those roles,you pull the curtain back and
you see the mechanics ofsomething, you see how health
systems work, and you don't justsee how health systems work.
(10:59):
You know, on the front linescenario.
I was a front line doctor in themost acute of specialties and
at the same time, I was learningabout the mechanics of health
systems at the very top of thosesystems, right at the
governance level, at thefinancing level, at the
political level, and the realityI was struck with was that I
(11:20):
was going to probably spend thenext 30, 40 years of my career
fundamentally becoming very,very frustrated, because I could
see many of the challenges andthe problems that health systems
face, not just in the UK butglobally, but very specifically
in the UK, some of thechallenges that health systems
(11:42):
face and I knew that was verylittle I could do about it, even
if, however influential orhowever political or whatever I
did, I could see the limitationsof the ability to make any
significant change, becausethere were certain structural
problems that I just didn'tthink anyone was trying to solve
(12:03):
, and so part of me realizingthat, realized that if there was
any way of resolving thosetensions and those problems, the
only way I could think of doingit was to try something
different.
I could see lots of peoplemaking lots of attempts to do
(12:23):
positive change within thehealth system, but really
struggling to make a systemadapt and change to what it
needs to do, you know, turningthe supertanker, as it were,
whereas I almost felt it wasalmost easier, in the same
analogy, to head out on arowboat or a speedboat in a
slightly different direction inthe hope of finding the right
(12:45):
destination, because otherwise Iknow I would get.
I would just become extremelydisheartened and demoralized,
not again by the job, not thefrontline aspect of the role,
because that bit wasunbelievably incredible, but the
inherently given the careerpath I'd taken.
Up till that point I realized Iwas never going to be just 100%
(13:09):
a frontline, frontlineclinician.
It just wasn't likely to panout that way because of all
these other roles I'd done and Icould see myself, even if I
there was a period between like2011 and 2014 2015 actually when
I'd actually stopped a lot ofmy political work.
I'd basically I'd done a lot ofstuff up till about 2012.
(13:32):
And I decided no, I'm going totry and just be a focused
frontline doctor and really,really concentrate on that.
And I actually really enjoyedit.
But I got sucked straight backin when there was all this
political strife and it wasactually not a choice in some
ways, because I got asked tocome back to do something that
(13:53):
was quite complicated and I kindof felt obliged to do it
because I'd had like arelatively unique set of
experiences that made itappropriate for me to do that
role.
And I went and did that rolebecause it was a technically
difficult role and it was likeyou know, and it needed to be
done.
And I guess I kind of thoughtabout it and I thought, well,
(14:15):
there's a lot of times when thatcould happen again and I can't
see myself not taking upchallenges when I see them in
front of me, and I'd ratherfocus on a challenge that I
could genuinely sink my teethinto and drive forward.
And then, like you know, justreally, really and frankly, the
startup life was really, reallyhard.
(14:35):
I mean, I knew and I did it thehardest way you could possibly
do it, like I threw myself fullyin, I didn't hedge my bets, I
didn't, you know, do a bit ofthis and a bit of that.
I I kind of realized that if Iwas going to do this, I wanted
to be as I said I'm.
When I do something, I reallyfocus and try and double down
and really make it happen likereally do the best I can.
And so I kind of I realizedthat if I was going to do this,
(14:58):
I'd do it that way anyway, andif I fail, I fail, but if I
succeed great, and and I guessit's that that I can't remember
who actually says this, becausethere's lots of attributions of
this statement.
But you don't want to be onyour deathbed and look back when
you're 80 and regret thechoices you've made.
I think they attribute it toJeff Bezos, but I think lots of
other people have said this aseffectively, and so I kind of I
(15:19):
had that mentality or thatthought process going through my
head of like what is thedecision here?
I would regret the least, orregret the most, or et cetera,
et cetera.
Speaker 2 (15:30):
And so did you literally go from one day you're
wearing the white coat,essentially to you know that you
finish on a Friday as a doctor,and then, on a Monday, you're
at a co-working space and you'rea startup founder.
Or was it a bit more nuancedthan that?
Speaker 1 (15:45):
It was slightly more nuanced, but not that different.
Actually, I kind of it was avery rapid transition.
I realized if I was going to doit I would do it full on.
And so there's a lot ofparticularly medics who do
startups.
They do tend to have like atransitional period where they
might work a bit.
But I was very clear that Iknew that if you're going to do
(16:08):
something you've just got to geton with it.
So I kind of did, and I alsowas a lot.
I was probably a lot older thanmost people starting a startup.
I would have been 37, maybe Ithink at the time 36, 37.
And I had two kids.
I had a baby that was under twomonths, like literally very new
, very new baby.
And I always say that my wife isjust ridiculously supportive
(16:30):
and she's very tolerant of mycrazy ideas.
And she she just basically saidto she was like I talked about
it with her, I'd I'd always beeninterested in the kind of
startup space and the ideas andyou know I'd read a lot about it
and I was really likeinterested in technology.
I was always interested in intechnology.
I was always interested intechnology.
I was always interested in thatspace.
But she kind of encouraged meand I again I, I mean I asked
(16:53):
her and she was encouraging andshe said you should just go for
whatever you think you want todo.
She actually said to me onceyou know that I've watched you
make some really crazy decisionsover the years and stuff that
I'd be scared to do, but youfind a way of it and I think you
shouldn't back down from yourinstinct basically.
So I kind of went with it.
Speaker 2 (17:09):
I love that and I'd be remiss if I didn't ask you
the question that I thinkprobably are on the lips of
those sort of people listeningDid you deliver your own
children?
No, god, no, are you allowed?
Speaker 1 (17:19):
to in the UK.
I don't think you are, unlessit's like you're literally in
the middle of a field and it'slike yeah it's you or nobody
else, yeah.
I don't think anyone would everencourage you to do that.
No, yeah, that's right.
Speaker 2 (17:34):
Had to ask that question.
So then you get started.
Now did you start the twobusinesses at the same time, and
actually it might be quite goodto talk a little bit about what
both the Healthcare LeadershipAcademy and Medics Academy are
all about.
You know what are they and whendid these two get started?
Speaker 1 (17:51):
So they kind of started at similar times.
But the Healthcare LeadershipAcademy, the HLA, is a social
enterprise, a not-for-profit.
In the UK we kind of call themCICs.
They're basically a communityinterest company, so they're
not-for-profits and et cetera.
That was basically my passionproject.
So that was what I reallyreally kind of.
I'd spent a lot of my careermentoring but first of all,
(18:12):
learning about leadership, likethe ideas and the concepts and
stuff like that.
And I just I'm interested inphilosophy and I read lots and
lots of books and and likereading kind of philosophy books
and non-fiction literature andso biographies and history and
things like that.
I like that area of literatureand so I'd always read a lot
(18:35):
about the ideas behind variousthings.
And so and the HLA was allabout kind of helping
individuals that were a bit likeme, that wanted, that were
early in their career,developing leadership journeys
in healthcare thinking andreflecting on who they were,
what they were trying to do,essentially trying to help them
be better and more effectiveleaders, and not just at the
(18:59):
latter stages of their careerbut actually quite early on
thinking about what theypotentially wanted to get out of
that aspect of their career.
And so it was just very much acourse based on my experience
that I did with a couple ofother people, kind of co-founded
it with me and supported medelivering the first few
(19:20):
programs, and that wasdefinitely not developed in the
kind of startup mentality.
And medics academy was thestartup.
That is the kind of thequintessential.
It's a technology basededucation company, so we build
education programs and obviouslymy whole career was in
healthcare education.
So healthcare and education andthat, those and workforce and
(19:42):
that's basically what thatcompany does is build education,
workforce development,education concepts, that kind of
thing.
And so the two kind of startedat the same time with the idea
that the HLA was really apassion project.
I didn't really expect it to goanywhere.
I thought it was just going tobe this thing I did for a couple
of years and it was on theweekends and I ran it on my own
(20:03):
time and I would do all thisstuff.
And then Medics Academy wasthis kind of commercial
technology company and I thoughtthe focus would be on the
technology.
And you know you see all thesethings about scaled technology
companies and the rapidity oftheir growth and their making.
You know they raise millionsand all of this kind of stuff.
So I thought, okay, well, maybethat's what I want to do,
that's how you do this.
(20:24):
And actually over the years,that's definitely not what
happened.
And the reality was that all thestuff that we were learning
about within building thetechnology company really helped
in the not-for-profit space,because there's loads and loads
of help and support actually forcommercial technology startup
(20:44):
companies.
It's surprising actually justhow much support there is.
There are incubators there,accelerators, there's books on
it, there are podcasts like thison it.
There's loads of stuff rightand it's exciting and people
want to do it, and there arebillionaires flying around in
planes and taking instagrams oftheir whatever it is.
There is a huge amount about it.
(21:05):
But actually building anot-for-profit, a social
enterprise, anything in thatspace and certainly at the time
when I did this was there wasn'tvery much around to support
someone doing that, and theweird thing was I was riding
these two horses, whereessentially one was just this.
You know, was all in thatstartup space and we ended up
being a Founders Factory company.
(21:25):
You know, in the Europe,founders Factory is quite big
and we ended up being afounder's factory company.
You know, in the europefounder's factory is quite big
and we ended up doing like awhole range of accelerators.
We got some awards and all ofthis and so we're getting loads
of support and we were in thehealth space.
We got some investors, all ofthis stuff and the
not-for-profit no one reallylike.
Everyone was just like, okay,what the hell is that about?
No one, you know that's not.
This is, and the weird thingwas because I was building the
(21:47):
two organizations at the sametime and and one was definitely
not meant to be an organization,one was just this kind of
passion project I did on theside.
I learned just so much aboutbuilding organizations, right,
and so, um, what was interestingwas that I learned I took a lot
of what I learned from thetechnology company, from the
commercial company, and appliedit into the not-for-profit and,
(22:10):
as a result, the HLA, like weprofessionalized a lot of things
that we normally wouldn'tprofessionalize.
