WEBVTT 00:00:02.439 --> 00:00:04.660 Thanks for joining me today, Sumitra. Really 00:00:04.660 --> 00:00:07.759 excited to have you here. Yo, Rashad. It is good 00:00:07.759 --> 00:00:11.519 to see you. I'm glad to be here. Let's start 00:00:11.519 --> 00:00:17.120 our journey back in 2005. Talk to me about your 00:00:17.120 --> 00:00:20.339 high school days and how you decided to pursue 00:00:20.339 --> 00:00:32.359 neuroscience. 2005? I was 15. I only did nerd 00:00:32.359 --> 00:00:36.659 extracurriculars and incredibly bad JV tennis. 00:00:36.840 --> 00:00:38.820 I think I lost every single game that I ever 00:00:38.820 --> 00:00:41.780 played in three years. Incredibly bad tennis, 00:00:42.520 --> 00:00:44.539 with an incredibly patient coach, speech and 00:00:44.539 --> 00:00:48.719 debate, science research, mock trial, and Science 00:00:48.719 --> 00:00:50.700 Olympiad were my really big extracurriculars, 00:00:50.920 --> 00:00:55.899 speech and debate really being my passion. I 00:00:55.899 --> 00:00:58.000 equivocated a lot on what I wanted my major to 00:00:58.000 --> 00:00:59.640 be when I went to college. I actually originally 00:00:59.640 --> 00:01:03.179 declared classics. And I was very keen to be 00:01:03.179 --> 00:01:05.939 a classics major. The small liberal arts school 00:01:05.939 --> 00:01:08.540 where I went to made a bet that no one who wanted 00:01:08.540 --> 00:01:10.420 to be pre -med would also want to be classics. 00:01:10.500 --> 00:01:13.840 So all the classics language classes conflicted 00:01:13.840 --> 00:01:16.120 with science labs. So I could never actually 00:01:16.120 --> 00:01:18.879 be a classics major. So neuroscience was very 00:01:18.879 --> 00:01:21.299 much a philosophical thing. I always found the 00:01:21.299 --> 00:01:24.109 fact that We're conscious and it feels like something 00:01:24.109 --> 00:01:28.390 to be alive to be the most strange and mysterious 00:01:28.390 --> 00:01:31.290 like thing in the universe and it made me really 00:01:31.290 --> 00:01:33.409 curious about neuroscience as a field because 00:01:33.409 --> 00:01:35.450 it felt like the most important kind of question 00:01:35.450 --> 00:01:40.179 to ask and neuroscience is such a interdisciplinary 00:01:40.179 --> 00:01:43.939 science, it's like very much in applied science. 00:01:44.120 --> 00:01:47.560 And I love the fact that I got to dabble in the 00:01:47.560 --> 00:01:50.079 concepts I was learning in chemistry and physics 00:01:50.079 --> 00:01:53.700 and simple biology and computer science and math, 00:01:54.000 --> 00:01:56.480 all of those in psychology and cognitive psychology 00:01:56.480 --> 00:01:59.200 in particular, like it was a field that had so 00:01:59.200 --> 00:02:01.760 many different kinds of lenses from different 00:02:01.760 --> 00:02:04.640 fields. So for all those reasons, when I did 00:02:04.640 --> 00:02:06.640 go to college, I found all of that very appealing. 00:02:08.539 --> 00:02:11.919 There's a general theory in investing that the 00:02:11.919 --> 00:02:15.719 people who succeed as founders kind of fit this 00:02:15.719 --> 00:02:18.580 persona where they had atypical hobbies in high 00:02:18.580 --> 00:02:22.759 school and in undergrad possibly. Do you find 00:02:22.759 --> 00:02:25.219 that rings through when you diligence founders 00:02:25.219 --> 00:02:28.000 and tell our audience how you spend your days 00:02:28.000 --> 00:02:32.099 now? Do you go deep into their careers and into 00:02:32.099 --> 00:02:34.719 their history and hobbies when they were children 00:02:34.719 --> 00:02:38.020 as well? You know, it's a good question. I'll 00:02:38.020 --> 00:02:40.699 start by where I spend my time. I work part -time 00:02:40.699 --> 00:02:43.500 as a physician, as an internal medicine hospitalist 00:02:43.500 --> 00:02:47.060 at a historic hospital in San Francisco in the 00:02:47.060 --> 00:02:50.680 community, treating a mostly poor local population 00:02:50.680 --> 00:02:55.259 that I'm very, very fond of. I run my VC fund 00:02:55.259 --> 00:02:57.639 full -time at Mountain Ventures, pre -seed seed. 00:02:58.280 --> 00:03:02.080 Uh with brandon another physician we helped build 00:03:02.080 --> 00:03:04.639 the fund several years ago Uh, and that was a 00:03:04.639 --> 00:03:07.580 whole story and we may get into later Uh, and 00:03:07.580 --> 00:03:11.219 in my spare time, uh between my two jobs, uh, 00:03:11.219 --> 00:03:12.860 my wife and I have recently become obsessed with 00:03:12.860 --> 00:03:16.020 surfing Which is our my new version of tennis 00:03:16.020 --> 00:03:18.139 something that I love doing and i'm just absolutely 00:03:18.139 --> 00:03:24.719 terrible at the you know There's I differ from 00:03:24.719 --> 00:03:28.800 a lot of investors. A lot of investors are very 00:03:28.800 --> 00:03:34.300 dogmatic about types and vibes. I'm very much 00:03:34.300 --> 00:03:37.280 a, you know, see people for all their complexity. 00:03:37.479 --> 00:03:39.639 There's many different ways of being right. It 00:03:39.639 --> 00:03:42.680 really matters. You know, is your strategy coherent? 00:03:42.919 --> 00:03:45.379 Is it coherent with my goals? I'm also a really 00:03:45.379 --> 00:03:48.560 big believer that we've had a generation of gut 00:03:48.560 --> 00:03:54.069 check intuitions that are sometimes right. Often 00:03:54.069 --> 00:03:56.330 wrong and there's a lot of money left on the 00:03:56.330 --> 00:03:59.050 table when you over index on those kinds of you 00:03:59.050 --> 00:04:03.090 know gut checks and vibes So for me the psychological 00:04:03.090 --> 00:04:06.889 profile of founder a typical hobby thing If it's 00:04:06.889 --> 00:04:09.810 true, I would find it, you know interesting and 00:04:09.810 --> 00:04:12.229 speaking to a certain pattern of facts But if 00:04:12.229 --> 00:04:15.409 it's wrong, I wouldn't see it as you know, a 00:04:15.409 --> 00:04:19.050 bad thing by any means one of my some of my best 00:04:19.050 --> 00:04:24.939 founders came from resource poor very strict, 00:04:24.939 --> 00:04:28.779 uh, childhoods overseas, where if they had any 00:04:28.779 --> 00:04:31.199 atypical hobbies, they would have been met with 00:04:31.199 --> 00:04:33.899 a slap on the face, not with, you know, praise 00:04:33.899 --> 00:04:36.579 and validation. And they're incredibly, you know, 00:04:36.720 --> 00:04:39.420 serious, competent, well adjusted, you know, 00:04:39.620 --> 00:04:41.620 living life of mind founders now, but they didn't 00:04:41.620 --> 00:04:44.220 have that particular story. And that makes sense. 00:04:44.379 --> 00:04:46.399 Given their background, it wouldn't be what I 00:04:46.399 --> 00:04:49.639 would expect for them. So I see it as my general, 00:04:49.779 --> 00:04:51.920 my short answer is, I don't think of it in that 00:04:51.920 --> 00:04:54.060 way. But my larger answer is the way I like to, 00:04:54.339 --> 00:04:57.879 I always like to see people not as just themselves, 00:04:57.980 --> 00:05:00.100 but like a whole pattern. And I like to keep 00:05:00.100 --> 00:05:02.279 an open mind about all the different ways and 00:05:02.279 --> 00:05:04.459 shapes and sizes those patterns could be that 00:05:04.459 --> 00:05:07.000 could be coherent. Mindful it may not be the 00:05:07.000 --> 00:05:09.680 kind that fits the sort of patterns that I had 00:05:09.680 --> 00:05:13.579 when I grew up. We'll go back to your undergrad 00:05:13.579 --> 00:05:18.319 days soon. There's a lot of talk in the big VC 00:05:18.319 --> 00:05:21.620 firms that AI will replace a lot of jobs, but 00:05:21.620 --> 00:05:23.759 it's never their job it will replace. It will 00:05:23.759 --> 00:05:27.920 replace all the other jobs of mine. Do you agree 00:05:27.920 --> 00:05:31.300 with that statement? And then I'll kind of going 00:05:31.300 --> 00:05:36.079 back to your work as a hospitalist as well. Do 00:05:36.079 --> 00:05:39.160 you think AI will replace a hospitalist or a 00:05:39.160 --> 00:05:45.879 VC's job first? Great questions In both, you 00:05:45.879 --> 00:05:49.779 know, there's a commonality with both in both 00:05:49.779 --> 00:05:54.579 you have someone who exercises judgment and sits 00:05:54.579 --> 00:05:58.860 with liability and There's institutional value 00:05:58.860 --> 00:06:01.660 if nothing else in having an individual who sits 00:06:01.660 --> 00:06:04.600 with liability as opposed to having You know 00:06:04.600 --> 00:06:07.720 kind of like, you know faceless liability. There's 00:06:07.720 --> 00:06:09.899 something about you know, the buck stops with 00:06:09.899 --> 00:06:14.120 someone someone is on the hook and they respond. 00:06:15.100 --> 00:06:17.399 They're on the hook for it. And because of that, 00:06:17.540 --> 00:06:20.139 the system kind of pays them mostly for that. 00:06:20.279 --> 00:06:23.519 I see a lot of clerical things that I do in the 00:06:23.519 --> 00:06:26.120 hospital as an internal medicine hospitalist 00:06:26.120 --> 00:06:28.360 really is like the system being like, we need 00:06:28.360 --> 00:06:30.199 someone to do this. Who sits with liability? 00:06:30.259 --> 00:06:32.259 Who oversees it? Because they make even better 00:06:32.259 --> 00:06:35.600 judgments than if that person were out of the 00:06:35.600 --> 00:06:39.019 loop. For structural reasons, I think that there's 00:06:39.019 --> 00:06:42.360 value in having some number of people. I see 00:06:42.360 --> 00:06:46.079 it less as the zero, like the one job going to 00:06:46.079 --> 00:06:50.050 zero is. always very hard. It becomes like one 00:06:50.050 --> 00:06:52.110 of those asymptotes where it just exponentially 00:06:52.110 --> 00:06:55.050 takes off. I see it as more like you may have 00:06:55.050 --> 00:06:57.629 100, but maybe you could get by with 80, maybe 00:06:57.629 --> 00:06:59.430 you could get by with 60, maybe you could get 00:06:59.430 --> 00:07:02.069 back with 40. Could you make that one person 00:07:02.069 --> 00:07:04.610 far more efficient? Instead of zero radiologists, 00:07:04.670 --> 00:07:06.670 if you have one radiologist doing the work of 00:07:06.670 --> 00:07:10.269 1 .4 radiologists, that's still a radical subversion 00:07:10.269 --> 00:07:12.930 of the status quo. And that one is much more 00:07:12.930 --> 00:07:16.819 achievable. I could see it that way. On the hospital 00:07:16.819 --> 00:07:21.579 side, there are parts of my job that with really 00:07:21.579 --> 00:07:24.879 good automation, I could greatly scale away. 00:07:25.550 --> 00:07:29.550 The most time consuming part of my job is the 00:07:29.550 --> 00:07:31.569 sitting at the bedside, holding hands and crying 00:07:31.569 --> 00:07:33.470 part of my job. The meeting people on the worst 00:07:33.470 --> 00:07:37.129 day of their lives, being there, navigating people, 00:07:37.529 --> 00:07:40.110 complex situations, being like, you know, this 00:07:40.110 --> 00:07:43.129 old person with dementia lives alone. They have 00:07:43.129 --> 00:07:45.050 a daughter who they abandoned when they were 00:07:45.050 --> 00:07:47.689 two. They have a landlord who like kind of shows 00:07:47.689 --> 00:07:50.129 up and helps them out. The landlord and the daughter 00:07:50.129 --> 00:07:52.579 disagree. Who do I make the surrogate decision 00:07:52.579 --> 00:07:55.600 maker? Like, you know, who do I turn to to represent 00:07:55.600 --> 00:07:57.620 the interests of this person? It's like stuff 00:07:57.620 --> 00:07:59.600 like that takes up most. I think also I work 00:07:59.600 --> 00:08:01.600 in a really socially complex population. So this 00:08:01.600 --> 00:08:03.319 may not be like a representative answer of what 00:08:03.319 --> 00:08:05.339 doctors do. This mainland is strange to many 00:08:05.339 --> 00:08:06.959 people listening. Like, what does this do doing? 00:08:07.000 --> 00:08:08.819 Like, what? But anyways, it's like, these are 00:08:08.819 --> 00:08:11.160 like the arts of my job. And those are harder 00:08:11.160 --> 00:08:14.480 things to automate. You could have an advanced 00:08:14.480 --> 00:08:17.579 AI solution. Do it. Even a perfect solution would 00:08:17.579 --> 00:08:20.420 probably just not land as credible in the same 00:08:20.420 --> 00:08:23.660 way. So on the hospital side, maybe one hospitalist 00:08:23.660 --> 00:08:25.939 can do the work of 1 .4 hospitalists in the future. 00:08:26.100 --> 00:08:28.139 Would it go to zero? I don't think so. There's 00:08:28.139 --> 00:08:31.259 a certain kind of top -year license craft intuition 00:08:31.259 --> 00:08:37.019 thing that you do. On the VC side, it's interesting. 