Releasing Your Inner Tiger…to Save Lives/Anne DeGheest - HealthTech, Fearless, Woman-led ~ Spark of Ages Ep. 4

Email us with any feedback for the show: spark@postion2.com
Find more great content like this at: https://www.position2.com/

Find Anne's DeGheest's artwork at: adegheest.com

Get ready to be inspired as we journey into the revolutionary world of HealthTech with our formidable guest, Anne DeGheest.  A powerhouse executive, investor, and mentor, Anne's extraordinary work has led to over $27 billion in market capitalization. She is the visionary who coined the term "health tech" back in 1985, and has been shaking up the industry ever since. 

We kick off our discussion navigating the complex web of HealthTech, its divergence from traditional MedTech and Biotech, and the profound impact it can have on healthcare efficiency and costs. We'll explore stories of successful startups, like VZQ, that are not just selling technology, but solving specific healthcare problems. Anne's insight on the importance of understanding stakeholder viewpoints in this sector and aligning with the right kind of investor is illuminating.

Towards the end, Anne shares her personal narrative full of tenacity and fearlessness, a beacon of inspiration especially for women entrepreneurs. She emphasizes the need for perseverance, flexibility, and self-belief in this challenging field. With her wisdom on providing feedback during the fundraising process and focusing on problem-solving, Anne presents invaluable lessons for healthcare startups. Listen in and ignite your passion for transforming healthcare through technology.


Producer: Anand Shah & Sandeep Parikh
Technical Director & Sound Designer: Sandeep Parikh
Executive Producers: Sandeep Parikh & Anand Shah
Associate Producers: Taryn Talley & Jesse Diep
Editor: Sean Meagher & Mat Greenleaf


#entrepreneur #innovation #healthtech #growth #venturecapital #vc #saas #saasmarketing  #marketoutlook  #sales #ai #consultant #consulting #technology #innovatorsmindset #innovators #innovator #product #revenue #revenuegrowth #management #managementconsulting #founder #entrepreneurship #data #analytics #dataanalytics #growth #growthmindset #growthhacking #salestechniques #salestips #enterprise  #business #bschools #bschoolscholarship #siliconvalley #company #companies #smartgrowth #efficiency #money #sustainability #sustainablegrowth #process #processimprovement #customerexperience #value #valuecreation #funny #podcast #comedy #desi #indian #community #patients #nurses #insurance #doctor

Website: https://www.position2.com/podcast/

Rajiv Parikh: https://www.linkedin.com/in/rajivparikh/

Sandeep Parikh: https://www.instagram.com/sandeepparikh/

Transcript

Rajiv Parikh: 0:14

Hello and welcome to the Spark of Ages podcast, where we're going to talk to founders, innovators, CEOs, investors, designers and artists I'm talking game changers about their big, world-shaping ideas and what sparked them.

Rajiv Parikh: 0:26

I'm your host, Rajiv Parikh, and I'm the CEO and founder of Position Squared, a growth marketing company based in Palo Alto. So, yes, I'm a Silicon Valley entrepreneur, but I'm also a business news junkie and history nerd. I'm fascinated by how big world-changing movements go from the spark of an idea to an innovation that reshapes our lives. In every episode, we're going to do a deep dive with our guests about what led them to their own Eureka moments and how they're going about executing it and, perhaps most importantly, how they get other people to believe in them so that their idea could someday become a spark for the ages. And if you like what you hear, take a moment to rate it and comment. You can also send feedback to us directly at sparkatpositionthenumber2.com. This is the Spark of Ages podcast. In addition to myself, we have our producer, Sandeep, who will occasionally chime in to make sure we don't get too in the weeds with tech jargon, yeah, very occasionally.

Sandeep Parikh: 1:28

Okay, it'll be gentle, it'll be light touch, and I also do the game.

Rajiv Parikh: 1:31

Sandeep rocks with games. Today, I'm excited because our guest is Anne DeGheest. She's someone who has dedicated her career as an executive, investor and mentor to quite literally help saving lives up to potentially 6 million lives over the last 40 years, according to her calculation. Now, that is a number. It's a big number. We're going to dig into how she got to that number and, frankly, I think she's being conservative.

Rajiv Parikh: 1:54

I got to know her really well over the years because I started a medical device company. I started it, I got it off the ground. I, of course, turned it over to other VCs and I learned about this amazing person, anne, who's known as just a winner when it comes to building companies and investing in health tech businesses. This was back in your natist days then. Huh Well, my wife's natist days. I was a high tech guy, so I started my first company, appearon, which was all about asthma therapeutics, Anne pioneered the health tech space.