And subsequently, actuallyabout four years in, three years
in, I realized actually that issomething like no one helps
people do, and I was helping allthese young clinicians coming
through who wanted to like dohave an impact on the world, and
some of them were starting tothink about social enterprises,
(22:31):
not-for-profits, charities as asvehicles to have that impact,
and I realized that I'm actuallyI've learned so much about both
the commercial side and the theactual, just the growing an
organization side that we builtan incubator.
I say I actually didn't.
So it was a colleague of mine,ali Jawad, who's now running his
own startup actually, who thetwo of us sat down and said all
(22:52):
this stuff going on with socialenterprise and not-for-profits,
they're just not getting anysupport.
So why don't we just completelylike with a blank sheet of
paper, really think about whatkind of support we would have
wanted I would have wanted backwhen I started the HLA in 2016.
And we came up with a model, anincubator model, which, honestly
(23:15):
speaking, was nothing like anyof the other things that we
couldn't find an incubator fornot-for-profits in Europe.
Actually, I think there was onein the US, but there wasn't
really anything like this inEurope at all, and certainly not
in healthcare sorry, not in thehealthcare space.
And so we basically startedthis thing and again built that
within the HLA, within theactual organisation, we built
the small incubator programmeand again it showed just how
(23:36):
much there was space for this,and so we built both
organisations at the same time.
Now, actually over the yearsthe commercial company Medics
Academy has provided an enormousamount of resource to help the
social enterprise build up and Ithink it's well over a million
pounds of resource has beenwe've kind of invested in
building out the hlainfrastructure and that's
(23:56):
through the technology we'vebuilt and various other things
that we've done and and actuallyand actually directly
supporting how we do it.
And so I think again, I don'tthink I would have been able to
do both, I wouldn't have doneeither of them particularly well
without the other one kind ofalmost helping and supporting,
because they each had someaspect of you know, they each
(24:17):
were kind of slightly different,but I mean, both of them are
mission driven.
I guess that's the otherimportant thing that we both in
both organizations they areincredibly mission-driven
organizations about trying toresolve slightly different
problems in healthcare, orprobably the same problem in
healthcare when it comes toworkforce and leadership and the
ideas about health systems, butcoming at it from slightly
(24:39):
different perspectives from theperspective in the HLA of
supporting an individual tobecome a better leader and
manage a health system, anindividual to become a better
leader and manage a healthsystem.
And from the Medics Academy,the commercial company, building
education programs, workforceto support the infrastructure of
healthcare just get betterbasically, how did you manage
your time across these twothings?
Speaker 2 (24:59):
Were you finding that you were just literally
different emails on thedifferent organisations
throughout the day?
Or did you time box and go look, I'm going to work on medics
academy in the mornings and theHLA, you know, in the afternoons
and the evenings.
Like how did how did you kindof divide the time we?
Speaker 1 (25:15):
had two.
We have two separate emailsystems and I mean, uh, quite
distinct organizationalstructures.
We've got two separate boardsof directors, but I guess
everyone that knew me knows mekind of.
There's a common mission in alot of the work, I guess.
And so whenever you talk aboutstartups, people fixate on the
individual, like the founder andit.
(25:36):
Honestly, there are bits ofboth organizations.
I don't really understand howcertain things happen, because
it's not my response, like it'sno, it wasn't my, it isn't my
responsibility, because peoplehave done, they've taken on
their own functions within it,and so the reality is that just
there's lots of, lots of otherpeople involved and those people
(25:58):
are absolutely yeah, I mean, I,I come and do these podcasts
and various other things, but onshami who and and shami was the
person who introduced ustogether said watch it, because
johan will not take credit foranything and he will deflect
questions about being a founderbecause he'll credit the team.
Speaker 2 (26:17):
That you're very humble, and there you go, you
are crediting the team, which isfantastic.
So when you got started, howdid you find that transition,
going from you know this storiedcareer as an obstetrician to
now being the startup founder?
What was the experience likefor you?
Was it what you thought itwould be when you got started?
Was it harder?
Speaker 1 (26:36):
Was it easier.
Obstetrics is an incrediblespecialty, right, because you're
made to make decisions rapidly,right, there's a problem in
front of you and your trainingkicks in, it's not?
You don't have time to think.
It's not having time to thinkin the same way that when you're
driving a car, you shouldn't bethinking right.
If you sit there thinking aboutwhat your left hand is doing,
your right hand is doing, yourleft foot is doing, your right
(26:58):
foot is doing, you're probablylike the worst drive in the
world ever, right?
You kind of naturally know howto drive the car right, and
obstetrics is very, very muchlike that at the acute end.
So when you're in an emergencysituation, you kind of your
training kicks in and you kindof just do things instinctually
because you've repeated the taskso many times.
(27:20):
Right, you've it's repetitiveemergency management, and so
that was an interesting one.
To go from that to a verydifferent type of stress,
because the stress of thatparticular scenario is one where
you know that the biggestoutcome, the biggest implication
(27:41):
of your actions actually doesnot have anything to do with you
, right?
So this is the other thing thatyou've got to think about if
you're an obstetrician, is that,even if you have the worst day
ever.
If something goes horrendouslywrong for you and you think
about it and it's traumatizingfor you, the chances are the
(28:01):
impact on someone else, or inthis case, a family is going to
be 20 times well, not even 20,just 100 times bigger and worse.
Right, because they have tolive with the consequences of
that for the rest of, not just,say, a baby's life, but the
parents and everyone else right,and so it's a very stressful
situation.
But it's a very different typeof stress and and actually it's
(28:25):
incredibly exhilarating.
But once you realize thatactually a lot of medicine, a
lot of that type of medicine, ispattern recognition.
You just have to recognizepatterns right and make
instinctual decisions that arereally, really basic, like do
the safest thing, always staysafe right, always do what you
need to do.
In startup land, it's stress,it's like really stressful, and
(28:48):
there are elements of patternrecognition right.
So, dealing with staff andother people, there's often
quite a lot of patternrecognition should, or how
someone interacts, or or whatwill work within the team and
what won't work within the team,and you develop a set of
(29:11):
pattern recognition that works.
You kind of get an idea of thiskind of deal may work, this may
not.
This is what like good lookslike and and people you know
they often talk about productmarket fit, where you've got
like a product and you adapt itto the market and it fits and
all of that stuff.
And I think that product marketfit applies in lots of
different contexts, not just tothe product of the company, but
(29:33):
lots of other elements like doyou have the right HR structure,
do you have the right financeteam, do you know whatever it is
?
And I guess those were very,very different patterns or
different problems that Itransitioned from one to the
other to solve.
But then there are otherelements which are very, very
similar which really helpedright, and one was rapid
(29:55):
decision making right andunderstanding that sometimes it
is better to just make adecision and do the best you can
with the information you haveand then correct when you get it
wrong or if you think it'sgoing wrong, or if you think
you've made the wrong decision.
Right, and that is very muchsomething that you do in
obstetrics right, you get theinformation you've got.
(30:17):
And if you don't make a decisionand just do something and get
on with it, or the decision isnot to do something, whatever it
is, but you make a decision andthen you take more data, more
information, and then you changeyour direction of travel
slightly and you tweak, and you,you know all of that, but you
know that not effectively justgetting completely paralyzed is
(30:40):
a really bad idea.
Right, by decision making andthe same is true in startups.
Right, the ability to make adecision is really important,
like it's so important andthat's probably the only main
function of a founder is thatability to make those decisions
early on and then later on,understanding that other people
(31:01):
should be allowed to makedecisions too, and it's that
that in in startup world, thattransition is also quite
difficult, because you're soused to being the sole decision
maker for some time and thenit's all the power sits with you
and then suddenly you'retransitioning organizations into
where you have to allow theorganization to evolve and it's
(31:24):
no longer really your baby onyour own.
It's like all the people whowere there at the beginning, and
there's groups of people inboth organizations who very much
are part of the absolute DNA ofthe two organizations and
without them the organizationsjust wouldn't be what they are.
So it's not just who I amanymore, right, and it's that
(31:47):
transition which is also quitedifficult, I'd say.
Speaker 2 (31:52):
Hey, just let me pause you there for a second and
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(32:13):
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(32:34):
Let's get back to the show.
See, for all founders that arelistening, or even those who are
considering being a founder,startups are really hard.
The decision making, the stress.
It's incredibly hard, butnobody dies.
If you get the decision making,the stress.
It's incredibly hard, butnobody dies.
If you get the decision wrong,you're like you could really
screw something up, but nobodydies.
So did you find?
(32:54):
Therefore, even though startupsare stressful and there would
have been days it was stressfulyou must have kind of had some
relief.
Well, I've done stress before,you know, and I've done it where
it's literally life and deathand I'm making decisions that
are really tricky and are goingto impact a family, a child, etc
.
Did you enjoy that in a sense,or was it actually?
It was just as stressful.
Speaker 1 (33:15):
Yeah, that's an interesting question.
I mean, the interesting thingis that modern obstetrics people
do die, but they don't likematernal death and fetal death
is like quite very low yeah.
And I mean fetal death, butcertainly maternal death is
something that you don't, and soyou've got life and death
decisions that have big impactsand, yes, definitely not
(33:37):
belittling that, because it'slike scary as hell.
I mean, I remember there werelots of times where the only
thing going through my head isdo not let my face say what the
hell is going Like.
Do not like.
You can't, like, I cannottransmit how stressed I am right
now, because that is not a goodidea.
It's all good.
Speaker 2 (33:53):
It's all good, it's fine.
Speaker 1 (33:56):
I'm happy, I'm smiling, it's fine, right?
So yeah, I guess that is true.
In terms of the startup space,it is really stressful because
the complexity grows and itdoesn't get simpler if that
makes sense.
And it doesn't get simpler ifthat makes sense.
In a sense, as the years wenton, it felt like the job got
(34:17):
actually quite a lot easier, inthat I'd seen it so many times
that the times when I hadn'tseen something, it was so
obvious I'd never seen thisbefore and therefore I was like
freaking out and I'm likequickly on, you know they had
phones, right.
So I'm quickly on my phone,like what the hell is this
situation?