00:08:37.679 --> 00:08:40.399 You sent me this message about quantitative trading 00:08:40.399 --> 00:08:43.320 a few days ago. And I've been thinking a lot 00:08:43.320 --> 00:08:47.330 about that. I think it depends on What is the 00:08:47.330 --> 00:08:50.470 kind of transaction you do? How much ambiguity 00:08:50.470 --> 00:08:54.309 are you assuming? How liquid is the market? What 00:08:54.309 --> 00:08:57.690 are the stakes of being wrong? If I were a high 00:08:57.690 --> 00:09:00.350 frequency trader, it would be much easier to 00:09:00.350 --> 00:09:02.769 replace me with a machine. And it's sort of a 00:09:02.769 --> 00:09:05.149 silly thing to say because high frequency traders 00:09:05.149 --> 00:09:06.950 are machines. Like they're essentially people 00:09:06.950 --> 00:09:09.909 who program machines like humans can't do that 00:09:09.909 --> 00:09:12.830 kind of asset trading anymore. But it's essentially 00:09:12.830 --> 00:09:16.570 extremely low transaction cost, super high information 00:09:16.570 --> 00:09:19.389 transactions, where if you're wrong in a microsecond, 00:09:19.549 --> 00:09:22.509 you liquidate your entire holdings. VC transactions 00:09:22.509 --> 00:09:25.820 are like super high ambiguity. They often involve 00:09:25.820 --> 00:09:28.120 doing things that are unprecedented and never 00:09:28.120 --> 00:09:30.159 seen before. So if you template match off what 00:09:30.159 --> 00:09:33.679 existed before, you may get mismatches, and it's 00:09:33.679 --> 00:09:39.460 extremely illiquid. So it's harder to do. In 00:09:39.460 --> 00:09:42.240 terms of not going from one to zero, but one 00:09:42.240 --> 00:09:45.639 person doing the work of 1 .5, the amount of 00:09:45.639 --> 00:09:48.320 time I've spent doing admin, overhead, clerical, 00:09:48.419 --> 00:09:50.860 et cetera, is exponentially lower today than 00:09:50.860 --> 00:09:53.840 it was a year ago, because we built a whole bunch 00:09:53.840 --> 00:09:57.940 of internal AI -based workflows. Sorry, Rashad. 00:09:57.960 --> 00:10:00.019 You asked for tight answers, and here I am giving 00:10:00.019 --> 00:10:02.899 long essays. Please forgive me. Let's stick with 00:10:02.899 --> 00:10:07.679 this. Something I've been thinking about is what 00:10:07.679 --> 00:10:10.639 patterns can I recognize with founders? And I've 00:10:10.639 --> 00:10:14.019 been debating with putting and maybe putting 00:10:14.019 --> 00:10:16.000 founders through is not the right terminology 00:10:16.000 --> 00:10:17.899 because I would be asking them and they can say 00:10:17.899 --> 00:10:23.740 no. Psychological tests and some validated some 00:10:23.740 --> 00:10:27.480 not like Myers -Briggs and Enneagrams and other 00:10:27.480 --> 00:10:30.440 forms of psychological testing and seeing if 00:10:30.440 --> 00:10:34.769 I can find patterns on what archetype makes the 00:10:34.769 --> 00:10:39.909 best founder. Now, I know this goes against vibe 00:10:39.909 --> 00:10:43.110 investing or, you know, I like this founder, 00:10:43.149 --> 00:10:45.210 they can sell. I don't know why they can sell. 00:10:45.389 --> 00:10:47.110 I don't know why I like them. They're just a 00:10:47.110 --> 00:10:51.029 charming person. Do you think there is an avenue 00:10:51.029 --> 00:10:53.750 and are you doing this trying to break down what 00:10:53.750 --> 00:10:57.539 founder charm means? and really trying to analyze 00:10:57.539 --> 00:11:00.379 that and trying to figure out quantitative patterns 00:11:00.379 --> 00:11:03.860 that then you can use to say, all the founders 00:11:03.860 --> 00:11:07.240 who apply to my fund do this test and then you 00:11:07.240 --> 00:11:10.019 have a filter before you speak to the founder. 00:11:17.340 --> 00:11:19.740 In terms of psychometrics, one of the things 00:11:19.740 --> 00:11:22.379 I really appreciate about neuroscience and also 00:11:22.379 --> 00:11:25.019 all the psychology classes I took was doing a 00:11:25.019 --> 00:11:29.000 really deep dive on the academic rigor, the face, 00:11:29.100 --> 00:11:31.240 and other kinds of validity for different kinds 00:11:31.240 --> 00:11:34.320 of psychometric tests. I would argue that most 00:11:34.320 --> 00:11:36.659 of our psychometric tests, the very best psychometric 00:11:36.659 --> 00:11:40.240 tests we have, Are not great. There's no universal 00:11:40.240 --> 00:11:42.580 test. They tend to be very culturally specific 00:11:42.580 --> 00:11:45.179 They tend to be like they tend not to generalize 00:11:45.179 --> 00:11:47.860 well over time The rigor of evidence behind them 00:11:47.860 --> 00:11:50.919 tends to be poor a lot of them come from a particularly 00:11:50.919 --> 00:11:53.639 bad era of like psychology research That was 00:11:53.639 --> 00:11:57.019 kind of bogus and bunk. So I see them as very 00:11:57.019 --> 00:12:00.450 flawed tools It's okay to use flawed tools. We 00:12:00.450 --> 00:12:02.149 do this in science all the time where we're like, 00:12:02.169 --> 00:12:04.029 you know, our measure is flawed. We know how 00:12:04.029 --> 00:12:06.450 it's flawed. So we can still use it in an effective 00:12:06.450 --> 00:12:10.169 way. If it's a final thought or a final part 00:12:10.169 --> 00:12:12.070 of a conversation, I would warn against that 00:12:12.070 --> 00:12:13.710 kind of workflow. I think that you would leave 00:12:13.710 --> 00:12:15.570 a lot of money on the table, filter out a lot 00:12:15.570 --> 00:12:18.730 of people. If it's like the start of a conversation 00:12:18.730 --> 00:12:21.110 and it surfaces things, I think in that way would 00:12:21.110 --> 00:12:23.370 be useful. And I'll toss out something strange 00:12:23.370 --> 00:12:26.149 and this is going to sound very flippant, but 00:12:26.149 --> 00:12:28.289 I really love tarot. I have this little tarot. 00:12:28.200 --> 00:12:30.580 app on my you know like tarot cards those like 00:12:30.580 --> 00:12:32.440 you know like i really enjoyed it my wife and 00:12:32.440 --> 00:12:34.539 i were bored sometime in the pandemics we like 00:12:34.539 --> 00:12:36.700 you know got really into this deep dive of tarot 00:12:36.700 --> 00:12:39.279 and tarot i like because you know objectively 00:12:39.279 --> 00:12:41.200 and i say this in candor this may offend people 00:12:41.200 --> 00:12:42.700 although i doubt the people who listen to your 00:12:42.700 --> 00:12:47.429 podcast You know, Tarot is bogus, but it's sort 00:12:47.429 --> 00:12:49.750 of fun because you flip something and you're 00:12:49.750 --> 00:12:52.330 like, you know, this is death upside down and 00:12:52.330 --> 00:12:54.129 it corresponds to this very kind of like vague 00:12:54.129 --> 00:12:56.110 and strange thing. But then I'm like, you know, 00:12:56.110 --> 00:12:57.669 I never really thought about vague and strange 00:12:57.669 --> 00:13:00.429 things that applies to like this decision, but 00:13:00.429 --> 00:13:02.330 it's just like a radically different point of 00:13:02.330 --> 00:13:04.429 view and a very strange one for me to revisit 00:13:04.429 --> 00:13:07.090 this thing that I'm thinking through. And sometimes, 00:13:07.090 --> 00:13:09.950 you know, just randomly flipping Tarot and taking 00:13:09.950 --> 00:13:12.370 a really weird point of view and being like, 00:13:12.389 --> 00:13:14.940 oh, Like I didn't think of this decision with 00:13:14.940 --> 00:13:17.139 these considerations, but just getting out of 00:13:17.139 --> 00:13:18.399 my head and getting into a radically different 00:13:18.399 --> 00:13:20.399 framework, you know, it surface stuff. I see 00:13:20.399 --> 00:13:22.279 that as an example of it's okay to use flawed 00:13:22.279 --> 00:13:24.980 tools. If you see the flaws and you use it as 00:13:24.980 --> 00:13:27.259 starting a conversation, like, you know, MBTI 00:13:27.259 --> 00:13:29.559 is great. If you get like an ENTJ or something 00:13:29.559 --> 00:13:31.360 and you're like, you know, this person, perhaps 00:13:31.360 --> 00:13:33.399 they're gruff, perhaps they're confident. Maybe 00:13:33.399 --> 00:13:36.679 they're overconfident. I'm curious to see, you 00:13:36.679 --> 00:13:38.259 know, what do they think about this? What do 00:13:38.259 --> 00:13:41.299 I learn about? I do some amount of, you know, 00:13:41.779 --> 00:13:44.039 psychological pinging when I diligence, but for 00:13:44.039 --> 00:13:46.620 me it's much more like how do you and I disagree? 00:13:47.019 --> 00:13:49.600 How do you and I have conflict? If I have a point 00:13:49.600 --> 00:13:51.740 of view and you have a point of view, you know, 00:13:51.879 --> 00:13:55.090 do I have influence with you? Are you like, when 00:13:55.090 --> 00:13:57.549 you have a thought process, how do you communicate? 00:13:58.350 --> 00:14:01.389 How are you in conflict? How are you with pushback? 00:14:01.730 --> 00:14:03.789 How do you treat people on your team? What are 00:14:03.789 --> 00:14:06.049 your internal dynamics? Those are some of the 00:14:06.049 --> 00:14:08.429 psychological factors that I probe. But I see 00:14:08.429 --> 00:14:10.990 it as very much there's no necessarily best pattern. 00:14:11.490 --> 00:14:13.669 Really, it's like, is your pattern effective 00:14:13.669 --> 00:14:16.070 for the sort of larger strategy that you're taking? 00:14:18.269 --> 00:14:21.389 Neuroscience, I think, is a very academic field. 00:14:21.809 --> 00:14:25.129 And you can break down our brain. And I think 00:14:25.129 --> 00:14:27.769 the science in this has changed recently in different 00:14:27.769 --> 00:14:30.970 pathways and cortical tracks. And this is what 00:14:30.970 --> 00:14:32.710 this does. This part of the brain is responsible 00:14:32.710 --> 00:14:36.850 for this. Political science, I would say, is 00:14:36.850 --> 00:14:41.250 on the opposite spectrum, where it's more about 00:14:41.250 --> 00:14:43.789 people and how you interact with people. How 00:14:43.789 --> 00:14:48.730 can you grow movement? I'm sure that the science 00:14:48.730 --> 00:14:51.389 part of political science is challenged at times. 00:14:52.850 --> 00:14:55.909 How did you go from neuroscience to political 00:14:55.909 --> 00:14:59.190 science? Or is it more streamlined than I'm making 00:14:59.190 --> 00:15:03.710 it out to be? When I was in college, I did a 00:15:03.710 --> 00:15:07.090 lot of student organizing, student union stuff. 00:15:07.129 --> 00:15:09.070 It was also the financial crisis. So a lot of 00:15:09.070 --> 00:15:11.710 stuff was going on. I'd see it less as it was 00:15:11.710 --> 00:15:14.269 something that I did and more just that the world 00:15:14.269 --> 00:15:17.090 happened to us. 2008 happened, budget cutbacks 00:15:17.090 --> 00:15:19.850 happened. I was at a college with a very progressive 00:15:19.850 --> 00:15:21.990 approach to financial aid. And there was this 00:15:21.990 --> 00:15:24.309 tension between faculty who said, don't, you 00:15:24.309 --> 00:15:26.509 know, stop hiring like the best faculty and paying 00:15:26.509 --> 00:15:28.750 them well. You know, maybe consider not being 00:15:28.750 --> 00:15:30.929 so like extremely generous. with your financial 00:15:30.929 --> 00:15:33.169 aid is like another area to cut. So we had a 00:15:33.169 --> 00:15:35.289 lot of moral gazing about, you know, what is 00:15:35.289 --> 00:15:37.429 the mission of this institution? What is important? 00:15:37.649 --> 00:15:39.370 How do we treat like, you know, the vulnerable? 00:15:39.490 --> 00:15:41.350 How do we see these things? It was one of those 00:15:41.350 --> 00:15:44.090 things where, you know, just like. It wasn't 00:15:44.090 --> 00:15:46.509 that I sought it out, but the world happened. 00:15:46.990 --> 00:15:50.370 And I'm very sympathetic to free societies. It 00:15:50.370 --> 00:15:53.690 was like 2011, 2012. Stuff was going on in Russia, 00:15:53.990 --> 00:15:55.629 like young people were going on the streets and 00:15:55.629 --> 00:15:58.549 protesting. Stuff was going on in Myanmar. Arab 00:15:58.549 --> 00:16:01.250 Spring was starting to kindle. There was one 00:16:01.250 --> 00:16:04.169 round of... Iran protests, there's a lot of interesting 00:16:04.169 --> 00:16:07.889 things happening globally. People who look like 00:16:07.889 --> 00:16:11.870 me and you at that time were going and, you know, 00:16:12.029 --> 00:16:14.009 being willing to be gunned down or have acid 00:16:14.009 --> 00:16:15.870 thrown in their face or all kinds of horrible 00:16:15.870 --> 00:16:18.730 stuff. So I got really into I spent this period 00:16:18.730 --> 00:16:21.429 of my life thinking, you know, how do I build 00:16:21.429 --> 00:16:23.970 organizations and influence and kind of find 00:16:23.970 --> 00:16:26.490 like key people and elites and like, you know, 00:16:26.610 --> 00:16:29.679 get them resources and back them? I saw that 00:16:29.679 --> 00:16:31.659 is a lot of stuff that just sort of happened 00:16:31.659 --> 00:16:34.240 and I fell into it. I didn't go towards it. But 00:16:34.240 --> 00:16:36.799 when I was in there, it really introduced me 00:16:36.799 --> 00:16:38.799 to these frameworks of, and I think this is what 00:16:38.799 --> 00:16:40.340 you're talking about when you say political science, 00:16:40.519 --> 00:16:42.960 political risk and political economy. Political 00:16:42.960 --> 00:16:45.480 risk is thinking for any kind of industry, any 00:16:45.480 --> 00:16:48.000 kind of business, any kind of anything. You know, 00:16:48.019 --> 00:16:50.879 how does the political situation matter? And 00:16:50.879 --> 00:16:53.840 political economy is any country or any sector 00:16:53.840 --> 00:16:56.379 where it doesn't matter necessarily, like how 00:16:56.379 --> 00:16:59.399 good markets are, et cetera. It's like the role 00:16:59.399 --> 00:17:01.659 of government is just so incredibly powerful. 