Rajiv Parikh: 2:23

She's the founder of health tech capital and med stars. She organizes and moderates the health tech conference on how to successfully build innovative health tech businesses and change healthcare delivery. Since she founded med stars in 1986, she's been a corporate development advisor to large healthcare companies and a mentor capitalist, specializing in investing and mentoring early stage companies in healthcare. Her life science portfolio companies have generated over $27 billion in market capitalization, including eight IPOs an amazing record. In 2010, anne founded health tech capital, a group of private investors dedicated to funding and mentoring new health tech startups to decrease healthcare costs and empower patients. Health tech capital is an ecosystem of angels, venture capitalists, providers, payers and a healthcare industry key players with three sets of expertise needed to succeed in the new health tech space. That's healthcare technology and user engagement. She also has an MBA from my favorite school, Harvard Business School, and a master's in business engineering from University of Brussels. Anne is also a recognized artist. You can find her at adegheest. com. Let's get to our conversation with Anne DeGheest. Anne, welcome to Spark of Ages.

Anne DeGheest: 3:52

Thank you, rajiv. I'm looking forward to this conversation.

Rajiv Parikh: 3:55

Awesome, anne. You coined the term health tech, and that's different than med tech. How do you define digital health and this term health tech?

Anne DeGheest: 4:04

Yeah, no, thank you for asking the question. So this was around 1985, so long time ago. Basically, at the time I was just coming out of a startup called Nelcore. If any of you have a device you put on your finger after COVID, that's called pulse oximeter and I launched that worldwide for that company, nelcore. So I had learned the experience of medical devices. But also before my prior company, I was in the early 1979, 1980, the computer and telecom industry in Silicon Valley and I had this dual knowledge.

Anne DeGheest: 4:32

And if you think about medical devices and med tech and biotech, it's all about taking a product risk, going after an existing market because you spend so much time five, 10 years to go doing clinical trials showing it works on animals, showing it was on humans, begging the FDA to agree with you. Finally going on the market. The last thing you're going to do is create a market. In traditional tech it's the reverse. It's all about high market risk, taking low product risk. So you're disrupting market, creating the market. So health tech was basically reversing the approach of traditional life science investment, which is to only investing company that have unique IP and it's all about a product risk, with a market waiting for them and says why don't we do the reverse, like we do in tech? Well, we're going to use off the shelf technology from the emerging computer and technology industry and improve workflow, improve efficacy, so that the end point, the measure of success, was reducing cost and improving time efficiencies. With traditional med tech and biotech, it's all about clinical outcome and efficacy and safety.

Anne DeGheest: 5:34

So it was a totally new paradigm and literally for me see 30 years, I was a lone ranger, kind of a lonely person there. People thought I was crazy. There was this crazy Belgium there and then I got lucky or smart, depending who you're talking to and I got all this company I help and they couldn't get funding because they had no IP. They were just changing the way we deliver drugs in the hospital setting, which nobody cared about, how we help the nurses be more efficient, which at the time nobody cared about, and so this company all went public. They had a hard time raising money and they end up with all these huge IPOs and very successful exit. So finally, my joke was that in 2010, I got so frustrated that every time I had, another group of entrepreneur was helping get the company off the ground, vcs couldn't get it. They say I got lucky last time, this one will never work, which was a very constant feedback I was getting.

Anne DeGheest: 6:23

You know, I started HealthTech Capital, which is I'm going to find other Maverick like me who wants to change healthcare. And if you think about it, everybody should care because at some time we're going to be patients or caregivers, we will go through this, and so we all have opinion about how screwed up the healthcare system is. You know, always joke. Finding a problem in healthcare is not a needle, a haystack, it's a haystack of needle. The magic is finding a business model that works for all the different stakeholders the physicians, the doctors, the hospitals and all of that.

Anne DeGheest: 6:54

So I started this group, healthtech Capital, with the idea that I would find other people are willing to give a tiny bit of money you know angel investors there and then I added VCs and corporate VCs afterwards to basically help this company get off the ground so they can show that it works, and then you can attract venture capital. So that's kind of the long journey. So I describe myself as the health tech pioneer. I coined the word health tech because there was MetTech and Biotech and I didn't want to have anything to do with healthcare IT for a long list of reasons and I said let's get the technology to improve usability of the existing way we deliver care.

Sandeep Parikh: 7:25

So cool. So, and in your bio it says that you've saved over 6 million people. Now, by my calculations, I think I've saved maybe four people in my life. I don't write, reggie, what's your number? Maybe eight? You saved me probably three or four times. You can only count me once, so you get nine lives.