Or or I'm phoning someone, or Iget help from someone, quickly
on, you know they had phonesright, so I'm quickly on my
phone, like what the hell isthis situation?
Or I'm phoning someone, or Iget help from someone, or I call
you know you send up the flag,and I was like I need help now.
(34:39):
Right, in startup land, theinteresting things is there's
just like a low level, permanentwhat the hell is going on?
Like genuinely what is going onhere, right?
And the other thing is inobstetrics, the weird thing was
that I mean I was on a laborward where you had a big degree
of control within a labor wardsetting, because you you had to
(35:00):
have a really good overview ofwhat's going on on this labor
ward, right as in that was in myjob, right.
So you'd have to.
You'd basically just need toknow what was happening with
each room.
You'd need to know what washappening with each room.
You'd need to know what'shappening with each, what's
going on in each scenario, andnot knowing was like the worst
thing ever, right?
I mean, like you just couldn't,you weren't allowed to do that,
you weren't allowed to not knowwhat was going on, right, it
(35:21):
was just not good.
Whereas in startup land, in thecompany, oh my God, the amount
of stuff I don't know that isgoing on in the company is like
enormous right, and if I worryabout it, I just would not sleep
at all, right, and so, and tobe fair, I don't I literally go
(35:42):
on and on and on at people aboutsleep and how important it is,
and yet I am terrible at it,right, and so you know you
stress about it and you knowthere are lots of times you're
like waking up and just thinking, oh god, I've got like my task
list is ridiculous and I need todo so.
It's just.
Yeah, it's a very differenttype of stress.
I mean I don't think there is abetter or worse version.
(36:02):
I don't think it was.
I mean, having experienced both, I can honestly say both are
awesome, that's the weird thing,right like I honestly say,
being an obstetrician is likejust simply the best career.
I wouldn't recommend people domy current job, but I would
definitely recommend people domy old job.
Right.
My old job was by far the bestjob that you can possibly have
(36:25):
on the planet ever.
Right, being an obstetricdoctor was genuinely
unbelievably cool.
Right, it was just something,and so I cannot in any way say
anything negative about that jobbecause, honestly speaking, I
still live off the buzz of a lotof what I got to do before.
So yeah, Very cool.
Speaker 2 (36:46):
Now with Medics Academy, did you take that
traditional path of I want to bethe Instagrammable guy, you
know, taking venture capital andthis is how we're going to go
and we're going to raisemultiple rounds and et cetera,
et cetera?
Or did you take that sort ofmore bootstrapped approach to
building the company?
Speaker 1 (37:02):
So I am terrible.
I've worked out, I'm good atraising money because, in order
to raise money, you basicallywhat you're doing is you're
painting a picture of somethingwith absolute certainty that has
like a 2% chance of success andlike, okay, in obstetrics I had
(37:26):
to be very, very confident inwhat I did, like there was no
chance.
I could just be, oh, I don'tknow what shall I do?
I can't do that, right.
But at the same time, I feltlike I knew what I was saying
and I knew where it was going Instartup world.
I guess we did actually raisemoney.
So we raised money.
We did two rounds in 2017 and2019.
(37:49):
And I was very good at theraising money part, right.
So the weird thing was thepeople who really, really,
really knew me and often who hadworked with me for a very long
time, or people that knew themand so had seen me doing lots of
stuff in my career they werevery quick to invest in the
(38:10):
company, right, I could not.
I did not seem to have the samemagic effect on people that
were just like who had big, andthe problem was that lots of my
friends were not stupidly rich,right, or lots of my family were
not, so I didn't have theability to just magic up money
from people that I didn't knowif that makes sense, and so so I
(38:31):
did raise money, we raisedmoney.
Actually, we raised money quitesuccessfully for the first,
like we did two rounds.
And then, in 2019, and I get, Igot told this like in no
uncertain terms by one personthat I did something which I
kind of took a look at thepattern of the company that I
was building, because it was inhealthcare and it was in
education, and it was theconfluence of the two, or the
(38:51):
interface of the company that Iwas building, because it was in
healthcare and it was ineducation, and it was the the
confluence of the two, or theinterface of the two areas, both
of which are very traditionalin that they're very
conservative.
Once you build something thatreally sticks in both industries
, it's really hard to dislodgeit, right.
That's the cool thing abouthealthcare and education.
However, to build something thatreally sticks also is not like
(39:14):
an instant issue, right.
It's not like you can just goin and you know, even if you're
sitting on a pile of like abillion dollars, it doesn't mean
you're going to somehow build ahealthcare organization or an
education organization.
I'll be frank, right, becausethere are so many reputational
factors and there are so manyother factors that go into a
(39:35):
confidence issue to do with whatyou're doing right, and I think
I guess the the best example isprobably something like haven,
right, which is the what the big, most invested, the biggest
startup, ever invested in, orsomething.
I think they raised a billiondollars or something from like
the three big you know, know,amazon and JP Morgan and
whatever, and yet they onlylasted 18 months or something I
think it was.
(39:55):
That was like that, thelifetime of that entire
organization.
And so the reality is it's not.
This is not the space I don'tthink you can just froth your
way through.
I mean, theranos is anotherexample, right.
I mean like one example of likejust complete and utter BS
ruling right, and you just can'tdo that, right.
You just it just doesn't work,right.
(40:17):
And so in 2019, I realized,after raising that round,
actually, to be fair, it didn't.
It wasn't in 2019, it was, butit was a few.
It was about a year or twolater when I realized that what
I was getting pressured to do,in terms of the decisions I was
making, would not meet theexpectations of the people
(40:38):
necessarily, and I had thatconversation.
I mean, I said you know, thereality is that this is probably
not going to be the thing thatjust blows up.
Right, that is going to.
I cannot.
And then the problem was that in2020, 2021, 20 like that was
frothy as hell, right, startupland was just these massive
valuations and at the time, Iwas like trying to work out how
(41:01):
to get the company to beprofitable and how to make it
last and be self-sufficient, inthe idea that if we are
self-sufficient, then I'm notconstantly trying to catch up,
I'm not constant, I can focus onwhat we're doing and building
the thing we're doing, ratherthan doing like just constantly
out there trying to grab moremoney and not like focus on on
(41:25):
building a, a genuinelysustainable company.
And I guess that was a decisionthat, in hindsight, I honestly
still don't know is the rightanswer, because I know that, for
where we are right now, it'sdefinitely the right answer.
Like we are definitely, youknow, we're self-sustaining,
we're doing like we're doing,but we're also relatively quite
(41:46):
small and there are lots ofcompanies that in this interim
who, like you're where thefounders were just fixated on
raising money and they just madethese enormous numbers right
work in that period during thispandemic, and I can't tell you.
I mean, yeah, some of themdon't exist anymore.
But I mean, you know, thequestion is, I don't know, you
know, what is the right thing todo.
(42:07):
I don't honestly know, is theanswer I don't know.
I can't, because I most peoplethere's.
The motivations of startupfounders are very different.
Right, my motivation is I wantto build an organization that's
still here in 50 years time.
Right, or in a hundred years.
I mean I'd like to build anorganization that, when I'm dead
, is not dead with me, if thatmakes sense.
Right, and so knowing that as amotivation I think makes it a
(42:31):
slightly better like in my mind.
It makes it more obvious what Ineed to do and for the whole
team, what we have to do, andalso it means how you build the
startup matters.
Ie that it's not about I mean,you know, you say this, but it's
really can't be about me,because it's building like in my
mind.
We're building institutions.
We're building two institutionsand they are hopefully going to
(42:53):
be institutions, and aninstitution can't be dependent
on one, two, five, 15 people.
It's got to have solidfoundations, if that makes sense
.
Speaker 2 (43:02):
What's the hardest thing that you've experienced in
this startup journey with youknow either organization that
you wouldn't have anticipatedkicking off your startup journey
?
Something that has really notso much floored you maybe it has
, but it's something that it wasway tougher than you thought.
Was it the capital raising?
Was it hiring?
Was it finding product marketfit?
(43:24):
What was that?
Speaker 1 (43:26):
I mean the most stressful thing by far by, like
a country.
The most stressful thing by farwas there was a period about 18
months into the company wherewe were genuinely teetering on
the edge.
Right, this is the commercialcompany and my wife very, very,
very, very, very supportively,basically agreed that we would
(43:49):
sell our family home in order torecapitalize the company.
Wow, okay, I mean rememberwe've got two young kids here,
right, and so like I honestlyhave to say no one should ever
do this.
This is why, like, this is nota good idea.
No, and basically we did it andwe were in rental accommodation
for like five years, six years,something like that, and it was
(44:10):
difficult and she made like shewas so supportive and like
never questioned that thisdecision, like she never held it
against me, like now she worksin the company.
I mean, she's worked in thecompany for a few years.
Right, for not, not since then,but she a few years later she
was like, oh well, you know sheactually came and helped with
the company in lots of ways.
Um, and so that level ofsupport is what do you say to
(44:34):
that?
Right, because you're on thejourney, but like everyone and
you know it's everyone elsearound, it's not just like Sarah
, it's not just my wife, buteveryone around me was like
hyper supportive, like friendsof mine and family members and
people like you know.
There were just so many peoplethat have just helped me over
the years and like that is likecrazy.
(44:56):
Right, it's like really crazyand I think part of it is
because I hope part of it isbecause we're kind of really
mission driven.
We are, we've got a missionthat we're on.
We want to do it.
We want to help people in doingit.
We've just spent the last fouryears working on gender in
healthcare and leadership andwe've done a whole series of
(45:17):
projects in Africa and Ethiopia.
Clearly, some of those decisionsare you're taking a very
long-termist view of the world.
To work in a war zone in themiddle of Ethiopia on gender
empowerment and gender-basedviolence and doing that from
within a commercial entity.
To do that and justifying thatto my board of directors was
(45:38):
always an interesting one, right, but they were so supportive,
right, because they were justlike okay, I see what you're,
what you're doing here.