00:17:01.860 --> 00:17:03.519 So if you're in like a very corrupt country, 00:17:03.340 --> 00:17:05.099 It's all political economy. It doesn't matter 00:17:05.099 --> 00:17:07.559 how good your idea is. It's like, but how do 00:17:07.559 --> 00:17:10.440 you get it through your local ministry that you 00:17:10.440 --> 00:17:14.960 have to deal with? And how do you navigate that? 00:17:15.160 --> 00:17:19.480 In health care, it's all political economy. All 00:17:19.480 --> 00:17:21.480 costs are driven by political economy. All revenues 00:17:21.480 --> 00:17:23.740 are driven by political economy. And it's very 00:17:23.740 --> 00:17:26.740 much understanding. How do you see the balance 00:17:26.740 --> 00:17:28.660 of power between different stakeholders? How 00:17:28.660 --> 00:17:31.299 does it change over time? How do you see the 00:17:31.299 --> 00:17:33.299 government's point of view on antitrust creating 00:17:33.299 --> 00:17:35.960 windows and weaknesses? A lot of the political 00:17:35.960 --> 00:17:38.819 stuff that I did unintentionally just because 00:17:38.819 --> 00:17:42.279 the world swept me up in it way back when, it 00:17:42.279 --> 00:17:44.859 gave me this sensibility that I found very helpful 00:17:44.859 --> 00:17:49.839 as a health care investor. Early on, and I'm 00:17:49.839 --> 00:17:52.400 not that I'm only I've only been investing for 00:17:52.400 --> 00:17:55.500 almost three years now. When I started, I would 00:17:55.500 --> 00:17:58.819 I would have these future maps in my head. I 00:17:58.819 --> 00:18:00.660 would say this is where the health care world 00:18:00.660 --> 00:18:03.880 is going. And this is what the market needs. 00:18:04.339 --> 00:18:06.640 I'm going to define this product I'm looking 00:18:06.640 --> 00:18:10.119 for in epigenetics as one of them and home care. 00:18:10.339 --> 00:18:12.799 Hospital home care was another one. And then 00:18:12.799 --> 00:18:15.380 I'm going to go out and find the best founders 00:18:15.380 --> 00:18:18.460 working in these specific niches. Currently, 00:18:18.460 --> 00:18:20.160 what I'm looking for is a founder working on 00:18:20.160 --> 00:18:22.420 an end -to -end solution for inbox management. 00:18:23.099 --> 00:18:26.359 And I still find myself pre -defining the market, 00:18:26.880 --> 00:18:29.880 which I'm looking for. There's another train 00:18:29.880 --> 00:18:32.539 of thought, and this is a more popular one. As 00:18:32.539 --> 00:18:34.920 long as the founder is building something in 00:18:34.920 --> 00:18:38.519 health, I will back the best founder I can find. 00:18:39.160 --> 00:18:43.299 I will deviate from my thesis of markets I'm 00:18:43.299 --> 00:18:45.039 looking for, and I would just go for the best 00:18:45.039 --> 00:18:49.700 founders. Do you have these mind maps where you're 00:18:49.700 --> 00:18:52.779 looking for these opportunities, and I just want 00:18:52.779 --> 00:18:54.779 to find the best person who's building in this? 00:18:55.299 --> 00:18:58.599 Or are you just generally, as long as it has 00:18:58.599 --> 00:19:00.900 the word health in it, I just want the best founder 00:19:00.900 --> 00:19:06.279 building in health care as a whole? I think that's 00:19:06.279 --> 00:19:09.519 a very good question. I would say our approach 00:19:09.519 --> 00:19:12.150 is very much the second. Because when we raise 00:19:12.150 --> 00:19:15.109 these funds, we have these predefined investment 00:19:15.109 --> 00:19:17.829 periods. So I have like three years, five years. 00:19:18.170 --> 00:19:20.710 So I have to get most of my first checks out 00:19:20.710 --> 00:19:23.490 during this pre -specified time. So there's this 00:19:23.490 --> 00:19:26.710 thing of what is the best, the most interesting 00:19:26.710 --> 00:19:29.509 that I'm seeing right now. But with that said, 00:19:29.710 --> 00:19:32.130 how we rank what the best health care idea is, 00:19:32.349 --> 00:19:35.519 if we do the second strategy, it really requires 00:19:35.519 --> 00:19:38.339 doing the first strategy. Like if you were to 00:19:38.339 --> 00:19:40.619 go out and say, who has the most credible health 00:19:40.619 --> 00:19:43.769 care ideas right now? It's often not like in 00:19:43.769 --> 00:19:45.730 our sector. It's like I think the real winner 00:19:45.730 --> 00:19:47.029 I've been thinking a lot about this like the 00:19:47.029 --> 00:19:50.309 real winners in our sector long term They don't 00:19:50.309 --> 00:19:52.329 win just based on like, you know, I'm making 00:19:52.329 --> 00:19:54.690 money or like money is going up month over month 00:19:54.690 --> 00:19:57.609 They're doing something like weird and strategic 00:19:57.609 --> 00:20:00.490 and like subversive in a very like long -term 00:20:00.490 --> 00:20:02.710 visionary way So if you were to go out and be 00:20:02.710 --> 00:20:04.509 like, what is the best health care company being 00:20:04.509 --> 00:20:07.190 built right now? Doing the second approach you'd 00:20:07.190 --> 00:20:09.150 still probably be executing the first approach 00:20:09.150 --> 00:20:11.049 where you're like hospital at home is where the 00:20:11.049 --> 00:20:13.619 puck is going I have conviction on that, like 00:20:13.619 --> 00:20:15.960 enabling technologies today, like those will 00:20:15.960 --> 00:20:17.920 be the best value companies today, they're going 00:20:17.920 --> 00:20:20.920 to be worth a ton of money in the imminent future. 00:20:21.099 --> 00:20:22.920 Like that's like the best most rational place 00:20:22.920 --> 00:20:25.559 for me to invest. How does that land on you, 00:20:25.660 --> 00:20:32.240 Rashad? Yeah, I think I have under index for 00:20:32.240 --> 00:20:34.299 how much the founder matters. And this may sound 00:20:34.299 --> 00:20:36.720 funny because you hear all the time, the founder 00:20:36.720 --> 00:20:41.369 is the most important thing. But given my somewhat 00:20:41.369 --> 00:20:44.349 rebellious thought nature, I inherently want 00:20:44.349 --> 00:20:46.470 to think against what everyone else is saying. 00:20:47.430 --> 00:20:49.849 And sometimes I think what everyone else is saying 00:20:49.849 --> 00:20:54.670 is right. Being consensus correct is easy to 00:20:54.670 --> 00:20:57.710 do. Going against the consensus of being correct 00:20:57.710 --> 00:21:01.970 is very difficult and usually you're wrong. So 00:21:01.970 --> 00:21:04.130 I'm changing my mind there and this is kind of 00:21:04.130 --> 00:21:07.269 just born out of experience. I've invested in 00:21:07.289 --> 00:21:09.490 in startups, and I'm not going to name names 00:21:09.490 --> 00:21:12.089 with amazing products, you know, this product 00:21:12.089 --> 00:21:15.849 is at that point, at least, I would say, five 00:21:15.849 --> 00:21:18.769 times better than anything else out there. But 00:21:18.769 --> 00:21:21.769 the founder conviction and specifically founder 00:21:21.769 --> 00:21:24.049 charm and this this I don't like that this is 00:21:24.049 --> 00:21:27.950 the truth that founder charm matters so much 00:21:27.950 --> 00:21:31.730 because I like to think substance and the product 00:21:31.730 --> 00:21:35.700 should matter more than salesmanship. But I'm 00:21:35.700 --> 00:21:38.259 starting to realize and I have realized salesmanship 00:21:38.259 --> 00:21:42.720 matters a lot more. So, you know, I've changed 00:21:42.720 --> 00:21:48.680 my thinking on this and I am more indexing for 00:21:48.680 --> 00:21:52.720 the ability to sell and just finding the best 00:21:52.720 --> 00:21:55.640 founder, right? If I have these predefined market 00:21:55.640 --> 00:21:58.680 maps and I can't find the best founder or no 00:21:58.680 --> 00:22:01.400 amazing founders building in them, then that's 00:22:01.400 --> 00:22:03.940 okay. I will just go for the best founder. And 00:22:03.940 --> 00:22:05.940 they will teach me about the market and where 00:22:05.940 --> 00:22:09.099 the world is going. And that's a little bit of 00:22:09.099 --> 00:22:11.740 ego because I like to believe because I'm a physician, 00:22:11.819 --> 00:22:14.059 because I'm thinking about this a lot, I can 00:22:14.059 --> 00:22:16.819 see where the world is going. But I think being 00:22:16.819 --> 00:22:20.180 a people picker and not a market picker is probably 00:22:20.180 --> 00:22:23.400 the better way to do this. You know, it's a good 00:22:23.400 --> 00:22:28.500 question. I was at dinner with a couple of the 00:22:28.500 --> 00:22:32.240 physician VCs in San Francisco and one of them 00:22:32.240 --> 00:22:35.960 who I believe is a mutual friend. We were just 00:22:35.960 --> 00:22:38.039 talking about what we do. And I said, we tend 00:22:38.039 --> 00:22:40.920 to be super hands -on. We love finding founders 00:22:40.920 --> 00:22:43.059 where we're like, this founder can grow to be 00:22:43.059 --> 00:22:45.299 a world -class executive. We can help get them 00:22:45.299 --> 00:22:47.640 there. And because we helped build them, we invested 00:22:47.640 --> 00:22:50.619 a great valuation now. We're specialists is what 00:22:50.619 --> 00:22:52.640 we do. We pick up the phone, we help, we coach, 00:22:52.779 --> 00:22:54.859 we mentor. It's what gives me joy. And I will 00:22:54.859 --> 00:22:57.000 make this person a total baller. It's going to 00:22:57.000 --> 00:22:59.259 be great. Like that's a good formula. And this 00:22:59.259 --> 00:23:01.759 person is like, I only choose founders who I 00:23:01.759 --> 00:23:04.059 never have to help again. I am a zero value add 00:23:04.059 --> 00:23:06.799 investor by design. Our founders have to be so 00:23:06.799 --> 00:23:09.779 good. They never need help for anything. And 00:23:09.779 --> 00:23:14.220 it was just such a fun and bombastic and wild 00:23:14.220 --> 00:23:18.809 point of view that It was it definitely had an 00:23:18.809 --> 00:23:22.569 impact on me for what it's worth I See it is, 00:23:22.569 --> 00:23:26.210 you know our sector It's not enough just to build 00:23:26.210 --> 00:23:28.589 the best product in our sector Our sector is 00:23:28.589 --> 00:23:33.349 so busted and super corrupt and crazy that you 00:23:33.349 --> 00:23:37.819 have to be it really helps to have good If deeply 00:23:37.819 --> 00:23:40.440 favors insiders, it helps to have some kind of 00:23:40.440 --> 00:23:43.799 insider ability to navigate. Or at least if you're 00:23:43.799 --> 00:23:46.259 a total outsider, have a certain kind of super 00:23:46.259 --> 00:23:48.480 sophistication to be able to navigate and execute 00:23:48.480 --> 00:23:51.039 in our field. Like too many super smart people, 00:23:51.440 --> 00:23:53.579 totally outsiders, actually build the thing that's 00:23:53.579 --> 00:23:56.039 very important. But it's not in dialogue with 00:23:56.039 --> 00:23:57.940 the health care system as it is. And it can't 00:23:57.940 --> 00:24:00.740 be influential if it's not. So I see a lot of 00:24:00.740 --> 00:24:06.579 value in Like when I look for a really good founder, 00:24:06.779 --> 00:24:08.960 I want to make sure that they can be effective 00:24:08.960 --> 00:24:12.660 in the world as it is. I see it as if they have 00:24:12.660 --> 00:24:15.559 deficiencies, I think of it as are these things 00:24:15.559 --> 00:24:17.539 that I can help with? Can I round it out with 00:24:17.539 --> 00:24:19.740 a key hire? Can I round it out with mentorship? 00:24:20.440 --> 00:24:21.920 Is it the kind of thing where I have influence, 00:24:21.960 --> 00:24:24.130 I don't have influence? But that's also part 00:24:24.130 --> 00:24:25.809 of an investment strategy where I actually like 00:24:25.809 --> 00:24:27.650 to be really hands on. I like to be like, you 00:24:27.650 --> 00:24:29.950 know, super domainy. Like, you know, it's part 00:24:29.950 --> 00:24:31.849 of how I source. It's part of how I get into 00:24:31.849 --> 00:24:33.750 the best deals of the deals that I get into. 00:24:33.890 --> 00:24:36.349 It's part of how I build my relationship and 00:24:36.349 --> 00:24:38.509 my brand. It's part of the promise I make LPs. 00:24:38.690 --> 00:24:41.450 So I would say it's a very reasonable strategy. 