How to Find $100M+ Startup Ideas in Any Market | Counsel Health, Muthu Alagappan
Meet Muthu, Founder & CEO of Council Health—a physician-turned-AI researcher on a mission to 10× the world’s clinical capacity by pairing doctors with “Iron ...
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Contributed by 刘嘉琪Transcript
Intro
- 00:00The Stanford commencement speech was really exciting time because it marks the end of medical school. One of the things that I think medicine has really taught me is the ability to identify out
- 00:08of 20 patients you may be taking care of who are the one or two patients that need all your attention right now and how do you really focus in an outsized
- 00:16way on the couple of problems in this case patients that matter the most. I think being a founder is very similar where when you're looking across maybe 20 fires of the company, having the
- 00:25ability to figure out what are the one or two that you are most well suited to solve and contribute to. So it's really a matter of prioritization and of
- 00:33knowing where to really pour your energy into at any given time. I think one piece of advice that's really helpful is where are my unique strengths most
- 00:40suited to have the most meaningful contributions?
- 00:50My name is Muella Gapen. I'm a physician by training, but spent the early part of my career as an AI researcher at Stanford and have spent the last many
- 00:58years building health technology companies. I'm the founder and CEO at Council Health. Council Health is an AI enabled virtual care company. We're
- 01:05redefining virtual care for the modern era. And our hope is that we can multiply the world's clinical capacity by creating perfect doctors to deliver
- 01:13the highest quality care to the next 10 billion people. What many patients describe to us as feeling like they have a doctor in their pocket. We're really excited to announce our $25 million
- 01:22series A co-led by Andre Horowitz A16Z and GV.
The Day I Knew I Had to Quit Being a Doctor
- 01:30Growing up, I had a speech impediment where I couldn't say the letter R. And I distinctly remember sitting in class and hoping the teacher wouldn't call on me
- 01:38to read out loud the sections. And I I actually remember counting the number of Rs in a given sentence to see which sentence I should volunteer to read to avoid, you know, being embarrassed.
- 01:47Later in my life did a lot of public speaking and speech and debate. And to me that was mostly a form of building conviction in a growth mindset and the
- 01:56idea that just because something is broken or doesn't work or isn't the way you want it doesn't mean that it can't be solved. And in a way that personal
- 02:03lesson of going from something becoming an impediment to eventually being a strength. So I grew up in Houston which is the home to the world's largest
- 02:11medical center another place with some of the best cancer hospitals, teaching hospitals, medical schools. And when you grow up in that environment and you
- 02:19still see cracks in the foundation, you still see misdiagnosis, challenges with access, weight times, diagnostic errors.
- 02:26you start to realize that even the best that we've ever created, the best medical centers, the best hospitals, the best doctors are still not quite at
- 02:34either the quality or capacity that we need to serve the broader uh US and global healthcare needs. There's a couple of times where I've felt the way
- 02:42we practice medicine today is just not good enough. And I remember many times being in clinic as a primary care physician, having a patient sit in front
- 02:50of me and explain their problems and knowing that there is some limitation I have in my memory, my recall, in my
- 02:57ability to connect the dots that was preventing me from helping this person in the best way possible. Humans were working off fallible memory, off logical
- 03:06and cognitive biases. We may be hungry before lunch and that's making us feel rushed with a particular patient. You're dealing with life or death decisions.
- 03:14Patients being rushed in with a heart attack. Being alone in the ICU at 2 a.m.
- 03:19with a patient whose blood pressure is falling and who is not responding to any medications. How do you comfort a family member who's grieving the loss of their
- 03:27son or daughter? And it felt like all of these were shortcomings. You know, I often felt guilty at the end of each clinic day realizing that if I had a perfect memory, if I had read every
- 03:36journal article, if I had infinite time, I could help these people so much better than I was. I remember practicing medicine and wanting to have an impact
- 03:44on people, but feeling like that impact was constrained to one patient at a time, one visit at a time. I've been fortunate in my career where I've gone
- 03:52into the depths of both clinical AI and AI research, but also the practice of medicine. Having two depths of experience, one in AI, one in medicine.
- 04:02And one of the things I was really excited about when transitioning from clinical medicine into technology was the ability to scale impact. The ability
- 04:10to help people not one at a time but at a large magnitude where a single software application, a single new algorithm, a new technique could
- 04:17suddenly help millions of people or billions of people. And that's what first led me to move away from daily practice in medicine to helping build technology companies that could have
- 04:26this large-scale paradigm shifting change on healthcare overall.
Stop Improving a Broken Idea (Do THIS Instead)
- 04:32[Music]
- 04:34Many of the AI solutions being worked on in healthcare were improving doctor's capacity by maybe 10% or 20%. But what
- 04:41that actually translates to then is instead of seeing four patients an hour, you're maybe only able to see five patients an hour. And while that is a
- 04:49meaningful improvement, we felt like it wasn't enough to truly make a difference in the access to care, in the quality of care, in how personalized care was.