I can, I explained it, I, youknow, I kind of justified it and
it fulfills the kind of missionthat we've set ourselves on,
without being hypocritical aboutit, we're not just saying it
for the sake of doing it, we'reactually going and doing this
stuff and so I think you know,in lots of ways, that is our.
(46:02):
That's like what I want.
Like I left a very rewardingrole in order to do what I
consider just as rewarding arole in a very different way.
Speaker 2 (46:12):
Just incredible actually listening to you.
You really are a real source ofinspiration.
My final question, I suppose,is you know, is there something
you would want to leave othersto consider, a piece of advice
for startup founders?
Maybe for people who are in aprofession currently not doing a
startup they might be inmedicine, or they might be in
law or whatever, and they're nothappy.
(46:34):
Yet there's a lot of pressureto stay within that profession,
to maintain the status, if youlike, of being in that
profession, or maybe somethingfor startup founders A piece of
advice you'd want to leavepeople that are listening to
this Stay, stay in theprofession.
Speaker 1 (46:51):
That's not what I thought you'd say I would say
that, like the, the, you knowsecurity is something that is
you have to really.
Okay, let me put it this way ifeveryone tells you to stay and
then you decide to leave, youmay may have made the right
decision for you, right?
But if people tell you to stayand it makes you stop and think,
(47:12):
should I stay?
You probably shouldn't leave,right?
Interesting.
So, and the other thing I'veworked out is that there is
absolutely no pattern to thisone right?
What makes a good founder?
Right?
I honestly, I've met so manydifferent people from so many
different backgrounds.
I honestly cannot say thatthere is a pattern for what
makes a good founder, becauseoften founders are contrarian,
(47:36):
so they are contrarian.
But the other thing is thatfounders are very, very
different in what motivates them, right.
So there is.
Some of them are just like,literally just want to make the
money.
I mean, they only care aboutthe money, and that is perfectly
fine.
I do not.
You know I'm not like some.
You know I'm not going to besome kumbaya kind of crazy, like
(47:57):
hippie on this stuff, right,like, if that's what motivates
you, that's fine, go for it.
Like, go and do that what youwant to do Right.
And then there are others thatare like mission driven and want
to do, and then there's peoplein the middle that kind of are
mission driven but they'rereally like not you know.
There's this kind of weird kindof interface between the two.
The one thing I'd say is justreally really know yourself.
(48:20):
Like you don't have to admit itin public, you don't have to
admit it on a podcast, you don'thave to tell everyone what you
want to do, you know.
You just have to admit it toyourself.
What is it it?
Why are you doing this like?
Why are you putting yourself?
If you're slightly older, yourfamily, everyone, you know why
are you putting people throughthis crazy decision?
(48:41):
The thing is, you can be aroundstartups without necessarily
being the founder.
You can be an early employee,you can be in venture, you can
be in finance, you can be.
You know there's lots of waysyou can be around the excitement
without necessarily doing thefounder job right.
And the reality is that I thinkin the first five years, the
(49:07):
majority of the companies I'veeither seen I've actually
invested in a few invested in orI've kind of like done Like the
reason why it fails is usuallybecause of the founders, right,
like that's the only reason Imean we can work up a percentage
, but really it's something todo with the founder or founding
team, right?
It's like that problem.
And so the question is just bereally, really sure that you're
(49:32):
making, especially if you comefrom a professional background,
because there's two elements tocoming from a professional
background which both play inyour favor and don't play in
your favor, right, the play inyour favor bit is that you have
history, context, expertise, etcetera, et cetera, and it gives
you a safety net right.
Expertise, etc, etc.
(49:53):
And it gives you a safety net,right.
So it gives you this safety netyou can go back to or you may
use at the same time as being afounder, etc, etc.
But that's also a negativeright, because you have a safety
net.
You're not walking thetightrope without the safety net
, right.
And that means there's otherkind of considerations that you
always play in your head.
Because if you're a founder,honestly the idea that you have
(50:15):
no self-doubt about what you'redoing I cannot imagine the level
of psychopathy you mustactually suffer in your head,
that's right.
The level of crazy you must beis just enormous, right.
So if you don't have thatself-doubt, then like, okay, I
don't know what to say to you,but if you do like you've got to
(50:35):
live with that self-doubt.
If that makes sense, right, andthat can be stressful.
So if, after all of hearingthat, and everyone tells you not
to do it, and your parents tellyou not to do it, and your
spouse and your partner tellsyou not to do it, and everyone
tells you not to do it and theydon't divorce you and they don't
throw you out on your ear andall of that stuff, you still
(50:55):
decide to go and do it, great,maybe it's the right job for you
johan, this has been anabsolute masterclass and I I
kind of I I really regret thatyou live in the uk and I live
here in new zealand, because Ijust think you'd be the kind of
guy I would love just hangingout talking over a glass of wine
.
Speaker 2 (51:13):
You're talking about history and great nonfiction
books and things.
This has been, as I say, a truemasterclass.
You are an inspiration, becauseI think you are very much
driven by mission.
You're going to have a massiveimpact.
The 80-year-old version ofyourself, I think, is going to
be very happy with the way thatyou've lived your life.
So I want to thank you for thetime you've given today.
(51:36):
I will make sure there's waysfor people to connect with you
on LinkedIn and through your twoorganizations as well and to
learn more about both.
Really, really appreciate thetime you've given today, johan.
Thank you so much.
Thanks, lord.
Speaker 1 (51:49):
Craig.
Speaker 2 (51:53):
Johan, thank you so much.
Thanks so great.
Hey, don't forget to check outdesk work, the team behind you
being able to buildhigh-performing offshore teams
for your startups and Smee's.
It's desk work, co.
Backslash, greg, and go andsave yourself some hard-earned
money.
If you're a founder, honestly, the idea that you have
no self-doubt about what you'redoing I cannot imagine the
level of psychopathy you mustactually suffer in your head.
That's right.
The level of crazy you must beis just enormous, right?
So if you don't have thatself-doubt, then like okay, I
(00:22):
don't know what to say to you.
But if you do like you've gotto live with that self-doubt,
then like okay, I don't knowwhat to say to you.
But if you do like you've gotto live with that self-doubt, if
that makes sense.
Speaker 2 (00:28):
Dr Johan Malawana.
He is, in addition to being amedical doctor, is also a
startup founder.
Speaker 1 (00:37):
And actually it's incredibly exhilarating that
once you realize that actually alot of medicine, a lot of that
type of medicine, is patternrecognition, you just have to
recognize patterns right andmake instinctual decisions that
are really, really basic, likedo the safest thing, always stay
safe, right, always do what youneed to do In startup land,
(00:58):
it's stress.
It's like really stressful.
Okay, let me put it this way Ifeveryone tells you to stay and
then you decide to leave, youmay have made the right decision
for you, right, but if peopletell you to stay and it makes
you stop and think, should Istay?
You probably shouldn't leave,right.
Speaker 2 (01:15):
Interesting, just incredible actually listening to
you.
You really are a real source ofinspiration.
Speaker 1 (01:21):
Yeah, I tend to be a kind of all or nothing kind of
person, so when I'm working onsomething I try and just be
really focused and get on withit.
Speaker 2 (01:31):
Hey everybody, it's Greg Sheehan.
Welcome to my podcast, whereyou will hear from a range of
guests, including those from thestartup world and those that
have had incredibly interestinglives and some stories to tell.
I would really appreciate it ifyou could hit the follow button
and share this amongst yourfriends, but, as you know, time
is limited, so let's get on withit and hear from our next guest
(01:53):
.
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(02:15):
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Now back to the show.
My guest today is Dr JohanMalawana.
He is, in addition to being amedical doctor, is also a
(02:57):
startup founder, and there'ssome pretty interesting
contrasts that we'll pull onthere.
He's also a bit of a politicianin and around medical politics
and governance and I understandactually at some point was even
the organiser of the juniordoctors strikes, or certainly
you know massively and behindthat.
So, johan, welcome to the show.
Hi, how are you, greg?
(03:18):
It's very, very cool to haveyou.
So you are the ManagingDirector of the Healthcare
Leadership Academy and you'realso the founder and CEO of the
Medics Academy.
But before we get to that,let's sort of start off a little
bit about your origin and thekind of kid you were.
Were you the sort of kid thatwas always destined to be a
doctor, or were you alwaysdestined to be a startup founder
(03:39):
?
Speaker 1 (03:39):
Ooh, that's a good one.
I don't really know.
I think I found my passion formedicine relatively late.
I enjoyed the sciences, Ienjoyed maths and things like
that, and I wasn't too botheredabout what I studied because as
a kid I was probably a bit lazyin terms of unless I found it
(04:00):
interesting, I didn't reallyapply myself.
And so I went into medicalschool and I think I only really
it's interesting because Ithink a lot of people like
describe this deep seatedpassion for medicine that from
when they were like six.
I can't pretend that that'swhat I had.
I come from a Sri Lankan familyand in Asian, especially Sri
Lankan, culture medicine is likea thing right, it's like an
(04:22):
aspirational goal you aim for,and so I went to medical school,
probably with some of the wrongreasons.
The interesting thing isactually, after I got to medical
school I actually discoveredmedicine is quite an interesting
subject and so I actuallyreally fell in love with the
subject of medicine, like thescience of it and the aspects of
it that were just not alsoscientific, that were quite
(04:45):
artistic.
I quite enjoyed that.
I loved the kind ofcommunication and the human
aspect of it, and then I endedup in obstetrics primarily, and
I always said to my studentswhen I was practicing that
basically obstetrics is one ofthe most interesting bits of
medicine, simply because it'sthe only time you go and see a
doctor for a happy reason, andso it was again.
(05:07):
I actually didn't really enjoyobstetrics at medical school,
but when I did a placement as ajunior doctor in obstetrics I
thought it was just amazing likegetting to deliver babies and
being around that and seeinglife come into the world and how
vulnerable little babies were,and so I absolutely fell in love
with that part of it basically.
So I really enjoyed that and soI absolutely fell in love with
that part of it basically, so Ireally enjoyed that, and so
(05:30):
that's how I ended up inmedicine basically, how long
were you a frontline clinicianand obstetrician?