00:24:41.609 --> 00:24:44.170 It's coherent for me and our colleague, the one 00:24:44.170 --> 00:24:46.509 who's like, I never help people, you know, like 00:24:46.509 --> 00:24:48.250 they can get bent after I give them a check, 00:24:48.289 --> 00:24:51.069 just go make money. You know, his strategy works 00:24:51.069 --> 00:24:52.650 for him because that's like totally the way. 00:24:52.680 --> 00:24:55.700 does he's like only moonshots it's either you 00:24:55.700 --> 00:24:59.539 know 100x or 0x he doesn't want 5x like you know 00:24:59.539 --> 00:25:01.960 and he just wants to like you know spray and 00:25:01.960 --> 00:25:04.480 pray and that's also a totally valid coherent 00:25:04.480 --> 00:25:07.240 strategy i think where it goes wrong is if you 00:25:07.240 --> 00:25:10.710 mix and match like if you You know, spray and 00:25:10.710 --> 00:25:13.509 pray, but then you spend too much time trying 00:25:13.509 --> 00:25:15.710 to be value -add with a financial strategy that 00:25:15.710 --> 00:25:17.529 doesn't support you in being value -add. You 00:25:17.529 --> 00:25:20.069 know, it doesn't work. Or in turn, if I do a 00:25:20.069 --> 00:25:21.970 lot of, like, prospective bets where, like, this 00:25:21.970 --> 00:25:24.670 person could pop and I have a lot of concentrated 00:25:24.670 --> 00:25:26.670 risk that they can pop and then I do nothing 00:25:26.670 --> 00:25:29.170 to help them pop, it's like a bad execution of 00:25:29.170 --> 00:25:32.069 my strategy. So I'd say the behavior could be 00:25:32.069 --> 00:25:33.829 a good behavior or bad behavior. It really depends 00:25:33.829 --> 00:25:35.789 on how does it fit into, like, you know, a whole 00:25:35.789 --> 00:25:40.680 scheme. If a company like OpenEvidence came to 00:25:40.680 --> 00:25:43.500 you and offered you something in their next round, 00:25:44.299 --> 00:25:46.299 would you invest in them? So a company that's 00:25:46.299 --> 00:25:48.039 growing, that has the potential to grow quite 00:25:48.039 --> 00:25:51.579 a bit more. But in the general thesis of things, 00:25:52.140 --> 00:25:55.259 it's a little bit too big. They're already valued 00:25:55.259 --> 00:25:58.470 over a billion. Would you invest in them? You 00:25:58.470 --> 00:26:01.849 know, if it was a company with excellent fundamentals, 00:26:01.950 --> 00:26:04.289 evaluation that I could believe, and it was, 00:26:04.289 --> 00:26:07.470 you know, a deal that I would love, and it was 00:26:07.470 --> 00:26:09.430 totally out of scope for the fund, what I would 00:26:09.430 --> 00:26:11.849 do is not invest out of the fund, but I'd go 00:26:11.849 --> 00:26:15.069 to my LPs and say, listen, it's out of scope 00:26:15.069 --> 00:26:18.289 of the fund. I'm not doing you dirty by not investing 00:26:18.289 --> 00:26:21.420 your fund money in this. because I made a promise 00:26:21.420 --> 00:26:23.259 for how I would spend that. This is out of scope. 00:26:23.720 --> 00:26:26.400 But this deal is on the table. I'll go to Insiders 00:26:26.400 --> 00:26:30.160 first. If you're interested, we can get you access. 00:26:30.220 --> 00:26:32.400 We can create the vehicle to do it. I would first 00:26:32.400 --> 00:26:34.980 make sure it's out of scope. If it's totally 00:26:34.980 --> 00:26:36.960 out of scope, I'd go to my current fund LPs. 00:26:37.259 --> 00:26:39.740 Then I go to all my firm LPs. And then I would 00:26:39.740 --> 00:26:42.500 go to just friends and others in the ecosystem 00:26:42.500 --> 00:26:45.819 in that order. I feel like that's the honest, 00:26:45.839 --> 00:26:48.319 fiduciary thing to do if a really good deal comes 00:26:48.319 --> 00:26:50.880 by. How do you think about it? What is your take? 00:26:53.160 --> 00:26:55.079 Yeah, to be frank with you, I've been struggling 00:26:55.079 --> 00:26:57.640 with this question because I'm sort of dealing 00:26:57.640 --> 00:27:00.880 with it right now. And I like your answer because 00:27:00.880 --> 00:27:07.240 I don't think it's fair to my investors to not 00:27:07.240 --> 00:27:09.819 present that opportunity and not invest in it 00:27:09.819 --> 00:27:14.019 myself, given that I believe that there is room 00:27:14.019 --> 00:27:16.789 for a considerable more growth. And it's a great 00:27:16.789 --> 00:27:19.269 company to invest in a great mission to back. 00:27:20.890 --> 00:27:24.109 Yeah, so I'm kind of on board here where I think 00:27:24.109 --> 00:27:27.089 it's fair. Now, given the question then becomes 00:27:27.089 --> 00:27:29.369 with your investors come back to you said, you 00:27:29.369 --> 00:27:32.470 know, I already invested in the fund. Can you 00:27:32.470 --> 00:27:36.569 invest in this company out of the fund? Because 00:27:36.569 --> 00:27:39.269 my fiduciary duty is to the investors. That's 00:27:39.269 --> 00:27:42.730 something I think I would be open to. How would 00:27:42.730 --> 00:27:46.440 you deal with that request from your LPs? I you 00:27:46.440 --> 00:27:48.460 know, we're going through fun creation right 00:27:48.460 --> 00:27:51.380 now. So we spent a lot of time doing some philosophical 00:27:51.380 --> 00:27:56.240 reflection I would see it this way our I would 00:27:56.240 --> 00:28:00.440 see it is is it Discretionary, is there a wiggle 00:28:00.440 --> 00:28:03.359 room or not? If there's wiggle room based on 00:28:03.359 --> 00:28:07.180 the fund mandate what we promised etc If there's 00:28:07.180 --> 00:28:09.140 wiggle room, then I would consider taking it 00:28:09.140 --> 00:28:12.240 to an LPAC like an LP advisory committee And 00:28:12.240 --> 00:28:15.980 I would say this deal, it's sort of bending our 00:28:15.980 --> 00:28:19.480 scope, but it's not crazy out of scope. What 00:28:19.480 --> 00:28:20.740 do you think? What do you think? It's a good 00:28:20.740 --> 00:28:23.059 opportunity. The LPs want it. What do you think? 00:28:23.440 --> 00:28:25.440 And I would use the LPAC as a way for LPs to 00:28:25.440 --> 00:28:27.720 have influence to make the decision. If it's 00:28:27.720 --> 00:28:30.259 widely out of scope, It sounds tough, but I would 00:28:30.259 --> 00:28:32.900 tell them, you know, people made a bet on us 00:28:32.900 --> 00:28:35.140 and they expect their money. I think of it as 00:28:35.140 --> 00:28:37.079 Gaussians, like a portfolio is really a bunch 00:28:37.079 --> 00:28:39.500 of Gaussians that behave in different ways and 00:28:39.500 --> 00:28:42.059 correlate to different things. And what we did 00:28:42.059 --> 00:28:44.660 is we promised to be one certain kind of Gaussian 00:28:44.660 --> 00:28:48.210 for people's portfolios. And we owe it to them 00:28:48.210 --> 00:28:50.650 to behave as we promise them. That's what gives 00:28:50.650 --> 00:28:52.750 them predictability. That's what gives them success. 00:28:53.250 --> 00:28:55.950 I could easily get into trading corn futures. 00:28:56.089 --> 00:28:57.990 And honestly, depending on what's going on with 00:28:57.990 --> 00:28:59.490 tariffs and stuff, corn futures are probably 00:28:59.490 --> 00:29:01.470 a really good idea right now. I could totally 00:29:01.470 --> 00:29:03.670 get into trading corn futures, and I could totally 00:29:03.670 --> 00:29:08.490 make some good money. I saw this crypto bankruptcy. 00:29:09.079 --> 00:29:11.579 Debt transaction come across my desk that was 00:29:11.579 --> 00:29:13.839 extremely attractive and had absolutely zero 00:29:13.839 --> 00:29:16.700 relevance and people made some kind of crazy 00:29:16.700 --> 00:29:19.980 5x 6x return very quickly doing this bankruptcy 00:29:19.980 --> 00:29:23.319 transaction on this Notable recent crypto company 00:29:23.319 --> 00:29:25.619 that went down and it was a really cool deal 00:29:25.619 --> 00:29:27.359 and it was just so widely out of scope It would 00:29:27.359 --> 00:29:29.660 be like wrong for me and the Gaussian behavior. 00:29:29.660 --> 00:29:32.720 I promised my LPs if I did make money, but I 00:29:32.720 --> 00:29:34.990 did it in a way that was like, you know a risk 00:29:34.990 --> 00:29:37.329 profile and a bet that's like way wild from what 00:29:37.329 --> 00:29:39.589 I promised. So that's how I'd see it. If it was 00:29:39.589 --> 00:29:41.910 plausible to get to LPAC, if it's not plausible, 00:29:42.349 --> 00:29:46.029 it sounds tough to say, but I'd say, you know, 00:29:46.049 --> 00:29:47.950 it's not right. It's not right. We're not being 00:29:47.950 --> 00:29:50.109 a good fiduciary to all of our LPs. If we do 00:29:50.109 --> 00:29:52.789 this, even if some LPs want, what I would tell 00:29:52.789 --> 00:29:55.210 them is, you know, how can we make this right? 00:29:55.250 --> 00:29:58.210 If you want SPV allocation and if it's an all 00:29:58.210 --> 00:30:00.369 insider SPV, like we'll do it without fees or 00:30:00.369 --> 00:30:02.549 whatever, like we're here for you. I can't do 00:30:02.549 --> 00:30:05.480 it out of the fund. It's not right. But I can 00:30:05.480 --> 00:30:08.880 like, you know help you otherwise Going back 00:30:08.880 --> 00:30:11.279 to your undergrad days was miss school always 00:30:11.279 --> 00:30:14.319 on the card. I Did my best to get out of it and 00:30:14.319 --> 00:30:16.559 I had a lot of South Asian pressure to go into 00:30:16.559 --> 00:30:21.059 it I would describe it as schizophrenic I fell 00:30:21.059 --> 00:30:23.440 in love with medicine, but I was pretty far on 00:30:23.440 --> 00:30:27.119 my journey before I did I Think that I went into 00:30:27.119 --> 00:30:30.279 it Definitely with the wrong motives and definitely 00:30:30.279 --> 00:30:33.230 with bad decision -making Whenever I give advice 00:30:33.230 --> 00:30:35.670 to people, I'm always like, you know, I'll tell 00:30:35.670 --> 00:30:37.150 you what I did. And I'm like, don't do what I 00:30:37.150 --> 00:30:38.789 did. Like I'll give you frameworks and I'll tell 00:30:38.789 --> 00:30:41.329 you the frameworks I wish I used. But, you know, 00:30:41.410 --> 00:30:44.170 I made it work and it is so dumb lucky that I 00:30:44.170 --> 00:30:47.910 did. I kind of love medicine. And in hindsight, 00:30:47.950 --> 00:30:51.890 you know, I'm glad I did what I did, but by all 00:30:51.890 --> 00:30:54.529 means, you know, it's kind of dumb luck that 00:30:54.529 --> 00:30:58.230 I fell in love with it. And how did you decide 00:30:58.230 --> 00:31:01.819 to do an MBA while in med school? I had this 00:31:01.819 --> 00:31:03.940 startup. The political stuff that was going on 00:31:03.940 --> 00:31:06.180 in the world just really swept me up into it. 00:31:06.180 --> 00:31:09.359 And I was doing a bunch of stuff with this colleague 00:31:09.359 --> 00:31:12.240 of mine. He was all in. A lot of stuff was coming 00:31:12.240 --> 00:31:17.160 to a head. And we just needed some time to see 00:31:17.160 --> 00:31:19.579 if we could make it work and where we could take 00:31:19.579 --> 00:31:24.099 it. And there was no way to get time off other 00:31:24.099 --> 00:31:27.619 than doing it via degree. So I shot my shot and 00:31:27.619 --> 00:31:31.880 I got really lucky. And my very weird application, 00:31:32.200 --> 00:31:35.400 which was largely panned by very normal people 00:31:35.400 --> 00:31:37.380 was very well received by Stanford for which 00:31:37.380 --> 00:31:39.859 I'm very grateful. So then I went and I did my 00:31:39.859 --> 00:31:43.740 MBA at Stanford. And I spent my first year basically 00:31:43.740 --> 00:31:46.460 treating it as a face -saving excuse so I could 00:31:46.460 --> 00:31:49.319 work all my spare time on this other thing that 00:31:49.319 --> 00:31:53.460 I had going on. Tell me a bit more about the 00:31:53.460 --> 00:31:58.450 other thing you had going on. got really good 00:31:58.450 --> 00:32:01.549 at building political movements, both around 00:32:01.549 --> 00:32:04.269 famous people and organizing large amounts of 00:32:04.269 --> 00:32:06.410 young people in the US and around the world, 00:32:06.809 --> 00:32:09.890 and very, very good at trafficking in elites, 00:32:10.289 --> 00:32:12.769 trafficking in for young people, student body 00:32:12.769 --> 00:32:15.710 presidents of top universities, Rhodes Scholars, 00:32:15.990 --> 00:32:20.230 Olympians. kids of billionaires, like, you know, 00:32:20.289 --> 00:32:22.009 the kids in Nobel laureates. On the flip side, 00:32:22.049 --> 00:32:23.930 it would be like the Nobel laureates, a whole 00:32:23.930 --> 00:32:27.170 bunch of US ambassadors, a bunch of foreign intelligence 00:32:27.170 --> 00:32:30.410 heads, a couple of heads of state. We got like 00:32:30.410 --> 00:32:33.369 really into if anyone was doing something around 00:32:33.369 --> 00:32:35.490 any of the causes we cared about. We cared a 00:32:35.490 --> 00:32:38.130 lot about countering violent extremism. We cared 00:32:38.130 --> 00:32:40.329 a lot about free society movements overseas, 00:32:40.890 --> 00:32:44.869 getting people access to Elite resources doing 00:32:44.869 --> 00:32:46.509 things like, you know taking someone who's like 00:32:46.509 --> 00:32:48.950 an intelligence chief from like, you know, one 00:32:48.950 --> 00:32:53.589 of the allied, you know, uh european powers who's 00:32:53.589 --> 00:32:55.589 now focusing on countering violent extremism 00:32:55.589 --> 00:32:57.869 this one, you know isis was recruiting on facebook 00:32:57.869 --> 00:33:00.450 that era taking them around silicon valley taking 00:33:00.450 --> 00:33:02.630 them to all the tech companies and Like, you 00:33:02.630 --> 00:33:04.430 know sitting them down and doing these like high 00:33:04.430 --> 00:33:07.509 -level conversations around Uh, you know, how 00:33:07.509 --> 00:33:10.069 do we do this track two diplomacy was also really 00:33:10.069 --> 00:33:12.150 interesting at this time. There was a lot of 00:33:12.150 --> 00:33:15.220 middle eastern tension, especially around Iran. 00:33:15.579 --> 00:33:17.319 It'd be kind of cool that we could do stuff like 00:33:17.319 --> 00:33:20.059 get a former head of Mossad and a former chief 00:33:20.059 --> 00:33:23.200 nuclear negotiator of Iran who, depending on 00:33:23.200 --> 00:33:25.579 how a presidential election goes, is either extremely 00:33:25.579 --> 00:33:28.539 influential or hiding out in Princeton and getting 00:33:28.539 --> 00:33:31.200 them, you know, talking and arguing on the side 00:33:31.200 --> 00:33:33.420 and getting like a smulk, stuff like that. We 00:33:33.420 --> 00:33:37.380 were just really good at doing that kind of stuff. 