In Defence of the Naïve Founder 

One of my most memorable moments from medical school was during my rotation in a psychiatric hospital. Unlike traditional medicine, you’re unlikely to figure out what is going on by sticking the patient with needles. Instead you learn to listen for inconsistencies that might indicate a delusion or hallucination.

On one occasion, I was taking a medical history from a well-kept man on a psychiatric ward who wouldn’t have looked out of place in a law firm or investment bank. That was until he started to describe, in all seriousness, that “agents” had been tailing him for weeks. Apparently, he had been assigned a top secret mission to penetrate a cult and was on the verge of uncovering a major conspiracy.

While delusions of this kind sound impressive, it wouldn’t be unusual to hear similarly grandiose stories from a startup founder.

Self-confidence to the point of delusional seems to be a common trait amongst successful founders. Later stage founders often admit to having no idea what they were getting themselves into when they first started their company. 

Continue reading

Does Artificial General Intelligence Explain Fermi’s Paradox? A “Human Compatible” Book Review

“He who controls the algorithms controls the universe.”

Like many tech entrepreneurs, I am a definite optimist. Despite the many challenges we face, I believe that, as a species, we have the resilience and ingenuity to build a better future, overcoming obstacles from climate change to an aging population.

In a similar vein, it has become clear that artificial intelligence will be one of the defining technologies of the twenty-first century. The question is when rather than if machines will be smarter than humans. There’s general consensus that we’re talking decades, not centuries. This is something that many people alive today will probably see.

In spite of this, I have given the question of AI safety and a potential apocalypse the same relative importance in my mind as seat belts likely had in the 1800s. One that seems like a good idea to explore, but an order of magnitude less important than figuring out how to consistently drive at speeds greater than 10mph.

The book that changed all of that was Human Compatible: AI and the Problem of Control by Stuart J. Russell. Human Compatible, courtesy of Quit Genius’ book club, has become one of my favorites of the year. 

Continue reading

The Art of Deciding

“To take away a man’s freedom of choice, even his freedom to make the wrong choice, is to manipulate him as though he were a puppet and not a person.”

Madeline L’Engle

The ability to decide is at the heart of what it means to be human. After all, history started with the hasty decision to take a bite of the forbidden fruit. And, like Adam most of us make consequential decisions with little to no thought. 

Decision-making is not taught in schools and rarely discussed in leadership circles. There are countless books on how to be more productive, yet relatively few on how to decide. In fact, it wasn’t until recently that academia moved away from the ludicrous idea that humans are rational beings and decision-making gained the fancy moniker, “behavioral economics”, signifying its elevation as a formal field of science, thanks to the work of prominent academics such as Daniel Kahneman and Richard Thaler.

Continue reading

The Most Important Thing I Learned During Y Combinator

Tuesday “dinners” were a big part of the YC experience. An opportunity to take a break from the grind, share notes and compare progress with fellow batchmates. 

But the highlight of the evening was always an off-the-record talk by an experienced startup founder who was, more often than not, also YC alumnus. During my batch (Winter 2018), we had the opportunity to hear from no less than Drew Houston (Dropbox), Brian Chesky and Joe Gebbia (Airbnb), and Emmit Shear and Justin Kan (Twitch), to name a few. 

The talk that I’ve thought back to the most was Sam Altman, former President of YC’s, opening address on “How to Succeed”.

Continue reading

Prescription Digital Therapeutics: Hope or Hype?

It’s been a wild year of innovation and growth in digital health. Necessity, after all, is the mother of invention. As the global pandemic arrived, digital health transformed from a convenience to a requirement. Yet contrary to popular belief, the spoils have not been evenly distributed.

The long-heralded class of “prescription digital therapeutics” has lagged in adoption, while the growth of “virtual care platforms” has been explosive. What differentiates each approach and what are the key takeaways for payers, providers, consumers, and investors? 

Continue reading

My Antifragile Investment Portfolio

If you thought that 2020 was a rollercoaster, my hunch is that 2021 has something special in store for us.

Barely one month in, the (former) democratically elected President of the United States fumbled Order 66. The S&P 500 and Bitcoin hit their all-time highs. “Meme stocks” became accepted financial jargon. A bunch of anti-establishment retail investors brought Wall St hedge funds to their knees. And as I write this, the global supply of silver is in the midst of being controlled by a subreddit.

The point I’m trying to make is that the future is uncertain and as Nassim Taleb would say, I make no time for the “charlatans” who think they can map it.

As a twenty-something-year-old, I have found myself asking what this means for my own fledgling asset portfolio. The financial press swivels between warnings of unchecked hubris followed by explanations of why “this time is different”.

Meanwhile, there seems to be an endlessly tantalizing buffet (pun-intended) of growth stocks, IPOs, SPACs, Bitcoin, Altcoins and meme stocks to choose from. It’s difficult to decide whether to play it safe or go all-in on the latest trend.

Continue reading

The UK and Creating an Innovative Health-Tech Culture

Imagine a near-infinite improbability drive that takes common, raw materials and transforms them into a conveyor belt of wealth-creating products and services. 

Once you owed such a device, you would do everything you could to preserve and protect it. The improbability drive I refer to is “innovation” and the UK was once good at it for healthcare. 

From penicillin to the smallpox vaccine, the UK has a long history of punching above its weight in the field of healthcare innovation. Unfortunately, we have ceded that lead, in part, due to an increasingly hostile culture towards health-tech entrepreneurs.

Here’s why. Innovation is the result of trial and error by tinkerers, often preceding our scientific understanding. It proliferates in decentralized environments where people are free to think, experiment and speculate. It is almost always bottom-up rather than top-down.

The first challenge is the UK’s centralized approach to healthcare that optimizes for low cost at the expense of innovation and spends 20% less per capita on healthcare than the OECD average.

A lack of willingness to invest in innovative health-tech projects coupled with bureaucratic decision-making has created an environment of limited opportunity for new upstarts. The result has been a brain drain of the best and brightest health-tech entrepreneurs migrating to more innovation-friendly markets.

Continue reading

The Mobile Health Paradox: Why Data Isn’t Nearly Enough

Health and fitness apps are all the rage at the moment, but do they actually help us live healthier lives?

Note: This article was originally published in TechCrunch on Feb 10, 2016.

Across most developed economies, healthcare costs are rising faster than inflation. In the U.K., the National Health Service (NHS) faces an estimated funding gap of £30 billion by 2020. In the U.S., the situation looks more bleak, with total annual healthcare spending surpassing $3.8 trillion, representing an astonishing 17.4 percent of the country’s total GDP.

A key cause of the rise in healthcare spending lies in the spiraling costs of treating preventable chronic diseases (such as obesity, heart disease, stroke and cancer), which account for 88 percent of total healthcare spending. This figure isn’t surprising when you consider that approximately half of all adults in the U.S. have one or more chronic conditions. More worryingly, seven of the top 10 causes of deaths occur as a result of preventable chronic diseases, with cigarette smoking alone accounting for 480,000 deaths in the U.S. every year.

These facts suggest that many of the key healthcare challenges of the twenty-first century lie in how we tackle chronic disease. This article will explore the role of mobile technologies in meeting these challenges, why they have failed to do so until now and what a solution might look like in the future.

Continue reading