About 10 years.
I really enjoyed the obstetricspart of my job.
I would say the other thing Ikind of talk about whenever
anyone asks me about that careerand the switch is that
essentially, when I made theswitch from medicine, the switch
is that essentially when I madethe switch from medicine, I
often find people are oftenrunning away from something,
(05:51):
whereas I very much runningtowards something and that was a
slightly different reason.
So I really loved my job, Iloved obstetrics, I loved
delivering babies.
I found something I was, Ithought I was quite good at and
I was passionate about.
But I was also very aware ofother things I really wanted to
(06:15):
solve and enjoyed and andgenuinely challenges I found
that I thought were challenging.
I thought that were reallyinteresting and so yeah, like I
say, I think I was runningtowards something as opposed to
away from something else.
Speaker 2 (06:31):
It's a massive change , though, to go from delivering
babies to delivering companiesand, before we get into the
startup nature, when you're aclinician and an obstetrician
and involved with obstetrics, isthat when you got involved with
the politics of medicine, ifyou like, and the governance
issues?
Is it true that you wereinvolved with the junior
(06:51):
doctor's strikes?
Speaker 1 (06:52):
So, no, I was always involved with student politics.
I was the president of mymedical school at Barton in
London, which is one of the fivemedical schools in London, so I
was the sabbatical president.
I held leadership roles inmedicine and healthcare
throughout, pretty much from themiddle of my medical school
career and then all the waythrough.
So I was always involved insome aspect of governance and
(07:15):
leadership and so, yes, itwasn't like a completely
different scenario and, yes, I,for there was actually two
periods so I was involved withthe.
So I was the lead for juniordoctors at the time when the
doctors went balloted and wentout on strike in 2015, 2016.
So that was the first time thatthat happened in, I think, 40
(07:35):
years in the UK.
But prior to that, I'd alsonegotiated a whole series of
aspects of the education spacein about seven, eight years
before that, when, again, therewere lots of difficulties within
the British medical system andI was appointed I was elected at
the right at the end of that toresolve some of those and
(07:58):
negotiate some of those and comeup with various policies.
So, again, it was quite a longperiod of life that I'd been
involved with that stuff.
It wasn't like something whereI got involved like very quickly
and or I'd spent a short timein it.
It was quite something.
I'd been basically workingalongside or around my medical
career for quite a long time.
Speaker 2 (08:20):
And you're still involved with the political
aspects of medicine.
Speaker 1 (08:23):
No, not really.
I mean I haven't been when.
No, not really, I mean Ihaven't been.
When I say not really, not atall.
Actually I haven't really beeninvolved in that side of the
professional work, probablypretty much since I left the
role as the lead for juniordoctors in 2016.
I did a couple of years kind ofsupporting the just being
(08:44):
around and kind of beinginvolved very much in the
background, but I pretty much mywork has been so full on, as
you can imagine, in a kind ofstartup, that I always tend to
throw myself fully into whateverI'm working on.
So, yeah, I tend to be a kindof all or nothing kind of person
.
So when I'm working onsomething, I try and just be
really focused and get on withit and do that, and so that's
(09:07):
basically what I've been doingfor the last eight years now.
Speaker 2 (09:10):
I'm really intrigued to dig into that sort of
transition from medicine acrossinto startups.
Now I can imagine that you know, when you've gone through all
of the hard work to get into medschool, you become the
president of your medical school, you know, president of the
student council, if you like ofthe medical school.
You become an obstetrician.
(09:31):
You are involved with medicalgovernance and politics.
The idea of essentially almostleaving that behind to go into a
startup must have had a bit ofI'm not even sure what the right
word is here some tension there, like there must have been
expectations that you wereputting on yourself or even
others were putting on yourself.
(09:52):
How did that go?
Take us through that process.
Speaker 1 (09:54):
Yes, I remember when I was early on in the process.
I remember a lot of, quite afew people, some very, very
prominent people, giving me,yeah, very um, interesting
advice about what was I doing,throwing away my career and my
life and and going and doingthis and given everything I'd
(10:16):
done and all the stuff I'dworked on, that I'm throwing
away a very well, in some ways,a secure career, so lots of
security in that career, butalso there was other aspects of
it which would have beenrelatively, I'd achieved certain
things and it would have beenmuch easier and to do other
things.
And so, yeah, it was.
(10:37):
It was an interestingtransition, I have to say.
I again it goes back to thisidea of running towards
something as opposed to runningaway from something like I think
that the weird thing was thatwhen I was heavily involved, I
mean, obviously, in those roles,you pull the curtain back and
you see the mechanics ofsomething, you see how health
systems work, and you don't justsee how health systems work.
(10:59):
You know, on the front linescenario.
I was a front line doctor in themost acute of specialties and
at the same time, I was learningabout the mechanics of health
systems at the very top of thosesystems, right at the
governance level, at thefinancing level, at the
political level, and the realityI was struck with was that I
(11:20):
was going to probably spend thenext 30, 40 years of my career
fundamentally becoming very,very frustrated, because I could
see many of the challenges andthe problems that health systems
face, not just in the UK butglobally, but very specifically
in the UK, some of thechallenges that health systems
(11:42):
face and I knew that was verylittle I could do about it, even
if, however influential orhowever political or whatever I
did, I could see the limitationsof the ability to make any
significant change, becausethere were certain structural
problems that I just didn'tthink anyone was trying to solve
(12:03):
, and so part of me realizingthat, realized that if there was
any way of resolving thosetensions and those problems, the
only way I could think of doingit was to try something
different.
I could see lots of peoplemaking lots of attempts to do
(12:23):
positive change within thehealth system, but really
struggling to make a systemadapt and change to what it
needs to do, you know, turningthe supertanker, as it were,
whereas I almost felt it wasalmost easier, in the same
analogy, to head out on arowboat or a speedboat in a
slightly different direction inthe hope of finding the right
(12:45):
destination, because otherwise Iknow I would get.
I would just become extremelydisheartened and demoralized,
not again by the job, not thefrontline aspect of the role,
because that bit wasunbelievably incredible, but the
inherently given the careerpath I'd taken.
Up till that point I realized Iwas never going to be just 100%
(13:09):
a frontline, frontlineclinician.
It just wasn't likely to panout that way because of all
these other roles I'd done and Icould see myself, even if I
there was a period between like2011 and 2014 2015 actually when
I'd actually stopped a lot ofmy political work.
I'd basically I'd done a lot ofstuff up till about 2012.
(13:32):
And I decided no, I'm going totry and just be a focused
frontline doctor and really,really concentrate on that.
And I actually really enjoyedit.
But I got sucked straight backin when there was all this
political strife and it wasactually not a choice in some
ways, because I got asked tocome back to do something that
(13:53):
was quite complicated and I kindof felt obliged to do it
because I'd had like arelatively unique set of
experiences that made itappropriate for me to do that
role.
And I went and did that rolebecause it was a technically
difficult role and it was likeyou know, and it needed to be
done.
And I guess I kind of thoughtabout it and I thought, well,
(14:15):
there's a lot of times when thatcould happen again and I can't
see myself not taking upchallenges when I see them in
front of me, and I'd ratherfocus on a challenge that I
could genuinely sink my teethinto and drive forward.
And then, like you know, justreally, really and frankly, the
startup life was really, reallyhard.
(14:35):
I mean, I knew and I did it thehardest way you could possibly
do it, like I threw myself fullyin, I didn't hedge my bets, I
didn't, you know, do a bit ofthis and a bit of that.
I I kind of realized that if Iwas going to do this, I wanted
to be as I said I'm.
When I do something, I reallyfocus and try and double down
and really make it happen likereally do the best I can.
And so I kind of I realizedthat if I was going to do this,
(14:58):
I'd do it that way anyway, andif I fail, I fail, but if I
succeed great, and and I guessit's that that I can't remember
who actually says this, becausethere's lots of attributions of
this statement.
But you don't want to be onyour deathbed and look back when
you're 80 and regret thechoices you've made.
I think they attribute it toJeff Bezos, but I think lots of
other people have said this aseffectively, and so I kind of I
(15:19):
had that mentality or thatthought process going through my
head of like what is thedecision here?
I would regret the least, orregret the most, or et cetera,
et cetera.
Speaker 2 (15:30):
And so did you literally go from one day you're
wearing the white coat,essentially to you know that you
finish on a Friday as a doctor,and then, on a Monday, you're
at a co-working space and you'rea startup founder.
Or was it a bit more nuancedthan that?
Speaker 1 (15:45):
It was slightly more nuanced, but not that different.
Actually, I kind of it was avery rapid transition.
I realized if I was going to doit I would do it full on.
And so there's a lot ofparticularly medics who do
startups.
They do tend to have like atransitional period where they
might work a bit.
But I was very clear that Iknew that if you're going to do
(16:08):
something you've just got to geton with it.
So I kind of did, and I alsowas a lot.
I was probably a lot older thanmost people starting a startup.
I would have been 37, maybe Ithink at the time 36, 37.
And I had two kids.
I had a baby that was under twomonths, like literally very new
, very new baby.
And I always say that my wife isjust ridiculously supportive
(16:30):
and she's very tolerant of mycrazy ideas.
And she she just basically saidto she was like I talked about
it with her, I'd I'd always beeninterested in the kind of
startup space and the ideas andyou know I'd read a lot about it
and I was really likeinterested in technology.
I was always interested in intechnology.
I was always interested intechnology.
I was always interested in thatspace.
But she kind of encouraged meand I again I, I mean I asked
(16:53):
her and she was encouraging andshe said you should just go for
whatever you think you want todo.
She actually said to me onceyou know that I've watched you
make some really crazy decisionsover the years and stuff that
I'd be scared to do, but youfind a way of it and I think you
shouldn't back down from yourinstinct basically.
So I kind of went with it.
Speaker 2 (17:09):
I love that and I'd be remiss if I didn't ask you
the question that I thinkprobably are on the lips of
those sort of people listeningDid you deliver your own
children?
No, god, no, are you allowed?
Speaker 1 (17:19):
to in the UK.