00:33:38.180 --> 00:33:41.220 It had And every now and then we'd be really 00:33:41.220 --> 00:33:44.059 good at monetizing it, but we kept finding cool 00:33:44.059 --> 00:33:45.960 opportunities to have impact that never really 00:33:45.960 --> 00:33:48.079 led to monetization. We built a lot of network 00:33:48.079 --> 00:33:50.400 power and we never really found a way to make 00:33:50.400 --> 00:33:55.079 a lot of cash. It was work that we were really 00:33:55.079 --> 00:33:57.960 good at doing and it was work that I enjoyed 00:33:57.960 --> 00:34:02.500 until I didn't. It was very much white knuckle 00:34:02.500 --> 00:34:07.059 politics and you had to have a very high tolerance 00:34:07.059 --> 00:34:10.219 for constant conflict. There's a lot of take 00:34:10.219 --> 00:34:13.539 a favor, call a favor, burn people. Like, you 00:34:13.539 --> 00:34:16.679 know, there'd be so many people mad at you. Some 00:34:16.679 --> 00:34:20.320 of them would be kind of scary people overseas 00:34:20.320 --> 00:34:23.260 who were, you know, quasi mobsters. You'd just 00:34:23.260 --> 00:34:25.909 sort of, you know, you'd end up in a lot of situations 00:34:25.909 --> 00:34:28.010 where you're like, you know, this is, this is 00:34:28.010 --> 00:34:31.070 a lot. The person I did it with was both extremely 00:34:31.070 --> 00:34:33.750 talented at it and had a supernatural patience 00:34:33.750 --> 00:34:36.329 for conflict. But at some point I was just like 00:34:36.329 --> 00:34:39.590 so spiritually crushed and unhappy. I didn't 00:34:39.590 --> 00:34:41.230 like the way that I was treating people and it 00:34:41.230 --> 00:34:43.429 just wasn't work that I wanted to do. So that 00:34:43.429 --> 00:34:45.489 was my sort of like full arc of that journey, 00:34:45.610 --> 00:34:48.329 which played out during my one and a half years 00:34:48.329 --> 00:34:53.280 of my two years of my MBA. What are some tactics 00:34:53.280 --> 00:34:56.079 you use to get these people in the same room 00:34:56.079 --> 00:34:58.639 together? Because I'm assuming a lot of people 00:34:58.639 --> 00:35:02.699 would love to, there's kind of the common saying, 00:35:03.000 --> 00:35:07.659 your network is your net worth. How were you 00:35:07.659 --> 00:35:10.960 able to get all these very influential people 00:35:10.960 --> 00:35:15.880 who run big structures and countries in the world? 00:35:18.349 --> 00:35:22.949 come in the same room together as determined 00:35:22.949 --> 00:35:27.719 by a couple MBA 20 -somethings at Stanford. You 00:35:27.719 --> 00:35:29.820 know good question a lot of it was what I would 00:35:29.820 --> 00:35:33.019 call silo arbitrage inside a silo There's a very 00:35:33.019 --> 00:35:35.500 clear ladder for influence across silos It's 00:35:35.500 --> 00:35:38.800 very unclear and if you take two very different 00:35:38.800 --> 00:35:42.659 silos and you cross pollinate them It's very 00:35:42.659 --> 00:35:45.360 hard for it's like usually the connections don't 00:35:45.360 --> 00:35:47.880 exist People are usually very flattered to be 00:35:47.880 --> 00:35:50.260 asked and it's very hard for them to size up 00:35:50.260 --> 00:35:53.159 You know, like is this like someone at my ladder 00:35:53.159 --> 00:35:56.329 level above me below me? and essentially what 00:35:56.329 --> 00:35:58.730 we did is we just sort of like you know parlayed 00:35:58.730 --> 00:36:00.989 we'd be like you know we have access here's like 00:36:00.989 --> 00:36:04.730 someone who uh we had a my colleague had a mentor 00:36:04.730 --> 00:36:08.800 who was a very important civil rights era leader 00:36:08.800 --> 00:36:10.760 at the State Department and a very prominent 00:36:10.760 --> 00:36:13.159 ambassador to some very key countries. But these 00:36:13.159 --> 00:36:14.980 are not like the first 25 countries that you 00:36:14.980 --> 00:36:16.719 would name, but they were very important in the 00:36:16.719 --> 00:36:19.199 year 1980. And for people in the State Department, 00:36:19.340 --> 00:36:21.900 this guy was a legend. And it's like, you know, 00:36:22.019 --> 00:36:24.739 his mentorship and sponsorship built us a lot 00:36:24.739 --> 00:36:27.099 of goodwill with a lot of recent ambassadors 00:36:27.099 --> 00:36:29.460 to a lot of countries. And when you have those 00:36:29.460 --> 00:36:31.760 people who are like, you know, the presidential 00:36:31.760 --> 00:36:33.599 election change, you know, like with the change 00:36:33.599 --> 00:36:36.480 of like already in the like presidency, a lot 00:36:36.480 --> 00:36:38.199 of political appointees are out. They're now 00:36:38.199 --> 00:36:41.139 back just like in the wild. They tend to be very 00:36:41.139 --> 00:36:43.380 powerful and influential people. So you go to 00:36:43.380 --> 00:36:44.980 them, they're flattered to be asked because you 00:36:44.980 --> 00:36:47.440 have the other guy. They have incredible cache 00:36:47.440 --> 00:36:49.460 with like the elites in the countries where they 00:36:49.460 --> 00:36:51.679 used to be the US ambassador to, and you get 00:36:51.679 --> 00:36:54.159 to know them. And then like you take those elites 00:36:54.159 --> 00:36:55.599 and then you're like, you know, in turn, you 00:36:55.599 --> 00:36:57.320 sort of like do a parlay where you're like, this 00:36:57.320 --> 00:37:00.159 is really siloed, this is really siloed, that's 00:37:00.159 --> 00:37:03.170 really siloed. I have connections here and it's 00:37:03.170 --> 00:37:05.010 kind of intriguing in their swagger. And how 00:37:05.010 --> 00:37:07.989 do I do something that's like very valuable and 00:37:07.989 --> 00:37:11.429 useful and use this to meet people in that silo? 00:37:11.489 --> 00:37:13.690 And in turn, when I meet people in that silo, 00:37:13.889 --> 00:37:15.929 like, you know, what can I do that's very valuable? 00:37:16.230 --> 00:37:19.889 I think a lot of it is knowing what is valuable 00:37:19.889 --> 00:37:22.489 to people. Who do people not know? And a lot 00:37:22.489 --> 00:37:24.269 of it is like, what is the kind of information 00:37:24.269 --> 00:37:29.699 that's like intriguing and valuable? Like, It's 00:37:29.699 --> 00:37:33.280 much better now, but at that time, the Bay Area 00:37:33.280 --> 00:37:36.059 was relatively disconnected from DC politics 00:37:36.059 --> 00:37:38.480 and the foreign affairs apparatus. You could 00:37:38.480 --> 00:37:41.360 get a lot of interesting conversations and bring 00:37:41.360 --> 00:37:44.980 some really visionary people to the table by 00:37:44.980 --> 00:37:48.500 bringing interesting foreign affairs types, policy 00:37:48.500 --> 00:37:51.159 types out this way. It was just like a pathway 00:37:51.159 --> 00:37:53.820 that was not very well -worn. So by doing that, 00:37:53.820 --> 00:37:55.940 we would just get interesting people at the table, 00:37:55.940 --> 00:38:00.130 and then we'd get to know them. network asset 00:38:00.130 --> 00:38:02.030 that we had was also super useful. There was 00:38:02.030 --> 00:38:04.130 like a whole bunch of people who were like, listen, 00:38:04.250 --> 00:38:06.449 I'm launching a book and I'd love to get like 00:38:06.449 --> 00:38:09.190 500 people to turn out for this event. And we 00:38:09.190 --> 00:38:11.590 could, you know, swap favors with various people 00:38:11.590 --> 00:38:13.309 and like, you don't get those kinds of crowds. 00:38:14.150 --> 00:38:17.690 So things like that, you know, a lot of it was, 00:38:17.690 --> 00:38:20.389 you know, parlaying, like doing something and 00:38:20.389 --> 00:38:21.909 thinking like three steps ahead and being like, 00:38:22.030 --> 00:38:24.840 how do we parlay this into this into that? And 00:38:24.840 --> 00:38:27.059 what's valuable for everyone? How do we solve 00:38:27.059 --> 00:38:30.719 their problems in a way that furthers our work? 00:38:32.059 --> 00:38:37.420 I believe that cultural heterogeneity is the 00:38:37.420 --> 00:38:42.039 path to, quote unquote, world peace. I think 00:38:42.039 --> 00:38:48.019 intermingling cultures, races, and following 00:38:48.019 --> 00:38:51.059 the Singapore experiment where we're dividing 00:38:51.059 --> 00:38:54.659 residential areas to ensure that the amount of 00:38:54.659 --> 00:38:57.820 diversity is stable across the residential areas. 00:38:57.860 --> 00:38:59.599 You don't get a little Portugal and a little 00:38:59.599 --> 00:39:03.739 Italy. It's all intermixed. I think that is the 00:39:03.739 --> 00:39:08.039 only path, I believe, for us to live peacefully 00:39:08.039 --> 00:39:12.579 in this world. Given what you know about politics 00:39:12.579 --> 00:39:16.599 and people, if you could snap your fingers and 00:39:16.599 --> 00:39:20.219 get rid of the concept of nations and have the 00:39:20.219 --> 00:39:23.920 world be one country, Would you do it and if 00:39:23.920 --> 00:39:26.900 you would why and if not, why not? You know, 00:39:26.900 --> 00:39:29.199 it's a good question. I think your point is a 00:39:29.199 --> 00:39:34.539 good one that people mixing People mixing is 00:39:34.539 --> 00:39:37.760 a good thing If I could get rid of countries 00:39:37.760 --> 00:39:41.199 today, I would not if I could make movement between 00:39:41.199 --> 00:39:44.519 countries much easier I would I think that the 00:39:44.519 --> 00:39:47.019 world I would make two observations. The first 00:39:47.019 --> 00:39:51.300 is that The world has many different countries, 00:39:51.639 --> 00:39:54.219 all of which have different configurations of 00:39:54.219 --> 00:39:57.480 social networks, freedoms, rights, obligations, 00:39:57.860 --> 00:40:01.440 etc. And if people could freely move... and find 00:40:01.440 --> 00:40:04.119 the place where they agree philosophically with 00:40:04.119 --> 00:40:06.539 where they are, that kind of flow of people I 00:40:06.539 --> 00:40:08.980 think is a directionally good thing. Like it's 00:40:08.980 --> 00:40:10.739 a secular trend, that kind of movement is good. 00:40:10.960 --> 00:40:13.199 There's a lot of ambiguity about what the right 00:40:13.199 --> 00:40:16.099 way is to dial a lot of these levers. You could 00:40:16.099 --> 00:40:18.760 say that the US has a very coherent bet around 00:40:18.760 --> 00:40:22.260 innovation versus a relatively brittle safety 00:40:22.260 --> 00:40:25.059 net. Canada is on that spectrum, but it's a little 00:40:25.059 --> 00:40:27.360 bit closer to like a slightly more robust safety 00:40:27.360 --> 00:40:30.300 net, but not more so. Sweden is on that spectrum, 00:40:30.500 --> 00:40:34.800 but it's more so on the safety net side. But 00:40:34.800 --> 00:40:38.099 innovative enough, certainly not innovative. 00:40:38.559 --> 00:40:40.719 And all of those are reasonable bets. A very 00:40:40.719 --> 00:40:42.880 reasonable person a priori would be very happy 00:40:42.880 --> 00:40:45.320 for doing the whole veil of ignorance thing. 