Siran Cao

Someone broke down the estimated costs of a $15 Sweetgreen salad. We need these cost graphics for digital health to help future founders. Especially for tech enabled cos, the greatest cost is labor. Much of the "value created" is in curation and matching, which means the gross margins are reliant on labor arbitrage. Pay someone $X, but get paid $X+Y% per visit. The challenge with healthcare is that you often have to pick one of two business models: 1. specialized, low volume, high cost, low gross margin % 2. generalized, high volume, low cost, high gross margin % I'd argue founders should focus on gross dollars over the lifetime of the customer (like Jeff Bezos said) instead of gross margin %'s, but we'll leave that for another time. The challenge is that many tech enabled digital health cos have high cost of goods sold (labor) and moderately high product, design, and engineering budgets. We must build differentiated solutions for patients, clinicians, and clients to be out incumbents, however, we're realizing that companies are ultimately valued on the discounted value of future cash flows. And the high SG&A costs at most organizations might be inbalanced to the unit economics of the business. I'm not sure the math pencils out for everyone unfortunately. But I'm just a guy on the internet, would love to hear the thoughts from those smarter than I (you!). Comment below. --- p.s. I have no idea the accuracy of the graphic and not an investor in Sweetgreen. Cheers. Credit: David Crowther

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Health x Climate: I have spent a lot of time thinking about the intersection of climate and health, so I appreciated the City Futures: HealthTech and ClimateTech Intersections panel discussion during NY Tech Week, with Ben Furnas, Sara Holoubek, and Joel Cesare as panelists. They highlighted the work happening in NYC; even though subway use helps our GHG emissions, there is still opportunity to prepare the city and electrify our buildings for the changes to come. Some key takeaways 🔄 Health + Climate: The effects of climate change impact our health and our health decisions impact climate change. We often think about climate and health in silos but they are very connected.  🔥 Heat waves: Hotter temperatures are the biggest risk to health from climate change, so we must prepare now. I learned about NYC's AC giveaway to support vulnerable communities.  🤓 New ideas: There is much opportunity to engage in mental cross training and leverage learnings from analogous spaces and industries at this intersection. What do you think about the intersection of health and climate? A big thanks to Climate Health Innovation & Learning Lab, Women in Healthtech and Fenwick for hosting this event and showcasing how government, innovators, and investors can work together to address these challenges. Thanks Oriana Fuentes and Chethan Sarabu, MD, FAMIA, FAAP for your thoughtful curation too! #climate #healthtech #innovation #NYtechweek

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It turns out, the Long Island Sound IS water. For these and other insights, check out this post about our seed funding round. 😬 #startups #fundraising #newyork

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Lots of people are asking me how Midi Health is using AI. Yesterday at an event at Stanford, I was introduced to Open Evidence - and told that I could save money by having our providers use it for advice. The founders say they developed OpenEvidence to cut through all the noise and misinformation that is the modern internet and build tools that are unbiased, widely accessible, international, up to date to the day, accurate, and free. I bet it often gets things right. But not always. And I am afraid it will be that way for a long time. I asked Open Evidence whether women with BRCA could use hormone replacement therapy. At Midi Health we know that estrogen is safe for women with BRCA and I was curious about the answer. We also know that If you haven't had your uterus removed, your provider will typically prescribe estrogen along with progesterone or progestin (progesterone-like medication). This is because estrogen alone, when not balanced by progesterone, can stimulate growth of the lining of the uterus, increasing the risk of endometrial cancer. Unfortunately, in this case, the feedback from Open Evidence is just completely incorrect. As far as I can tell - the advice is completely made up - a true hallucination. When we think about how to use AI in healthcare - we are using it to make our providers more efficient and take away easy tasks - but definitely do not rely on it for medical care. You should not either. Zachary Ziegler and Travis Zack, MD, PhD it would be great to get this right!

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😅 How did Dan end up manufacturing large quantities of pharmaceutically optimized LSD? 1. Founder of HealthMode 2. Acquired by MindMed to become CMO 3. Run an FDA breakthrough program for LSD in anxiety Full episode in the comments 👇

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Some thoughts after spending some time with a handful of builders and investors in NYC this past week! 1. New York City is quietly fostering one of the most vibrant and underrated consumer founder communities in the country. This ecosystem is bursting with innovative energy, driven by founders who are deeply embedded in culture and consumer behavior. For those who haven’t tapped in yet, I strongly recommend paying attention—it’s a hotbed of potential that’s primed for growth. 2. Understanding and valuing consumer products demands more than just financial acumen; it requires a deep understanding of culture, trends, and human behavior. Many investors are stepping away, not because the space isn’t viable, but because they lack the nuanced taste and cultural insight necessary to identify and nurture truly impactful consumer products. This gap presents a massive opportunity for those who “get it” to dominate the market with culturally relevant investments. 3. In today’s world, a product or service that lacks a strong community component is missing the mark. Community isn’t just an add-on; it’s the foundation upon which modern consumer brands are built. Doubling down on building and nurturing a community around your product can create a powerful network effect, driving organic growth and fostering long-term loyalty. 4. The next wave of consumer social platforms won’t look like the traditional social networks we’ve become accustomed to. Instead, we’ll see social experiences seamlessly integrated into other aspects of daily life, such as fashion, education, and real-world interactions. This evolution will redefine how we connect, share, and engage, creating new opportunities for innovation at the intersection of technology and everyday life. 5. Simplicity wins — In a world overflowing with options and information, simplicity is the ultimate competitive advantage. Products and services that cut through the noise with straightforward, intuitive designs and clear value propositions will stand out. Complexity might seem impressive, but simplicity is what drives adoption and sustained success in the consumer market.

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Something that's struck me about startup service providers - "We take x% of your business, y% of your funding round, and you pay an upfront fee." Starts to feel like a death of a thousand cuts...but as a founder you're still carrying all the risk. It can feel like a losing battle but you have to back yourself to ask, "why is it all three of these terms?" - If you're paying an upfront fee then the other two should be dropped, if a service provider wants to carry the risk of not charging upfront fee's then sweat equity makes sense. Feel's ripe for disruption. #founders #fundraising #serviceproviders

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