- 04:57Speeding up doctors by 20% wasn't going to solve that problem. And so we really wanted to go at the root cause of the problem, which is not how do you do
- 05:05administrative work faster, but how do you actually deliver care itself faster, higher quality, more personalized. So we set out on this mission to think in
- 05:14multiples, not percentages. What does it look like to 10x the world's clinical supply? We had a choice of do we want to build software that tried to practice
- 05:22medicine on its own or one that augmented existing doctors and we felt really strongly that the right care model here would be one that combined AI
- 05:30with human doctors for supervision and guidance such that you get the best of both worlds. We believe either alone is insufficient. AI only chat bots have the
- 05:39problem of hallucination, a lack of supervision and a lack of ability to actually action on the advice they give.
- 05:45And human doctors have the fundamental laws of physics that constrain their ability to see enough patients with enough quality in a given time. We
- 05:53started thinking about our AI augmentation as a sort of iron man suit for our clinicians. Imagine a physician that can supercharge their own abilities. You know, essentially obtain
- 06:01these clinical superpowers by using our AI platform. They could suddenly remember every article they've ever read. They could review a patient's
- 06:09chart, even if it's hundreds of pages, within seconds. And the other unique thing about council is that we built our own physician group in house. So today we run and operate a 50-st state medical
- 06:17practice with our own employed physicians. And the reason that's important is it means we control not only the iron man suit but the iron men and women themselves and we can truly
- 06:26create the best combination of human and AI working together. Many patients describe to us as feeling like they have a doctor in their pocket. I've often
- 06:33tried to make decisions where are my strengths was really important to solve some of the hardest challenges ahead in the world of clinical AI. It's because
- 06:42these problems aren't specific to a single domain. They sort of cross over between both domains. It requires you to understand how do doctors do it today,
- 06:51but also requires you to understand the art of the possible with AI. If you only understood one of those two disciplines, you would be fundamentally constrained
- 06:59both in the creativity but also the depth of the types of solutions you could create. And we all have different strengths. But where are my unique
- 07:05strengths most suited to have the most meaningful contributions in startups? This is often called founder market fit.
- 07:12But where are you as a founder best suited to solve a particular market challenge?
Choose Only One Important Thing or Achieve Nothing
- 07:20One of the things that I found as a founder is there are always so many fires so to speak going on at the company or in the business and it's
- 07:29really impossible to devote your full attention to all of those fires at one time and if you try you end up doing a subpar job across the board. One of the
- 07:38things that I think medicine has really taught me is the ability to identify out of 20 patients you may be taking care of, who are the one or two patients that
- 07:45need all your attention right now. And how do you really focus in an outsized way on the couple of problems, in this case patients, that matter the most?
- 07:53When building a company like Council Health, there are two themes constantly in tension. One is the medical theme and premise of do no harm, the hypocratic
- 08:01oat, and the other is the startup adage of move fast and break things. The idea that only by taking risks and moving quickly can you truly unlock innovation
- 08:10at scale. When building a medical AI care delivery platform like council, those two things could be at odds. But we found a really elegant way to resolve
- 08:18them. First and foremost, we focus on do no harm. How do we ensure that everything we deploy, every aspect of the care model, not only has physician
- 08:26supervision baked in, but also has been evaluated and tested to be highquality, safe, and at the very least exceeding
- 08:34the performance of the world's very best doctors. At the same time, because we have an in-house physician group, we're able to safeguard our AI where we can
- 08:42have our AI take risks, be more innovative in the way the AI is suggesting diagnoses and reviewing the literature, knowing that all of those
- 08:50things will be safeguarded and supervised by a physician in the loop.
- 08:54In that way, we get to enjoy the best of both worlds. We get to make sure the end patient experiences no harm, yet at the same time, we can have our AI push the boundaries of what AI is capable of.
The ONE Thing I had to Tell Stanford
- 09:09The world as we know it in healthcare and most industries will probably change fundamentally over the next 5 years.
- 09:15There's going to be a massive reshuffleling of norms and paradigms.
- 09:19The way we interact with a lawyer, a doctor, an accountant, even an investor will change greatly in the next 5 years.
- 09:26We even wonder sometimes will we tell our children in 20 or 30 years about this concept of primary care doctors and will they look at us with sort of
- 09:34admiration and wonder at this idea that there was only a single person and they didn't really remember your medical records and if you traveled you couldn't
- 09:41really get access to them and maybe one day that'll all feel a bit old-fashioned. Not solving perhaps for the next 5 years but solving for what
- 09:48the world will look like as a result of this reshuffleling. If it's the case that everyone is accessing care via their phone, what does that mean in
- 09:56terms of computational and video needs on a phone? What does that mean for how we structureies?
- 10:02Don't act like you hit a triple when you were born on third base.
- 10:07While today is a celebration, I think it's also a recognition that in one way or another, we were all born on third base.
- 10:14You know, so many of us are born with so many things that we're fortunate for, that we've been sort of gifted. And in my mind, I view a lot of that as a
- 10:21responsibility to then give back, not just proportionally, but even in an outsized way. And so I think a lot of what motivates me is giving back in a
- 10:30way that feels outsized to what's been given to me in terms of opportunities, in terms of the people I've met, the education I've been able to receive.