00:40:45.400 --> 00:40:47.159 Someone could be very happy through the veil, 00:40:47.320 --> 00:40:49.159 choosing to be in any one of those societies 00:40:49.159 --> 00:40:52.639 based on totally normal preferences. Fully respect 00:40:52.639 --> 00:40:58.349 that. Totally respect that. There was this really 00:40:58.349 --> 00:41:00.469 good book. I never actually learned how to say 00:41:00.469 --> 00:41:02.230 his last name I'm gonna put it in chat in case 00:41:02.230 --> 00:41:04.130 you know how to say it. Have you ever heard of 00:41:04.130 --> 00:41:10.349 this guy? He's a MIT economic historian Turkish 00:41:10.349 --> 00:41:14.409 I Have his book, but I haven't read it. His book 00:41:14.409 --> 00:41:18.789 is awesome. His book is awesome Darren I can 00:41:18.789 --> 00:41:21.230 mogul his books are you know, he wrote a really 00:41:21.230 --> 00:41:25.110 good book on technology power and social transformation 00:41:25.420 --> 00:41:27.820 all of these things that were great technologies 00:41:27.820 --> 00:41:30.760 on a secular trend, like a super long 50, 100 00:41:30.760 --> 00:41:35.280 year trend, such as automation in the textile 00:41:35.280 --> 00:41:38.340 industry in the United Kingdom or England way 00:41:38.340 --> 00:41:41.699 back when. All of those were good trends that 00:41:41.699 --> 00:41:44.659 lurched society forward, and they were just like 00:41:44.659 --> 00:41:46.739 super catastrophic, wrecked a bunch of lives, 00:41:47.019 --> 00:41:49.019 people went hungry, people died, like it was 00:41:49.019 --> 00:41:51.639 super frictional when it actually went down. 00:41:52.039 --> 00:41:54.280 Really good secular trends tend to be very frictional, 00:41:54.420 --> 00:41:58.130 and it's useful to buy very I feel like the past 00:41:58.130 --> 00:42:00.550 15 years has been like a very humbling demonstration 00:42:00.550 --> 00:42:02.550 of, you know, just what those are. I feel like 00:42:02.550 --> 00:42:05.250 if nation borders disappeared today, you'd have 00:42:05.250 --> 00:42:08.289 7 billion people with wildly different configurations 00:42:08.289 --> 00:42:10.750 of how they want to live, what obligations they 00:42:10.750 --> 00:42:14.010 feel towards each other, et cetera. Over a thousand 00:42:14.010 --> 00:42:16.710 years, it may be a very stable equilibrium that 00:42:16.710 --> 00:42:18.630 emerges, but the chaos of that would be quite 00:42:18.630 --> 00:42:21.289 high. But if we kept borders today and we had 00:42:21.289 --> 00:42:23.489 better and freer movement of people and goods 00:42:23.489 --> 00:42:27.940 across borders, that would be still pretty revolutionary, 00:42:28.360 --> 00:42:33.940 but I think a much more gentle change. For those 00:42:33.940 --> 00:42:36.139 listening, his book, and I have read a third 00:42:36.139 --> 00:42:38.800 of it, Power and Progress, Our Thousand Year 00:42:38.800 --> 00:42:41.500 Struggle Over Technology and Prosperity, and 00:42:41.500 --> 00:42:45.139 it's Darren and Simon Johnson. And I think it 00:42:45.139 --> 00:42:49.559 picks on this notion that, and this is again, 00:42:49.599 --> 00:42:52.519 a common notion among the investing world that, 00:42:52.519 --> 00:42:57.469 you know, all technologies improve humanity and 00:42:57.469 --> 00:43:00.869 are net positive. And from what I remember, Darren 00:43:00.869 --> 00:43:04.929 argues that that's not necessarily true. When 00:43:04.929 --> 00:43:08.650 do you think we will cross the barrier of too 00:43:08.650 --> 00:43:12.929 much technology, too much efficiency, and we 00:43:12.929 --> 00:43:15.349 will actually suffer? Maybe we will live 200 00:43:15.349 --> 00:43:19.230 years, but it will be 200 years filled with depression 00:43:19.230 --> 00:43:22.829 and sadness and misery as opposed to living a 00:43:22.829 --> 00:43:27.579 happy 70 years. You know, I'm a big fan of growth. 00:43:27.659 --> 00:43:29.880 I'm a big fan of growth, and I'm a big fan of 00:43:29.880 --> 00:43:33.860 the potential for a great future. Human norms 00:43:33.860 --> 00:43:38.159 have to change around the state of technology. 00:43:39.260 --> 00:43:41.519 And human norms are very slow to change. You 00:43:41.519 --> 00:43:43.880 see this with birth rates, where a lot of countries, 00:43:44.320 --> 00:43:46.739 when child mortality drops, birth rates continue 00:43:46.739 --> 00:43:49.480 to be very high, and you see a lot of frictions 00:43:49.480 --> 00:43:52.099 in population. You'd see that as an example of 00:43:52.099 --> 00:43:55.329 how human norms are slow. You see teachers talk 00:43:55.329 --> 00:43:58.210 about gen alpha and how spooked they are about 00:43:58.210 --> 00:44:00.010 the weird behaviors. I don't know how old your 00:44:00.010 --> 00:44:02.090 kids are shot if they're gen alpha or gen z, 00:44:02.429 --> 00:44:04.670 but you see teachers, you know, I'm sure you 00:44:04.670 --> 00:44:06.929 had a lot of philosophical conversations with 00:44:06.929 --> 00:44:09.670 your wife about screen time. It's a good example 00:44:09.670 --> 00:44:13.590 of how it takes a hot minute. for people to norm 00:44:13.590 --> 00:44:16.570 around technology. I think technology is great 00:44:16.570 --> 00:44:19.670 in the long term, and I see it not as we should 00:44:19.670 --> 00:44:22.449 see technology as good or see technology as bad, 00:44:22.789 --> 00:44:24.730 but we should see it as where there's friction, 00:44:25.250 --> 00:44:28.070 there's light, and where there's friction, there's 00:44:28.070 --> 00:44:31.420 just so much heat. And the heat to reality, the 00:44:31.420 --> 00:44:33.360 heat can be really destabilizing. I think a lot 00:44:33.360 --> 00:44:35.239 of the political trends we've seen in the past 00:44:35.239 --> 00:44:38.059 five, six years in Europe are an example of very 00:44:38.059 --> 00:44:44.610 well -intended visionary policies around... You 00:44:44.610 --> 00:44:47.690 know things like refugees an issue very like 00:44:47.690 --> 00:44:49.909 close to me and important to me and then like 00:44:49.909 --> 00:44:52.809 a wild societal backlash You know against too 00:44:52.809 --> 00:44:56.190 many refugees too quickly Leading to like, you 00:44:56.190 --> 00:44:59.469 know wild swings in politics and a lot of destabilization 00:44:59.469 --> 00:45:03.349 in global politics and you see that and you're 00:45:03.349 --> 00:45:08.559 like, you know sometimes it's worth kind of slow 00:45:08.559 --> 00:45:10.599 walking and being a little bit more cautious. 00:45:11.000 --> 00:45:12.820 If we're really thinking about what stage is 00:45:12.820 --> 00:45:14.940 this best on the order of like 200 years and 00:45:14.940 --> 00:45:17.519 500 years, sometimes going slower, but I would 00:45:17.519 --> 00:45:19.860 say it's definitely not worth stopping. It's 00:45:19.860 --> 00:45:21.619 more, we should see it as trade -offs, we should 00:45:21.619 --> 00:45:26.260 see it as complex. The startup founding team 00:45:26.260 --> 00:45:33.010 A has an amazing AI engineer. But a mediocre 00:45:33.010 --> 00:45:35.429 domain expert and for building in health care 00:45:35.429 --> 00:45:39.010 a mediocre physician or a clinician So our funding 00:45:39.010 --> 00:45:43.090 team be as a mediocre engineer, but an amazing 00:45:43.090 --> 00:45:46.150 physician or clinician on the team. Which team 00:45:46.150 --> 00:45:51.530 do you pick? Totally depends All my answers every 00:45:51.530 --> 00:45:53.329 time we do this for shot. I always give my it 00:45:53.329 --> 00:45:56.579 totally depends and my it's not categorical, 00:45:56.920 --> 00:45:59.300 it's all hyper contextual, so I must be your 00:45:59.300 --> 00:46:03.519 most tedious guest. I would argue this. At every 00:46:03.519 --> 00:46:06.840 company, at every phase, there is an axis of 00:46:06.840 --> 00:46:09.900 complexity. There's like a single thing that 00:46:09.900 --> 00:46:12.559 just stands above as the hardest possible thing 00:46:12.559 --> 00:46:16.809 that they do. For example, sometimes it is technology, 00:46:17.010 --> 00:46:19.030 like the really hard thing about this company 00:46:19.030 --> 00:46:22.090 is this very, very hard tech problem. Sometimes, 00:46:22.329 --> 00:46:23.769 especially in our sector, because our sector 00:46:23.769 --> 00:46:26.289 is so busted, corrupt, and inefficient, it's 00:46:26.289 --> 00:46:28.650 entirely strategic. The technology exists off 00:46:28.650 --> 00:46:30.989 the shelf. The exact configuration of how you 00:46:30.989 --> 00:46:34.730 use it, how you dial it in, requires an exceptional 00:46:34.730 --> 00:46:37.710 strategic savvy well beyond what a common person 00:46:37.710 --> 00:46:41.010 off the street can do. Like that itself is distinguishing 00:46:41.010 --> 00:46:43.949 enough to be the thing that's basis of the company. 00:46:44.309 --> 00:46:46.989 Some companies are like hardcore deep tech companies, 00:46:47.050 --> 00:46:48.510 you got to have the smartest people in the world 00:46:48.510 --> 00:46:51.210 doing it and it totally pays. And in that case, 00:46:51.210 --> 00:46:53.530 it's like do the engineer team and either I play 00:46:53.530 --> 00:46:55.550 the role of the clinician or we replace the clinician 00:46:55.550 --> 00:46:57.409 or we upskill the clinician, we do whatever. 00:46:57.769 --> 00:46:59.929 But the engineer is like a scarce asset and it 00:46:59.929 --> 00:47:03.150 makes sense. If that like weak physician strong 00:47:03.150 --> 00:47:05.630 engineer is doing something else. So for example, 00:47:05.730 --> 00:47:08.590 one of my very successful companies is doing 00:47:08.590 --> 00:47:13.420 an MSO strategy with pediatric OTs. It's very 00:47:13.420 --> 00:47:15.559 similar to what's been done in mental health 00:47:15.559 --> 00:47:18.559 and it is a technologically straightforward almost 00:47:18.559 --> 00:47:21.159 trivial company Largely doing technologically 00:47:21.159 --> 00:47:24.659 solve problems, but it has an extremely strategic 00:47:24.659 --> 00:47:27.860 very domain specific kind of go -to -market if 00:47:27.860 --> 00:47:30.820 you have the very weak clinician, strong engineer 00:47:30.820 --> 00:47:32.980 doing the latter business, they're totally going 00:47:32.980 --> 00:47:35.579 to flounder because like the really good engineer 00:47:35.579 --> 00:47:37.960 is using like 1 % of their strength. It's like 00:47:37.960 --> 00:47:40.300 if you and I were lifting weights and you could 00:47:40.300 --> 00:47:42.659 lift like, you know, if you bench like, you know, 00:47:42.760 --> 00:47:45.000 350 pounds and I bench, I forget my real bench 00:47:45.000 --> 00:47:46.320 is like, I don't know, like 50, but it's like 00:47:46.320 --> 00:47:48.420 the bar plus a little bit, but you and I are 00:47:48.420 --> 00:47:50.539 benching one pound dumbbells. Like it doesn't 00:47:50.539 --> 00:47:53.380 matter that you can bench like, you know, like, 00:47:53.559 --> 00:47:55.559 you know, like my hand will move like pretty 00:47:55.559 --> 00:47:58.579 fast as well. Like I'm barely using your raw. 00:47:58.480 --> 00:48:01.539 power. So it's like, you know, how much does 00:48:01.539 --> 00:48:03.739 the raw power matter in that case? So I see it 00:48:03.739 --> 00:48:05.420 as that I see it as like, what is the kind of 00:48:05.420 --> 00:48:08.239 problem they're solving? Another company that 00:48:08.239 --> 00:48:11.719 I'm very fond of did AI hearing aids, and they 00:48:11.719 --> 00:48:15.579 solved a bunch of very complex human audiology 00:48:15.579 --> 00:48:19.519 audiogram problems. And it was essentially a 00:48:19.519 --> 00:48:23.500 like math company, like a math physiology company 00:48:23.500 --> 00:48:26.719 for like, you know, six years. And there it paid 00:48:26.719 --> 00:48:30.570 to have the most hardcore domain experts ever. 00:48:30.889 --> 00:48:32.969 And now they're commercializing in hearing aids, 00:48:33.070 --> 00:48:35.050 which is like a super strategic busted space 00:48:35.050 --> 00:48:38.570 and the complexities entirely generic strategy, 00:48:38.670 --> 00:48:41.070 go to market complexity. It's not like, you know, 00:48:41.170 --> 00:48:44.909 best engineer in the world complexity. Do you 00:48:44.909 --> 00:48:48.550 think a good distribution strategy or a good 00:48:48.550 --> 00:48:53.519 network into your customers? Could be where defensibility 00:48:53.519 --> 00:48:55.860 lies oftentimes when I look for defensibility 00:48:55.860 --> 00:48:59.820 as you know, what's IP? But it could it just 00:48:59.820 --> 00:49:02.179 be like I'm an influencer in this space and that's 00:49:02.179 --> 00:49:05.000 my defensibility I would say more than influencer 00:49:05.000 --> 00:49:08.260 if you can get sales and grab land Have you used 00:49:08.260 --> 00:49:10.440 a bridge Rashad like have you used a bridge when 00:49:10.440 --> 00:49:13.559 rounding? I saw the inpatient workflow for my 00:49:13.559 --> 00:49:15.719 hospital and it was garbage. It was like totally 00:49:15.719 --> 00:49:20.849 garbage. It was so bad And for this to be the 00:49:20.849 --> 00:49:24.690 unicorn, incumbent, best company in the field, 00:49:24.769 --> 00:49:29.070 and I'm like, this product is trash. For my use 00:49:29.070 --> 00:49:32.369 case specifically, the amount of redundancy and 00:49:32.369 --> 00:49:34.530 work that it takes, like opening up a portal, 00:49:34.869 --> 00:49:39.829 copying, pasting text, it is so silly and bad 00:49:39.829 --> 00:49:41.610 at what it does, at least for Android and for 00:49:41.610 --> 00:49:43.409 inpatient hospital is drowning. It just sucks. 