I don't think you are, unlessit's like you're literally in
the middle of a field and it'slike yeah it's you or nobody
else, yeah.
I don't think anyone would everencourage you to do that.
No, yeah, that's right.
Speaker 2 (17:34):
Had to ask that question.
So then you get started.
Now did you start the twobusinesses at the same time, and
actually it might be quite goodto talk a little bit about what
both the Healthcare LeadershipAcademy and Medics Academy are
all about.
You know what are they and whendid these two get started?
Speaker 1 (17:51):
So they kind of started at similar times.
But the Healthcare LeadershipAcademy, the HLA, is a social
enterprise, a not-for-profit.
In the UK we kind of call themCICs.
They're basically a communityinterest company, so they're
not-for-profits and et cetera.
That was basically my passionproject.
So that was what I reallyreally kind of.
I'd spent a lot of my careermentoring but first of all,
(18:12):
learning about leadership, likethe ideas and the concepts and
stuff like that.
And I just I'm interested inphilosophy and I read lots and
lots of books and and likereading kind of philosophy books
and non-fiction literature andso biographies and history and
things like that.
I like that area of literatureand so I'd always read a lot
(18:35):
about the ideas behind variousthings.
And so and the HLA was allabout kind of helping
individuals that were a bit likeme, that wanted, that were
early in their career,developing leadership journeys
in healthcare thinking andreflecting on who they were,
what they were trying to do,essentially trying to help them
be better and more effectiveleaders, and not just at the
(18:59):
latter stages of their careerbut actually quite early on
thinking about what theypotentially wanted to get out of
that aspect of their career.
And so it was just very much acourse based on my experience
that I did with a couple ofother people, kind of co-founded
it with me and supported medelivering the first few
(19:20):
programs, and that wasdefinitely not developed in the
kind of startup mentality.
And medics academy was thestartup.
That is the kind of thequintessential.
It's a technology basededucation company, so we build
education programs and obviouslymy whole career was in
healthcare education.
So healthcare and education andthat, those and workforce and
(19:42):
that's basically what thatcompany does is build education,
workforce development,education concepts, that kind of
thing.
And so the two kind of startedat the same time with the idea
that the HLA was really apassion project.
I didn't really expect it to goanywhere.
I thought it was just going tobe this thing I did for a couple
of years and it was on theweekends and I ran it on my own
(20:03):
time and I would do all thisstuff.
And then Medics Academy wasthis kind of commercial
technology company and I thoughtthe focus would be on the
technology.
And you know you see all thesethings about scaled technology
companies and the rapidity oftheir growth and their making.
You know they raise millionsand all of this kind of stuff.
So I thought, okay, well, maybethat's what I want to do,
that's how you do this.
(20:24):
And actually over the years,that's definitely not what
happened.
And the reality was that all thestuff that we were learning
about within building thetechnology company really helped
in the not-for-profit space,because there's loads and loads
of help and support actually forcommercial technology startup
(20:44):
companies.
It's surprising actually justhow much support there is.
There are incubators there,accelerators, there's books on
it, there are podcasts like thison it.
There's loads of stuff rightand it's exciting and people
want to do it, and there arebillionaires flying around in
planes and taking instagrams oftheir whatever it is.
There is a huge amount about it.
(21:05):
But actually building anot-for-profit, a social
enterprise, anything in thatspace and certainly at the time
when I did this was there wasn'tvery much around to support
someone doing that, and theweird thing was I was riding
these two horses, whereessentially one was just this.
You know, was all in thatstartup space and we ended up
being a Founders Factory company.
(21:25):
You know, in the Europe,founders Factory is quite big
and we ended up being afounder's factory company.
You know, in the europefounder's factory is quite big
and we ended up doing like awhole range of accelerators.
We got some awards and all ofthis and so we're getting loads
of support and we were in thehealth space.
We got some investors, all ofthis stuff and the
not-for-profit no one reallylike.
Everyone was just like, okay,what the hell is that about?
No one, you know that's not.
This is, and the weird thingwas because I was building the
(21:47):
two organizations at the sametime and and one was definitely
not meant to be an organization,one was just this kind of
passion project I did on theside.
I learned just so much aboutbuilding organizations, right,
and so, um, what was interestingwas that I learned I took a lot
of what I learned from thetechnology company, from the
commercial company, and appliedit into the not-for-profit and,
(22:10):
as a result, the HLA, like weprofessionalized a lot of things
that we normally wouldn'tprofessionalize.
And subsequently, actuallyabout four years in, three years
in, I realized actually that issomething like no one helps
people do, and I was helping allthese young clinicians coming
through who wanted to like dohave an impact on the world, and
some of them were starting tothink about social enterprises,
(22:31):
not-for-profits, charities as asvehicles to have that impact,
and I realized that I'm actuallyI've learned so much about both
the commercial side and the theactual, just the growing an
organization side that we builtan incubator.
I say I actually didn't.
So it was a colleague of mine,ali Jawad, who's now running his
own startup actually, who thetwo of us sat down and said all
(22:52):
this stuff going on with socialenterprise and not-for-profits,
they're just not getting anysupport.
So why don't we just completelylike with a blank sheet of
paper, really think about whatkind of support we would have
wanted I would have wanted backwhen I started the HLA in 2016.
And we came up with a model, anincubator model, which, honestly
(23:15):
speaking, was nothing like anyof the other things that we
couldn't find an incubator fornot-for-profits in Europe.
Actually, I think there was onein the US, but there wasn't
really anything like this inEurope at all, and certainly not
in healthcare sorry, not in thehealthcare space.
And so we basically startedthis thing and again built that
within the HLA, within theactual organisation, we built
the small incubator programmeand again it showed just how
(23:36):
much there was space for this,and so we built both
organisations at the same time.
Now, actually over the yearsthe commercial company Medics
Academy has provided an enormousamount of resource to help the
social enterprise build up and Ithink it's well over a million
pounds of resource has beenwe've kind of invested in
building out the hlainfrastructure and that's
(23:56):
through the technology we'vebuilt and various other things
that we've done and and actuallyand actually directly
supporting how we do it.
And so I think again, I don'tthink I would have been able to
do both, I wouldn't have doneeither of them particularly well
without the other one kind ofalmost helping and supporting,
because they each had someaspect of you know, they each
(24:17):
were kind of slightly different,but I mean, both of them are
mission driven.
I guess that's the otherimportant thing that we both in
both organizations they areincredibly mission-driven
organizations about trying toresolve slightly different
problems in healthcare, orprobably the same problem in
healthcare when it comes toworkforce and leadership and the
ideas about health systems, butcoming at it from slightly
(24:39):
different perspectives from theperspective in the HLA of
supporting an individual tobecome a better leader and
manage a health system, anindividual to become a better
leader and manage a healthsystem.
And from the Medics Academy,the commercial company, building
education programs, workforceto support the infrastructure of
healthcare just get betterbasically, how did you manage
your time across these twothings?
Speaker 2 (24:59):
Were you finding that you were just literally
different emails on thedifferent organisations
throughout the day?
Or did you time box and go look, I'm going to work on medics
academy in the mornings and theHLA, you know, in the afternoons
and the evenings.
Like how did how did you kindof divide the time we?
Speaker 1 (25:15):
had two.
We have two separate emailsystems and I mean, uh, quite
distinct organizationalstructures.
We've got two separate boardsof directors, but I guess
everyone that knew me knows mekind of.
There's a common mission in alot of the work, I guess.
And so whenever you talk aboutstartups, people fixate on the
individual, like the founder andit.
(25:36):
Honestly, there are bits ofboth organizations.
I don't really understand howcertain things happen, because
it's not my response, like it'sno, it wasn't my, it isn't my
responsibility, because peoplehave done, they've taken on
their own functions within it,and so the reality is that just
there's lots of, lots of otherpeople involved and those people
(25:58):
are absolutely yeah, I mean, I,I come and do these podcasts
and various other things, but onshami who and and shami was the
person who introduced ustogether said watch it, because
johan will not take credit foranything and he will deflect
questions about being a founderbecause he'll credit the team.
Speaker 2 (26:17):
That you're very humble, and there you go, you
are crediting the team, which isfantastic.
So when you got started, howdid you find that transition,
going from you know this storiedcareer as an obstetrician to
now being the startup founder?
What was the experience likefor you?
Was it what you thought itwould be when you got started?
Was it harder?
Speaker 1 (26:36):
Was it easier.
Obstetrics is an incrediblespecialty, right, because you're
made to make decisions rapidly,right, there's a problem in
front of you and your trainingkicks in, it's not?
You don't have time to think.
It's not having time to thinkin the same way that when you're
driving a car, you shouldn't bethinking right.
If you sit there thinking aboutwhat your left hand is doing,
your right hand is doing, yourleft foot is doing, your right
(26:58):
foot is doing, you're probablylike the worst drive in the
world ever, right?
You kind of naturally know howto drive the car right, and
obstetrics is very, very muchlike that at the acute end.
So when you're in an emergencysituation, you kind of your
training kicks in and you kindof just do things instinctually
because you've repeated the taskso many times.
(27:20):
Right, you've it's repetitiveemergency management, and so
that was an interesting one.
To go from that to a verydifferent type of stress,
because the stress of thatparticular scenario is one where
you know that the biggestoutcome, the biggest implication
(27:41):
of your actions actually doesnot have anything to do with you
, right?
So this is the other thing thatyou've got to think about if
you're an obstetrician, is that,even if you have the worst day
ever.
If something goes horrendouslywrong for you and you think
about it and it's traumatizingfor you, the chances are the
(28:01):
impact on someone else, or inthis case, a family is going to
be 20 times well, not even 20,just 100 times bigger and worse.
Right, because they have tolive with the consequences of
that for the rest of, not just,say, a baby's life, but the
parents and everyone else right,and so it's a very stressful
situation.
But it's a very different typeof stress and and actually it's
(28:25):
incredibly exhilarating.
But once you realize thatactually a lot of medicine, a
lot of that type of medicine, ispattern recognition.
