Vinod Khosla, Founder of Khosla Ventures was the keynote speaker at the July meeting of Health 2.0 Silicon Valley. By design, he answered questions from the largely entrepreneurial audience for almost an hour. It was fun & informative.
Vinod teed up the Q&A session with these opening remarks:
“Digital health is a radical opportunity. There are two classes of things that I see: 1) Administrative support and IT 2) Companies that are developing new science and new medicine. Traditional doctors won’t recognize what it is about. Both are important. Both offer plenty of startup opportunities. And, in all of these, we will see great companies being built.”
He told us that he is just finishing up a paper describing his vision of the digital health world. It started out as a three page blog, but now, the latest version is 70 pages long. He said that it is so long because whenever people complain about what he has said, he has to do research to respond. This paper, he said, “is the best he has to offer of his views of digital health care.”
He went on to say,
“If my view is right, most of what doctors do today will be eliminated. Most means diagnosis, most means of prescribing care, and it includes monitoring which basically doesn’t happen today. And, it will happen at a fraction of the cost — essentially free — all over the world, and pretty close to equal access to everyone. If I am right the single biggest change will be to make the consumer (the patient), the CEO of his own health…Today’s health care is more sick care than health care, and I hope we will go from sick care to well care or at least predictive care.”
The consumer will be so much better informed:
“Often better informed than the doctor…and the doctor’s role will change. Now, many people quote me as saying ‘just eliminate the doctors and some machine will take care of you’. That is not what I intend…I don’t think you will rely on the system to make ethical decisions in medicine, you won’t rely on a system to be a mentor or coach you through an illness.”
“the role of a doctor will change radically”…and “who you admit into medical school will change dramatically. I sometimes joke that UCLA Film School graduates may play doctors better than doctors who are selected more for IQ than EQ. Your nurses may do a lot more than what today’s median doctor does. But most exciting to me, I think, is that all of this will be available everywhere in the world.”
He concluded his opening remarks by saying,
“Most of what I speculate will be wrong – but wrong in the specifics and directionally right I believe… just because you can’t predict the future doesn’t mean the present is going to continue – it just means you can’t predict the future. I believe it is easy to predict directionality but it is hard to predict specifics, and on the specifics I will usually be wrong. But that doesn’t prevent me from speculating how that may happen.”
50 Minutes of Q & A
What followed was almost 50 minutes of questions and answers from the audience. To make it easier for you, my dear readers, to navigate this long video, I have listed each question with the time that it was asked so you can skip to the questions that are of most interest to you. Enjoy!
5:37 Is now a good time to invest in healthcare or should we do it in 5 to 10 years? If so, why?
9:00 What are some of your favorite investments to date in healthcare on the consumer side or the data side?
12:07 What about other companies, like non-digital health companies? Companies in biology, chemistry…that kind of innovation?
13:25 One of the things that people always ask is how do they compete as a small startup against these huge incumbents like the insurance companies, the hospital chains that have billions and billions of dollars?
13:56 So if you had to pick one – and you can’t say both and you can’t say it depends, which one is more important from an investment perspective: improving outcomes? Or reducing costs?
15:07 We keep hearing about healthcare companies, hospitals, payers, and wellness companies trying to build digital health technologies themselves when there are so many great innovative emerging companies out there. What do you say to those hospitals and health plans that are trying to do that work?
17:59 What was the best decision you made in your life and how did you make that decision?
20:44 What do you think about healthcare software in high growth population countries like India and China? Do you have any suggestions or tips?
21:57 What is the main criteria VCs look for while considering healthcare technology startups serving adjacent healthcare markets such as dentistry or conventional medical providers?
23:59 Do you consider it validation or do you get turned off if another VC is investing in the same space?
27:15 If you really care about improving outcomes, how do you survive as an entrepreneur, especially as a woman entrepreneur?
30:20 You talked about outcomes being a big driver for you. Given that 56% of bankruptcies in the country are from people who can’t afford the cost of healthcare, what do you see as the largest catalyst for cost transparency for driving down costs?
32:58 Is there an opportunity to help people in their 20s and 30s make the right decisions?
36:12 What partnerships do you believe are necessary to make new technologies truly disruptive when there is an existing infrastructure that you have to go up against? Are government/academic partnerships necessary at the beginning?
39:28 What companies, similar to WellDoc, are doing a great job of making personal data actionable? What about their approaches are really effective?
44:46 What kind of technology will have an impact on behavior? What are your thoughts on personalized medicine and the kinds of technologies that will have an impact on it?
46:40 Is the VC world more about glamour and who you know rather than the product you are building?
49:03 What is your take on the new Apple Health Kit?
49:30 What do you look for in an entrepreneur?
50:54 Do you expect any changes in the FDA regulatory landscape in the near future with regards to being able to bring out new technology changes? Do you think VCs are currently focused on drawing management fees versus leading companies to success?
How to Contact Vinod Kholsa
Vinod closed by saying,
“We are always looking for plans, but we are always looking for great people. We are always hiring in our portfolio. Anyone who wants to send a resume, please send it, a resume, a business plan, a comment…whatever you like. I love getting feedback…Feel free to email me at firstname.lastname@example.org…that is the best way to get hold of me. I try to be sure every email gets answered.”