00:49:43.750 --> 00:49:45.690 It's totally built for a very different use case. 00:49:46.489 --> 00:49:48.949 My employer is very much like, it doesn't matter. 00:49:49.110 --> 00:49:51.670 This is what we're doing. You know, this is what 00:49:51.670 --> 00:49:54.150 Epic likes. This is what like, you know, our 00:49:54.150 --> 00:49:56.909 like hospital system likes. This is what's like, 00:49:57.050 --> 00:49:58.730 it's entirely a distribution thing. The best 00:49:58.730 --> 00:50:00.889 product doesn't win. The meritocracy doesn't 00:50:00.889 --> 00:50:02.989 work in healthcare. It is like way too corrupt, 00:50:03.010 --> 00:50:06.050 you know, access to distribution, strategic, 00:50:06.369 --> 00:50:08.610 you know, strategically navigating tech lockout, 00:50:08.730 --> 00:50:11.210 tech value chain is where a lot of value comes 00:50:11.210 --> 00:50:12.929 up. There's also why whenever you hang out with 00:50:12.929 --> 00:50:14.630 doctors, all we ever do is complain about the 00:50:14.630 --> 00:50:17.710 tools we have. it's like weird things lead to 00:50:17.710 --> 00:50:20.829 the winners. It's not like the best product won 00:50:20.829 --> 00:50:23.010 and next week when a better product comes out, 00:50:23.349 --> 00:50:25.789 we'll immediately grab it. It's entirely who 00:50:25.789 --> 00:50:28.150 grabbed land and had like, you know, these relationships 00:50:28.150 --> 00:50:33.610 to navigate way back when. That being said, how 00:50:33.610 --> 00:50:37.670 much do you index for having an amazing product 00:50:37.670 --> 00:50:39.929 when looking at founders? And, you know, I'll 00:50:39.929 --> 00:50:42.280 kind of... bring this conversation is that I've 00:50:42.280 --> 00:50:45.340 had conversations with founders where I'm looking 00:50:45.340 --> 00:50:47.260 at their product, I'm looking at what they're 00:50:47.260 --> 00:50:49.579 saying, and I'm thinking, you know, there's no 00:50:49.579 --> 00:50:51.760 way this is going to succeed. And then they say, 00:50:51.980 --> 00:50:54.360 we launched six months ago and we're doing 200 00:50:54.360 --> 00:50:58.039 ,000 a month in revenue. How do you kind of deal 00:50:58.039 --> 00:51:01.320 with that scenario and what do you do when that 00:51:01.320 --> 00:51:07.030 happens? I love being wrong because There's something 00:51:07.030 --> 00:51:08.909 that I thought was true that's not true. So I'd 00:51:08.909 --> 00:51:11.969 be very intrigued in that situation to be like, 00:51:11.969 --> 00:51:15.269 why was my gut hunch way wrong? I put a lot of 00:51:15.269 --> 00:51:19.630 value in empiric validation. When I think of 00:51:19.630 --> 00:51:23.289 products, I think of them in the context of enterprise 00:51:23.289 --> 00:51:28.070 sales. In health care, no one can say yes, but 00:51:28.070 --> 00:51:30.170 everyone can say no. It's like the worst kind 00:51:30.170 --> 00:51:34.590 of and hardest enterprise sale. And I think of 00:51:34.590 --> 00:51:38.239 it specifically I use a sales qualification system 00:51:38.239 --> 00:51:42.099 called MedPic. I like to go through it letter 00:51:42.099 --> 00:51:44.019 by letter. There's a really good Salesforce article 00:51:44.019 --> 00:51:45.760 that breaks it down and is like, here are all 00:51:45.760 --> 00:51:48.420 the categories. Here's how you kind of qualify 00:51:48.420 --> 00:51:51.099 your pipeline to say this is a good customer, 00:51:51.239 --> 00:51:53.179 this is a bad customer. I go through that framework 00:51:53.179 --> 00:51:55.500 and I try to understand if I was looking at a 00:51:55.500 --> 00:52:00.059 sales pipeline, is this a product that... Could 00:52:00.059 --> 00:52:02.699 get through an enterprise sales process. I would 00:52:02.699 --> 00:52:05.219 think about is this something an economic buyer 00:52:05.219 --> 00:52:08.579 an internal champion and an end user would all 00:52:08.579 --> 00:52:12.760 be thrilled about and I see it as You know, there's 00:52:12.760 --> 00:52:14.639 this joke that I hear from a lot of my friends 00:52:14.639 --> 00:52:16.420 who are in their 30s who were single and dating 00:52:16.420 --> 00:52:19.059 Where you know anything less than a hell? Yeah 00:52:19.059 --> 00:52:21.699 as a hell no where you just have to like, you 00:52:21.699 --> 00:52:23.960 know It's like you're kind of like in your groove 00:52:23.960 --> 00:52:25.460 and you're very settled if you're gonna change 00:52:25.460 --> 00:52:26.880 something You really have to be ripped out of 00:52:26.880 --> 00:52:30.329 your seat. The same is true for enterprise sales, 00:52:30.750 --> 00:52:32.130 you gotta be ripped out of your seat. It's gotta 00:52:32.130 --> 00:52:34.050 be really good. It's gotta be motivating to all 00:52:34.050 --> 00:52:36.809 those key holders. So if they don't have sales, 00:52:37.170 --> 00:52:39.269 I think a lot theoretically about that framework. 00:52:39.309 --> 00:52:42.309 And I think about... How does it, when I picture 00:52:42.309 --> 00:52:44.010 a year from now and they're actually selling, 00:52:44.269 --> 00:52:47.449 where will this product naturally be successful? 00:52:47.550 --> 00:52:49.309 Where will it get stuck? What are the kinds of 00:52:49.309 --> 00:52:51.429 customers? Where in those customers will it get 00:52:51.429 --> 00:52:54.289 stuck? And how do I form an opinion about, can 00:52:54.289 --> 00:52:56.570 any product win in this space and get through? 00:52:57.730 --> 00:53:00.210 What do the founders think? Are they sophisticated 00:53:00.210 --> 00:53:02.570 in sales? Do they have discipline? If I offer 00:53:02.570 --> 00:53:04.909 this framework, how do they engage? If it was 00:53:04.909 --> 00:53:06.670 the example you gave where they're like, yeah, 00:53:06.690 --> 00:53:09.289 you know, like Mic Drop, we're doing 200K in 00:53:09.289 --> 00:53:11.469 sales we just launched. I'd be like, that's pretty 00:53:11.469 --> 00:53:14.050 dope. And I'd be like, what worked? What worked? 00:53:14.230 --> 00:53:17.170 And how do I use my framework of how enterprise 00:53:17.170 --> 00:53:20.449 sales happened to figure out my theory of mind 00:53:20.449 --> 00:53:22.230 for all those stakeholders and different kinds 00:53:22.230 --> 00:53:24.789 of customers? Clearly, these folks discovered 00:53:24.789 --> 00:53:26.610 something interesting. And I'd be like, teach 00:53:26.610 --> 00:53:30.690 me what is the signal here? What is the sort 00:53:30.690 --> 00:53:32.550 of thing I can learn about the world from what 00:53:32.550 --> 00:53:38.050 you guys experienced? Oftentimes, when I look 00:53:38.050 --> 00:53:42.030 at DEX, my mind inherently goes, how does this 00:53:42.030 --> 00:53:44.750 increase revenue for the organization or the 00:53:44.750 --> 00:53:50.130 buyer, as opposed to the other side of the coin 00:53:50.130 --> 00:53:54.869 being, how does it save expenses? And I generally 00:53:54.869 --> 00:53:57.269 think if there is no CPD court, you can bill 00:53:57.269 --> 00:54:00.090 for this and in practice, not just in theory, 00:54:00.409 --> 00:54:02.690 and there is no revenue model for this, it's 00:54:02.690 --> 00:54:04.869 unlikely to succeed. Now, AIS credits have argued 00:54:04.869 --> 00:54:09.269 against this clearly, right? How do you think 00:54:09.269 --> 00:54:13.010 of, when a startup is pitching to you, do they 00:54:13.010 --> 00:54:16.190 need to tell you, this is a CPD code, this is 00:54:16.190 --> 00:54:18.849 how my customer will make money by using my product? 00:54:19.769 --> 00:54:22.769 Or is it more, you know, I'm just gonna grow 00:54:22.769 --> 00:54:25.510 and grow and grow and I will get sticky enough 00:54:25.510 --> 00:54:27.769 that at some point people will pay for my solution 00:54:27.769 --> 00:54:30.530 as it becomes incorporated into their workflow 00:54:30.530 --> 00:54:32.989 and they cannot work without it. And it seems 00:54:32.989 --> 00:54:36.250 like open evidence, Hippocratic AI, AI scribes. 00:54:36.570 --> 00:54:38.789 It seemed like they're all like, we're just going 00:54:38.789 --> 00:54:42.010 to grow. And then people eventually pay for it 00:54:42.010 --> 00:54:44.550 because it's almost like oxygen. Open Evidence 00:54:44.550 --> 00:54:47.110 has something clever going on. They have NPIs. 00:54:47.190 --> 00:54:49.329 They have search queries by what people submit 00:54:49.329 --> 00:54:51.329 and they sell pharma ads. So they've essentially 00:54:51.329 --> 00:54:54.130 stolen Doximity's business model, but made it 00:54:54.130 --> 00:54:56.250 much more valuable. I see Doximity is a bogus 00:54:56.250 --> 00:54:58.289 company that we only use for free facts. It's 00:54:58.289 --> 00:55:00.610 like our dirty secret is doctors. I've never 00:55:00.610 --> 00:55:04.139 met anyone who's ever used Doximity ever. for 00:55:04.139 --> 00:55:06.239 anything and all I do is hang out with Help IT 00:55:06.239 --> 00:55:09.159 people. What else does it do? It has a newsfeed. 00:55:09.260 --> 00:55:12.480 I don't know. That's the amazing thing. I use 00:55:12.480 --> 00:55:14.960 it as a phone, like a phone app and a fax machine. 00:55:15.219 --> 00:55:17.400 And basically they have my NPI and they make 00:55:17.400 --> 00:55:19.380 all their revenue through ads and open evidence 00:55:19.380 --> 00:55:21.500 is done the same. And that is just such a dope 00:55:21.500 --> 00:55:23.960 and good business model. If it remains free forever, 00:55:24.539 --> 00:55:27.289 they're like... pilling, you know, they're milling, 00:55:27.289 --> 00:55:29.610 you know, GLP one adds to me knowing my NPI, 00:55:29.730 --> 00:55:32.710 my geography, etc. That will make them boatloads 00:55:32.710 --> 00:55:34.829 of money forever. If that's all they do, like 00:55:34.829 --> 00:55:37.349 they've already made a ton. So that model I find 00:55:37.349 --> 00:55:40.809 really fascinating. For your question, I use 00:55:40.809 --> 00:55:42.849 the framework I mentioned, the enterprise sale 00:55:42.849 --> 00:55:44.969 framework, I think of for the economic buyer, 00:55:45.730 --> 00:55:47.730 different kinds of economic buyers care about 00:55:47.730 --> 00:55:50.230 different things. If it's a healthcare system, 00:55:50.429 --> 00:55:55.980 they almost always Discount any promise of like 00:55:55.980 --> 00:55:58.699 I reduce costs so you will make money in a statistical 00:55:58.699 --> 00:56:01.380 sense long term Because it's like the wells been 00:56:01.380 --> 00:56:03.199 poisoned so many companies have said that for 00:56:03.199 --> 00:56:05.559 so long and it's never true So it's like they 00:56:05.559 --> 00:56:07.539 would believe that if you've been on market for 00:56:07.539 --> 00:56:10.460 five years and you have Incredible validation 00:56:10.460 --> 00:56:12.639 help economic outcomes like they will buy that 00:56:12.639 --> 00:56:15.619 story Revenue is a much easier story for them 00:56:15.619 --> 00:56:18.539 to tell there are weird niches where people will 00:56:18.539 --> 00:56:22.300 pay for other things like if you're in a cash 00:56:22.300 --> 00:56:24.820 pay competitive specialty doing something that 00:56:24.820 --> 00:56:27.940 really benefits from like white glove concierge 00:56:27.940 --> 00:56:30.219 service there's an intriguing willingness to 00:56:30.219 --> 00:56:32.820 pay where people are like you know if it makes 00:56:32.820 --> 00:56:35.630 people do their knee surgery with me and not 00:56:35.630 --> 00:56:37.449 the person next door, you know, that's interesting. 00:56:37.550 --> 00:56:39.829 Like that is interesting to me. So for folks 00:56:39.829 --> 00:56:41.909 like that, they may pay for different things. 