You just have to recognizepatterns right and make
instinctual decisions that arereally, really basic, like do
the safest thing, always staysafe right, always do what you
need to do.
In startup land, it's stress,it's like really stressful, and
(28:48):
there are elements of patternrecognition right.
So, dealing with staff andother people, there's often
quite a lot of patternrecognition should, or how
someone interacts, or or whatwill work within the team and
what won't work within the team,and you develop a set of
(29:11):
pattern recognition that works.
You kind of get an idea of thiskind of deal may work, this may
not.
This is what like good lookslike and and people you know
they often talk about productmarket fit, where you've got
like a product and you adapt itto the market and it fits and
all of that stuff.
And I think that product marketfit applies in lots of
different contexts, not just tothe product of the company, but
(29:33):
lots of other elements like doyou have the right HR structure,
do you have the right financeteam, do you know whatever it is
?
And I guess those were very,very different patterns or
different problems that Itransitioned from one to the
other to solve.
But then there are otherelements which are very, very
similar which really helpedright, and one was rapid
(29:55):
decision making right andunderstanding that sometimes it
is better to just make adecision and do the best you can
with the information you haveand then correct when you get it
wrong or if you think it'sgoing wrong, or if you think
you've made the wrong decision.
Right, and that is very muchsomething that you do in
obstetrics right, you get theinformation you've got.
(30:17):
And if you don't make a decisionand just do something and get
on with it, or the decision isnot to do something, whatever it
is, but you make a decision andthen you take more data, more
information, and then you changeyour direction of travel
slightly and you tweak, and you,you know all of that, but you
know that not effectively justgetting completely paralyzed is
(30:40):
a really bad idea.
Right, by decision making andthe same is true in startups.
Right, the ability to make adecision is really important,
like it's so important andthat's probably the only main
function of a founder is thatability to make those decisions
early on and then later on,understanding that other people
(31:01):
should be allowed to makedecisions too, and it's that
that in in startup world, thattransition is also quite
difficult, because you're soused to being the sole decision
maker for some time and thenit's all the power sits with you
and then suddenly you'retransitioning organizations into
where you have to allow theorganization to evolve and it's
(31:24):
no longer really your baby onyour own.
It's like all the people whowere there at the beginning, and
there's groups of people inboth organizations who very much
are part of the absolute DNA ofthe two organizations and
without them the organizationsjust wouldn't be what they are.
So it's not just who I amanymore, right, and it's that
(31:47):
transition which is also quitedifficult, I'd say.
Speaker 2 (31:52):
Hey, just let me pause you there for a second and
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(32:13):
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(32:34):
Let's get back to the show.
See, for all founders that arelistening, or even those who are
considering being a founder,startups are really hard.
The decision making, the stress.
It's incredibly hard, butnobody dies.
If you get the decision making,the stress.
It's incredibly hard, butnobody dies.
If you get the decision wrong,you're like you could really
screw something up, but nobodydies.
So did you find?
(32:54):
Therefore, even though startupsare stressful and there would
have been days it was stressfulyou must have kind of had some
relief.
Well, I've done stress before,you know, and I've done it where
it's literally life and deathand I'm making decisions that
are really tricky and are goingto impact a family, a child, etc
.
Did you enjoy that in a sense,or was it actually?
It was just as stressful.
Speaker 1 (33:15):
Yeah, that's an interesting question.
I mean, the interesting thingis that modern obstetrics people
do die, but they don't likematernal death and fetal death
is like quite very low yeah.
And I mean fetal death, butcertainly maternal death is
something that you don't, and soyou've got life and death
decisions that have big impactsand, yes, definitely not
(33:37):
belittling that, because it'slike scary as hell.
I mean, I remember there werelots of times where the only
thing going through my head isdo not let my face say what the
hell is going Like.
Do not like.
You can't, like, I cannottransmit how stressed I am right
now, because that is not a goodidea.
It's all good.
Speaker 2 (33:53):
It's all good, it's fine.
Speaker 1 (33:56):
I'm happy, I'm smiling, it's fine, right?
So yeah, I guess that is true.
In terms of the startup space,it is really stressful because
the complexity grows and itdoesn't get simpler if that
makes sense.
And it doesn't get simpler ifthat makes sense.
In a sense, as the years wenton, it felt like the job got
(34:17):
actually quite a lot easier, inthat I'd seen it so many times
that the times when I hadn'tseen something, it was so
obvious I'd never seen thisbefore and therefore I was like
freaking out and I'm likequickly on, you know they had
phones, right.
So I'm quickly on my phone,like what the hell is this
situation?
Or or I'm phoning someone, or Iget help from someone, quickly
on, you know they had phonesright, so I'm quickly on my
phone, like what the hell isthis situation?
Or I'm phoning someone, or Iget help from someone, or I call
you know you send up the flag,and I was like I need help now.
(34:39):
Right, in startup land, theinteresting things is there's
just like a low level, permanentwhat the hell is going on?
Like genuinely what is going onhere, right?
And the other thing is inobstetrics, the weird thing was
that I mean I was on a laborward where you had a big degree
of control within a labor wardsetting, because you you had to
(35:00):
have a really good overview ofwhat's going on on this labor
ward, right as in that was in myjob, right.
So you'd have to.
You'd basically just need toknow what was happening with
each room.
You'd need to know what washappening with each room.
You'd need to know what'shappening with each, what's
going on in each scenario, andnot knowing was like the worst
thing ever, right?
I mean, like you just couldn't,you weren't allowed to do that,
you weren't allowed to not knowwhat was going on, right, it
(35:21):
was just not good.
Whereas in startup land, in thecompany, oh my God, the amount
of stuff I don't know that isgoing on in the company is like
enormous right, and if I worryabout it, I just would not sleep
at all, right, and so, and tobe fair, I don't I literally go
(35:42):
on and on and on at people aboutsleep and how important it is,
and yet I am terrible at it,right, and so you know you
stress about it and you knowthere are lots of times you're
like waking up and just thinking, oh god, I've got like my task
list is ridiculous and I need todo so.
It's just.
Yeah, it's a very differenttype of stress.
I mean I don't think there is abetter or worse version.
(36:02):
I don't think it was.
I mean, having experienced both, I can honestly say both are
awesome, that's the weird thing,right like I honestly say,
being an obstetrician is likejust simply the best career.
I wouldn't recommend people domy current job, but I would
definitely recommend people domy old job.
Right.
My old job was by far the bestjob that you can possibly have
(36:25):
on the planet ever.
Right, being an obstetricdoctor was genuinely
unbelievably cool.
Right, it was just something,and so I cannot in any way say
anything negative about that jobbecause, honestly speaking, I
still live off the buzz of a lotof what I got to do before.
So yeah, Very cool.
Speaker 2 (36:46):
Now with Medics Academy, did you take that
traditional path of I want to bethe Instagrammable guy, you
know, taking venture capital andthis is how we're going to go
and we're going to raisemultiple rounds and et cetera,
et cetera?
Or did you take that sort ofmore bootstrapped approach to
building the company?
Speaker 1 (37:02):
So I am terrible.
I've worked out, I'm good atraising money because, in order
to raise money, you basicallywhat you're doing is you're
painting a picture of somethingwith absolute certainty that has
like a 2% chance of success andlike, okay, in obstetrics I had
(37:26):
to be very, very confident inwhat I did, like there was no
chance.
I could just be, oh, I don'tknow what shall I do?
I can't do that, right.
But at the same time, I feltlike I knew what I was saying
and I knew where it was going Instartup world.
I guess we did actually raisemoney.
So we raised money.
We did two rounds in 2017 and2019.
(37:49):
And I was very good at theraising money part, right.
So the weird thing was thepeople who really, really,
really knew me and often who hadworked with me for a very long
time, or people that knew themand so had seen me doing lots of
stuff in my career they werevery quick to invest in the
(38:10):
company, right, I could not.
I did not seem to have the samemagic effect on people that
were just like who had big, andthe problem was that lots of my
friends were not stupidly rich,right, or lots of my family were
not, so I didn't have theability to just magic up money
from people that I didn't knowif that makes sense, and so so I
(38:31):
did raise money, we raisedmoney.
Actually, we raised money quitesuccessfully for the first,
like we did two rounds.
And then, in 2019, and I get, Igot told this like in no
uncertain terms by one personthat I did something which I
kind of took a look at thepattern of the company that I
was building, because it was inhealthcare and it was in
education, and it was theconfluence of the two, or the
(38:51):
interface of the company that Iwas building, because it was in
healthcare and it was ineducation, and it was the the
confluence of the two, or theinterface of the two areas, both
of which are very traditionalin that they're very
conservative.
Once you build something thatreally sticks in both industries
, it's really hard to dislodgeit, right.
That's the cool thing abouthealthcare and education.
However, to build something thatreally sticks also is not like
(39:14):
an instant issue, right.
It's not like you can just goin and you know, even if you're
sitting on a pile of like abillion dollars, it doesn't mean
you're going to somehow build ahealthcare organization or an
education organization.
I'll be frank, right, becausethere are so many reputational
factors and there are so manyother factors that go into a
(39:35):
confidence issue to do with whatyou're doing right, and I think
I guess the the best example isprobably something like haven,
right, which is the what the big, most invested, the biggest
startup, ever invested in, orsomething.
I think they raised a billiondollars or something from like
the three big you know, know,amazon and JP Morgan and
whatever, and yet they onlylasted 18 months or something I
think it was.
(39:55):
That was like that, thelifetime of that entire
organization.
And so the reality is it's not.
This is not the space I don'tthink you can just froth your
way through.
I mean, theranos is anotherexample, right.
I mean like one example of likejust complete and utter BS
ruling right, and you just can'tdo that, right.
You just it just doesn't work,right.
(40:17):
And so in 2019, I realized,after raising that round,
actually, to be fair, it didn't.
It wasn't in 2019, it was, butit was a few.
It was about a year or twolater when I realized that what
I was getting pressured to do,in terms of the decisions I was
making, would not meet theexpectations of the people
(40:38):
necessarily, and I had thatconversation.