00:56:42.190 --> 00:56:44.570 I use that as my wedge to be like, is this a 00:56:44.570 --> 00:56:50.050 credible story? Can it move customers? What would 00:56:50.050 --> 00:56:53.909 your 20 year old self think of the work you're 00:56:53.909 --> 00:56:55.989 doing right now and where you are right now, 00:56:56.190 --> 00:57:06.539 your career? You know, I think the most intriguing 00:57:06.539 --> 00:57:12.380 thing my 20 -year -old self would clue into is 00:57:12.380 --> 00:57:17.079 the fact that I live my life not totally obsessed 00:57:17.079 --> 00:57:19.699 with status and with hype when I was 20. And 00:57:19.699 --> 00:57:21.139 I think one of the reasons I stuck with this 00:57:21.139 --> 00:57:23.500 politics thing as long as I did is I was so... 00:57:24.789 --> 00:57:28.070 fixated in the rat race and prestige and hype, 00:57:28.309 --> 00:57:31.110 etc. After I had my big burnout and I was like, 00:57:31.170 --> 00:57:32.829 I just want to do stuff that I enjoy with people 00:57:32.829 --> 00:57:35.250 I like, I had the courage to say, you know, I 00:57:35.250 --> 00:57:37.190 don't want to join a fund. I'd rather build a 00:57:37.190 --> 00:57:39.090 fund. I'd rather be like, you know, I'd rather 00:57:39.090 --> 00:57:40.710 like go to a happy hour and everyone be like, 00:57:40.710 --> 00:57:42.389 I don't know this guy, I'm gonna go hit up like, 00:57:42.389 --> 00:57:44.510 you know, this dude from like famous fund instead. 00:57:44.829 --> 00:57:46.829 Like, I'm totally happy being a background character. 00:57:46.829 --> 00:57:49.250 I'm totally happy just being a random like, you 00:57:49.250 --> 00:57:52.780 know, guy doing his thing. I'm not so concerned 00:57:52.780 --> 00:57:56.519 about like, you know, status, hype, rank. I just 00:57:56.519 --> 00:57:58.260 like being good at what I do, doing it with people 00:57:58.260 --> 00:58:00.639 I love, you know, hanging out with folks I really 00:58:00.639 --> 00:58:02.559 care about. I think that would have been the 00:58:02.559 --> 00:58:04.980 thing that really sticks with 20 year old me. 00:58:05.199 --> 00:58:07.480 And it would have been very strange and it would 00:58:07.480 --> 00:58:09.539 have been very frustrating because it's one of 00:58:09.539 --> 00:58:11.579 those things that's like insight versus knowledge. 00:58:11.619 --> 00:58:13.820 Like you can give knowledge. You can be like, 00:58:13.880 --> 00:58:16.099 yo, like, let me show you this math proof. And 00:58:16.099 --> 00:58:17.679 it's like, cool, like, cool. Like now I know 00:58:17.679 --> 00:58:19.719 it. Then there's insight, which you just have 00:58:19.719 --> 00:58:22.239 to learn. And I think that I'm kind of stupid. 00:58:22.639 --> 00:58:24.400 I just couldn't understand the stove is hot until 00:58:24.400 --> 00:58:26.320 I kept touching it and burning my hand. And finally 00:58:26.320 --> 00:58:28.320 the inside hit me and I'm like, ah, like, you 00:58:28.320 --> 00:58:30.860 know, this is how it works. So that would be 00:58:30.860 --> 00:58:33.420 the thing that most surprises me. And it probably 00:58:33.420 --> 00:58:35.739 would have like perplexed me and maybe infuriated 00:58:35.739 --> 00:58:37.860 me because I would have been like, cool. But 00:58:37.860 --> 00:58:39.820 like, I don't know how I become that guy, you 00:58:39.820 --> 00:58:41.400 know, because I still kind of really care about 00:58:41.400 --> 00:58:47.400 these things. What are you excited about in healthcare 00:58:47.400 --> 00:58:50.429 in the next five years? And what are you excited 00:58:50.429 --> 00:58:56.050 about with your personal career life? In my, 00:58:56.190 --> 00:59:03.130 you know, so on the VC side. I think that there 00:59:03.130 --> 00:59:08.289 is an unstable we had after like 30 to 40 years 00:59:08.289 --> 00:59:13.010 of extremely stable policy consensus, bipartisan 00:59:13.010 --> 00:59:16.159 on health care. It's become a total knife fight. 00:59:16.480 --> 00:59:18.780 Like the balance of power between payers, big 00:59:18.780 --> 00:59:22.219 providers, small providers, life science, pharma 00:59:22.219 --> 00:59:25.139 is all kinds of messed up. How it maps to left 00:59:25.139 --> 00:59:27.380 and right, how it maps to parties, all messed 00:59:27.380 --> 00:59:30.639 up. Who wins and who loses, totally messed up. 00:59:31.059 --> 00:59:33.659 The Trump administration has basically burnt 00:59:33.659 --> 00:59:35.420 down everything that we understood about, you 00:59:35.420 --> 00:59:38.239 know, balance of power in our sector, you know, 00:59:38.239 --> 00:59:41.099 when they came in. And if you look at their policy 00:59:41.099 --> 00:59:45.840 considerations, it's all over the map. It's terrifying 00:59:45.840 --> 00:59:50.460 as a citizen. But the old system that's kind 00:59:50.460 --> 00:59:52.900 of burning down had a whole bunch of problems 00:59:52.900 --> 00:59:56.079 with it. And I'm very curious about, is there 00:59:56.079 --> 01:00:00.019 a window in all this chaos to back the right 01:00:00.019 --> 01:00:01.360 kinds of companies, the kinds of companies that 01:00:01.360 --> 01:00:03.719 I'd be proud to see exist in the world that can 01:00:03.719 --> 01:00:06.000 build and blossom because a lot of stuff is cracking 01:00:06.000 --> 01:00:08.440 in our healthcare system? Is there something 01:00:08.440 --> 01:00:11.400 that we could do that's interesting and better? 01:00:11.679 --> 01:00:15.880 I find that stuff really intriguing. And we always 01:00:15.880 --> 01:00:18.400 talk about how there's like a new era of AI, 01:00:18.619 --> 01:00:21.340 but this recent era of AI is a whole bunch more 01:00:21.340 --> 01:00:24.260 interesting than CNNs were 10 years ago. So I'm 01:00:24.260 --> 01:00:27.280 also very intrigued by, you know, what are the 01:00:27.280 --> 01:00:29.940 kinds of things like maybe actually, like we're 01:00:29.940 --> 01:00:31.739 actually finally getting serious about stuff 01:00:31.739 --> 01:00:35.570 that can minimize paperwork burden, etc. really 01:00:35.570 --> 01:00:38.070 not by improving the existence of paperwork, 01:00:38.230 --> 01:00:40.250 but really just making paperwork a tedious things 01:00:40.250 --> 01:00:42.769 that computers fight with each other about and 01:00:42.769 --> 01:00:44.929 sort of disintermediate us more and more. These 01:00:44.929 --> 01:00:47.769 are some things I'm excited about in my investing 01:00:47.769 --> 01:00:51.829 hat. In my personal hat... One of the really 01:00:51.829 --> 01:00:54.650 big insights I had as a VCA is that work expands 01:00:54.650 --> 01:00:56.469 to fill the time. You probably feel this. There's 01:00:56.469 --> 01:00:59.210 like an infinite number of happy hours and things 01:00:59.210 --> 01:01:01.610 you can do, et cetera. And sometime in the past 01:01:01.610 --> 01:01:04.050 two years, just running a team of four, I got 01:01:04.050 --> 01:01:06.329 so busy that I had to cut down a lot and I just 01:01:06.329 --> 01:01:08.769 did a lot less. And the amazing thing is I found 01:01:08.769 --> 01:01:11.050 out that I could both do a lot less and still 01:01:11.050 --> 01:01:15.170 be as or more effective and have actually like 01:01:15.170 --> 01:01:18.929 free time to think and do deep work. And the 01:01:18.929 --> 01:01:20.650 thing I'm most excited about my personal life 01:01:20.650 --> 01:01:24.449 is more deep work. In an entire year, me and 01:01:24.449 --> 01:01:27.449 you as VCs, there's one or two documents that 01:01:27.449 --> 01:01:29.690 we signed and wires that we approved that were 01:01:29.690 --> 01:01:31.550 by and far the single most important stuff we 01:01:31.550 --> 01:01:33.730 did that year. And if that was all we did that 01:01:33.730 --> 01:01:35.909 year in the story of our lives, that would probably 01:01:35.909 --> 01:01:39.869 be enough. Everything else washes away. I like 01:01:39.869 --> 01:01:44.110 the idea of more time spinning around in a chair 01:01:44.110 --> 01:01:49.000 or floating around in the ocean. thinking, thinking 01:01:49.000 --> 01:01:52.760 deep instead of just going, you know, five days 01:01:52.760 --> 01:01:55.000 a week, you know, seven to eight hours of 30 01:01:55.000 --> 01:01:58.880 minute coffee chats back to back. There's a lot 01:01:58.880 --> 01:02:02.800 of physicians listening to this podcast and they're 01:02:02.800 --> 01:02:06.039 wanting to break into startup investing, venture 01:02:06.039 --> 01:02:09.579 capital, entrepreneurship. What piece of advice 01:02:09.579 --> 01:02:13.300 do you have for them? I would toss out a few 01:02:13.300 --> 01:02:15.980 things on the entrepreneurship side, I would 01:02:15.980 --> 01:02:19.630 say Don't overthink it. Doctors have always been 01:02:19.630 --> 01:02:23.670 entrepreneurial. Almost everyone who you think 01:02:23.670 --> 01:02:25.769 of when you were a kid and they were doctors 01:02:25.769 --> 01:02:27.909 were doing something like very entrepreneurial. 01:02:28.909 --> 01:02:31.550 And almost certainly because of the nature of 01:02:31.550 --> 01:02:35.500 our work. You have a fixed and totally safe employment 01:02:35.500 --> 01:02:37.420 thing that you can turn to if everything blows 01:02:37.420 --> 01:02:40.219 up So feel that you have swagger random people 01:02:40.219 --> 01:02:42.980 just show up and start doing things people with 01:02:42.980 --> 01:02:45.420 less tools than you This is a great era because 01:02:45.420 --> 01:02:46.860 there's a million things that you don't know 01:02:46.860 --> 01:02:48.619 and there's so many tools that can help you There 01:02:48.619 --> 01:02:50.679 are people they can help you and also a chat 01:02:50.679 --> 01:02:52.480 GPT now. It's like, you know, it's pretty good 01:02:52.940 --> 01:02:55.019 Like, you know, it may not know everything and 01:02:55.019 --> 01:02:56.780 it won't be an expert, but it certainly is a 01:02:56.780 --> 01:02:59.119 few chapters ahead of you in a bunch of, you 01:02:59.119 --> 01:03:01.119 know, entrepreneurship topics you want to learn 01:03:01.119 --> 01:03:03.539 about. It'll point you in the way to, you know, 01:03:03.699 --> 01:03:05.300 read and learn and grow. We've learned harder 01:03:05.300 --> 01:03:07.420 things. I would say on the entrepreneurship side, 01:03:07.460 --> 01:03:10.699 go for it. On the healthcare side, I would say 01:03:10.699 --> 01:03:14.840 the most important thing for investing either 01:03:14.840 --> 01:03:19.000 time or money in a company is no access of complexity 01:03:19.000 --> 01:03:22.619 and know where you're smart. And if the main 01:03:22.619 --> 01:03:25.239 complexity in something is, let's say you're 01:03:25.239 --> 01:03:26.880 a cardiologist, let's say you're an interventional 01:03:26.880 --> 01:03:28.860 cardiologist and you're looking at stents. And 01:03:28.860 --> 01:03:31.599 if the main axis of complexity for that company 01:03:31.599 --> 01:03:36.559 is like a technical innovation in some kind of 01:03:36.559 --> 01:03:39.170 technical. innovation that's legible to you as 01:03:39.170 --> 01:03:40.769 a proceduralist who does it where you're like, 01:03:40.809 --> 01:03:43.250 if we do this, this kind of a big deal, like 01:03:43.250 --> 01:03:45.210 I would pay a lot more money, cool, that is a 01:03:45.210 --> 01:03:47.769 good bet. If the axis of complexity is totally 01:03:47.769 --> 01:03:49.750 illegible to you, if you're an interventional 01:03:49.750 --> 01:03:51.829 cardiologist, and you're looking at an orthopedic 01:03:51.829 --> 01:03:54.809 screw for hand surgery that angles slightly differently 01:03:54.809 --> 01:03:56.909 than the incumbent screw, then it's like, you 01:03:56.909 --> 01:03:59.349 know, have humility and like be like, you know, 01:03:59.389 --> 01:04:03.130 is this like, you know, like, is this really 01:04:03.130 --> 01:04:04.949 like, you know, the right kind of bet? The other 01:04:04.949 --> 01:04:07.289 is that you're too smart to have to know everything 01:04:07.289 --> 01:04:09.469 and be the extra expert. In the same way, we 01:04:09.469 --> 01:04:11.590 don't expect the interventional cardiologist 01:04:11.590 --> 01:04:16.829 also to be an expert in, you know, advanced management 01:04:16.829 --> 01:04:19.329 of renal tubular acidosis or something. It's 01:04:19.329 --> 01:04:21.130 like, use the team, use the team in the same 01:04:21.130 --> 01:04:22.949 way. It's like you're too smart to be like, you 01:04:22.949 --> 01:04:25.289 know, learning everything and being the expert. 01:04:25.710 --> 01:04:27.650 It's like if you see a deal and you love it and 01:04:27.650 --> 01:04:31.550 you're like, I love this med device. I love the 01:04:31.550 --> 01:04:33.829 technology. But the whole cap table thing, some 01:04:33.829 --> 01:04:36.050 of these weird terms that they've given to us, 01:04:36.329 --> 01:04:38.510 that's kind of beyond me. It's cool. You're too 01:04:38.510 --> 01:04:41.010 smart to become an expert in that. Use the team. 01:04:41.130 --> 01:04:43.469 Use the team. Ask friends. Ask your network, 01:04:43.530 --> 01:04:46.090 et cetera. It's how we work in the hospital. 01:04:46.329 --> 01:04:47.969 I think it's also what makes us successful when 01:04:47.969 --> 01:04:50.530 we invest. I think we're much more team player 01:04:50.530 --> 01:04:53.309 oriented. It's the same game. Use the same skills. 01:04:54.889 --> 01:04:57.670 Awesome. Thanks so much, Dmitry. Cool. Appreciate 01:04:57.670 --> 01:04:59.230 you, Rashad. It's always fun to do this.