I mean, I said you know, thereality is that this is probably
not going to be the thing thatjust blows up.
Right, that is going to.
I cannot.
And then the problem was that in2020, 2021, 20 like that was
frothy as hell, right, startupland was just these massive
valuations and at the time, Iwas like trying to work out how
(41:01):
to get the company to beprofitable and how to make it
last and be self-sufficient, inthe idea that if we are
self-sufficient, then I'm notconstantly trying to catch up,
I'm not constant, I can focus onwhat we're doing and building
the thing we're doing, ratherthan doing like just constantly
out there trying to grab moremoney and not like focus on on
(41:25):
building a, a genuinelysustainable company.
And I guess that was a decisionthat, in hindsight, I honestly
still don't know is the rightanswer, because I know that, for
where we are right now, it'sdefinitely the right answer.
Like we are definitely, youknow, we're self-sustaining,
we're doing like we're doing,but we're also relatively quite
(41:46):
small and there are lots ofcompanies that in this interim
who, like you're where thefounders were just fixated on
raising money and they just madethese enormous numbers right
work in that period during thispandemic, and I can't tell you.
I mean, yeah, some of themdon't exist anymore.
But I mean, you know, thequestion is, I don't know, you
know, what is the right thing todo.
(42:07):
I don't honestly know, is theanswer I don't know.
I can't, because I most peoplethere's.
The motivations of startupfounders are very different.
Right, my motivation is I wantto build an organization that's
still here in 50 years time.
Right, or in a hundred years.
I mean I'd like to build anorganization that, when I'm dead
, is not dead with me, if thatmakes sense.
Right, and so knowing that as amotivation I think makes it a
(42:31):
slightly better like in my mind.
It makes it more obvious what Ineed to do and for the whole
team, what we have to do, andalso it means how you build the
startup matters.
Ie that it's not about I mean,you know, you say this, but it's
really can't be about me,because it's building like in my
mind.
We're building institutions.
We're building two institutionsand they are hopefully going to
(42:53):
be institutions, and aninstitution can't be dependent
on one, two, five, 15 people.
It's got to have solidfoundations, if that makes sense
.
Speaker 2 (43:02):
What's the hardest thing that you've experienced in
this startup journey with youknow either organization that
you wouldn't have anticipatedkicking off your startup journey
?
Something that has really notso much floored you maybe it has
, but it's something that it wasway tougher than you thought.
Was it the capital raising?
Was it hiring?
Was it finding product marketfit?
(43:24):
What was that?
Speaker 1 (43:26):
I mean the most stressful thing by far by, like
a country.
The most stressful thing by farwas there was a period about 18
months into the company wherewe were genuinely teetering on
the edge.
Right, this is the commercialcompany and my wife very, very,
very, very, very supportively,basically agreed that we would
(43:49):
sell our family home in order torecapitalize the company.
Wow, okay, I mean rememberwe've got two young kids here,
right, and so like I honestlyhave to say no one should ever
do this.
This is why, like, this is nota good idea.
No, and basically we did it andwe were in rental accommodation
for like five years, six years,something like that, and it was
(44:10):
difficult and she made like shewas so supportive and like
never questioned that thisdecision, like she never held it
against me, like now she worksin the company.
I mean, she's worked in thecompany for a few years.
Right, for not, not since then,but she a few years later she
was like, oh well, you know sheactually came and helped with
the company in lots of ways.
Um, and so that level ofsupport is what do you say to
(44:34):
that?
Right, because you're on thejourney, but like everyone and
you know it's everyone elsearound, it's not just like Sarah
, it's not just my wife, buteveryone around me was like
hyper supportive, like friendsof mine and family members and
people like you know.
There were just so many peoplethat have just helped me over
the years and like that is likecrazy.
(44:56):
Right, it's like really crazyand I think part of it is
because I hope part of it isbecause we're kind of really
mission driven.
We are, we've got a missionthat we're on.
We want to do it.
We want to help people in doingit.
We've just spent the last fouryears working on gender in
healthcare and leadership andwe've done a whole series of
(45:17):
projects in Africa and Ethiopia.
Clearly, some of those decisionsare you're taking a very
long-termist view of the world.
To work in a war zone in themiddle of Ethiopia on gender
empowerment and gender-basedviolence and doing that from
within a commercial entity.
To do that and justifying thatto my board of directors was
(45:38):
always an interesting one, right, but they were so supportive,
right, because they were justlike okay, I see what you're,
what you're doing here.
I can, I explained it, I, youknow, I kind of justified it and
it fulfills the kind of missionthat we've set ourselves on,
without being hypocritical aboutit, we're not just saying it
for the sake of doing it, we'reactually going and doing this
stuff and so I think you know,in lots of ways, that is our.
(46:02):
That's like what I want.
Like I left a very rewardingrole in order to do what I
consider just as rewarding arole in a very different way.
Speaker 2 (46:12):
Just incredible actually listening to you.
You really are a real source ofinspiration.
My final question, I suppose,is you know, is there something
you would want to leave othersto consider, a piece of advice
for startup founders?
Maybe for people who are in aprofession currently not doing a
startup they might be inmedicine, or they might be in
law or whatever, and they're nothappy.
(46:34):
Yet there's a lot of pressureto stay within that profession,
to maintain the status, if youlike, of being in that
profession, or maybe somethingfor startup founders A piece of
advice you'd want to leavepeople that are listening to
this Stay, stay in theprofession.
Speaker 1 (46:51):
That's not what I thought you'd say I would say
that, like the, the, you knowsecurity is something that is
you have to really.
Okay, let me put it this way ifeveryone tells you to stay and
then you decide to leave, youmay may have made the right
decision for you, right?
But if people tell you to stayand it makes you stop and think,
(47:12):
should I stay?
You probably shouldn't leave,right?
Interesting.
So, and the other thing I'veworked out is that there is
absolutely no pattern to thisone right?
What makes a good founder?
Right?
I honestly, I've met so manydifferent people from so many
different backgrounds.
I honestly cannot say thatthere is a pattern for what
makes a good founder, becauseoften founders are contrarian,
(47:36):
so they are contrarian.
But the other thing is thatfounders are very, very
different in what motivates them, right.
So there is.
Some of them are just like,literally just want to make the
money.
I mean, they only care aboutthe money, and that is perfectly
fine.
I do not.
You know I'm not like some.
You know I'm not going to besome kumbaya kind of crazy, like
(47:57):
hippie on this stuff, right,like, if that's what motivates
you, that's fine, go for it.
Like, go and do that what youwant to do Right.
And then there are others thatare like mission driven and want
to do, and then there's peoplein the middle that kind of are
mission driven but they'rereally like not you know.
There's this kind of weird kindof interface between the two.
The one thing I'd say is justreally really know yourself.
(48:20):
Like you don't have to admit itin public, you don't have to
admit it on a podcast, you don'thave to tell everyone what you
want to do, you know.
You just have to admit it toyourself.
What is it it?
Why are you doing this like?
Why are you putting yourself?
If you're slightly older, yourfamily, everyone, you know why
are you putting people throughthis crazy decision?
(48:41):
The thing is, you can be aroundstartups without necessarily
being the founder.
You can be an early employee,you can be in venture, you can
be in finance, you can be.
You know there's lots of waysyou can be around the excitement
without necessarily doing thefounder job right.
And the reality is that I thinkin the first five years, the
(49:07):
majority of the companies I'veeither seen I've actually
invested in a few invested in orI've kind of like done Like the
reason why it fails is usuallybecause of the founders, right,
like that's the only reason Imean we can work up a percentage
, but really it's something todo with the founder or founding
team, right?
It's like that problem.
And so the question is just bereally, really sure that you're
(49:32):
making, especially if you comefrom a professional background,
because there's two elements tocoming from a professional
background which both play inyour favor and don't play in
your favor, right, the play inyour favor bit is that you have
history, context, expertise, etcetera, et cetera, and it gives
you a safety net right.
Expertise, etc, etc.
(49:53):
And it gives you a safety net,right.
So it gives you this safety netyou can go back to or you may
use at the same time as being afounder, etc, etc.
But that's also a negativeright, because you have a safety
net.
You're not walking thetightrope without the safety net
, right.
And that means there's otherkind of considerations that you
always play in your head.
Because if you're a founder,honestly the idea that you have
(50:15):
no self-doubt about what you'redoing I cannot imagine the level
of psychopathy you mustactually suffer in your head,
that's right.
The level of crazy you must beis just enormous, right.
So if you don't have thatself-doubt, then like, okay, I
don't know what to say to you,but if you do like you've got to
(50:35):
live with that self-doubt.
If that makes sense, right, andthat can be stressful.
So if, after all of hearingthat, and everyone tells you not
to do it, and your parents tellyou not to do it, and your
spouse and your partner tellsyou not to do it, and everyone
tells you not to do it and theydon't divorce you and they don't
throw you out on your ear andall of that stuff, you still
(50:55):
decide to go and do it, great,maybe it's the right job for you
johan, this has been anabsolute masterclass and I I
kind of I I really regret thatyou live in the uk and I live
here in new zealand, because Ijust think you'd be the kind of
guy I would love just hangingout talking over a glass of wine
.
Speaker 2 (51:13):
You're talking about history and great nonfiction
books and things.
This has been, as I say, a truemasterclass.
You are an inspiration, becauseI think you are very much
driven by mission.
You're going to have a massiveimpact.
The 80-year-old version ofyourself, I think, is going to
be very happy with the way thatyou've lived your life.
So I want to thank you for thetime you've given today.
(51:36):
I will make sure there's waysfor people to connect with you
on LinkedIn and through your twoorganizations as well and to
learn more about both.
Really, really appreciate thetime you've given today, johan.
Thank you so much.
Thanks, lord.
Speaker 1 (51:49):
Craig.
Speaker 2 (51:53):
Johan, thank you so much.
Thanks so great.
Hey, don't forget to check outdesk work, the team behind you
being able to buildhigh-performing offshore teams
for your startups and Smee's.
It's desk work, co.
Backslash, greg, and go andsave yourself some hard-earned
money.
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