Rajiv Parikh: 7:40

Yeah, I've saved a bunch of people multiple times and probably a bunch of people have saved me, so maybe, on balance, I'm at yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah yeah, yeah.

Anne DeGheest: 7:52

Well, you know, the nice thing about healthcare is that every startup is difficult, it is painful, it's a life-changing journey there, but when it does work, it has an impact with a huge scale, and so the way I came up with that numbers was really funny. My son was in high school and they had asked some parents to do like a panel on what should be different careers, and of course, everybody wanted to be a venture capitalist, to which I told them I say well, what's your experience paid value to the entrepreneurs as opposed to, you know, having a nice lifestyle? And so I decided I need to have a way to basically tell the people that you can have a huge impact on life. So I basically calculated that based on, for example, in pulse oximetry with Nelcor, at a time we had 50 to 75,000 mishaps per year and this was documented, which was a way to say people were dying in anesthesia. That shouldn't have happened. You know you can die for clinical reasons, and after we launched pulse oximetry, that dropped by a factor of 80, 80%. So all of that has been documented. I multiply that number every year and I know this was the case in Europe and other places like that. So that was one.

Anne DeGheest: 8:51

Vzq, which was another very successful startup, is a company that came out of John Hopkins and in this case, of John Hopkins.

Anne DeGheest: 8:57

They monitor all the patients in the ICUs and send all the vital signs remotely to remote locations. So think about the air traffic controller for the intensive care unit. Is what they were doing and then, as the patient was starting going in the wrong directions, they intervened earlier, as opposed to wait for the intensivist to come twice a day for 15 minutes. The data has been documented in 2030 in multiple studies, showing that they were able to decrease by 20% the mortality in the ICU. So, since you knew that they were now monitoring around 15% to 20% of the ICU patients in the country, because the system now has been sold everywhere, and then you know what the mortality rate in the ICU, because that's also published, and then you multiply all the numbers, you end up with some of these numbers there, and there were some other. You know type of technology there. So they were all based on not my finger in the air based on real data and then, looking over certain period there, it's probably higher than that by now, but you know it's not me personally doing it.

Rajiv Parikh: 9:52

It's a good conservative number. I think that's fair. I gotta say, though, like I mean I know we're jumping ahead I think the pulse oximetry device is one of the most imaginative uses of a medical device. It's very simple. It just goes on your finger and it can tell you the oxygen saturation in your blood, and that can tell you a whole bunch of things.

Anne DeGheest: 10:12

It also gives you your heart rate. If people learn, for example, with COVID, is that when your normal saturation is 97% at sea level, and then that's your arterial blood and then the venus is at 75%, so you really have a very short window between 97% to 75% to deliver oxygen to the tissue. So when COVID happens, what people learn is that when you're dropping because your lungs are not functioning right because of the virus, the heart rate can double. So your resting heart rate can go from 60 to 120. So those two numbers are really essential to tell you go to the ER, get some help right away.

Anne DeGheest: 10:44

But in the early days it took two years to explain to anesthesiologists with very sophisticated clinicians that they were thinking before in millimeter of mercury they were looking at the percent of oxygen in your blood, which is only 3% of the oxygen. 97% of the oxygen is carried by the hemoglobin there. So every new concept when you ask people to speak English to French, for example, you have to spend some time explaining it and we did that. But we became the fastest standard of care ever in the medical device technology there and that's because we worked at creating education, being market leaders, showing that it works on babies, on adults, in surgeries, in recovery rooms, in intensive care units. It's market creation, and that's the thing I was leading. Is the whole marketing area Really cool.

Rajiv Parikh: 11:27

My wife actually worked for Bill News Company Natives Medical, oh yes, so I got to meet him early on. And Wendy Hutton of Cayman, who I think you overlapped with.

Anne DeGheest: 11:36

Yeah, I hired Wendy into an L-Corp.

Rajiv Parikh: 11:38

That's right. She was an investor in my medical device, my one and only medical device company.

Anne DeGheest: 11:44

Oh, it is a small world.

Rajiv Parikh: 11:46

I wish I had you on my board, because then we would have really kicked by. So VCs say that one of the trickiest things about investing in health care is that their returns in many cases hinge on humans changing their personal behavior, and that's a lot harder than building a B2B SaaS platform. As I mentioned, I've started a medical device company. I'd never imagined how hard it would be to get that off the ground, because not only do you have to get the technology built into market and sometimes it's a research technology too, something that you can produce but you also have to convince the most skeptical people in the world doctors to actually use your product and then medical societies to embed that in their standard of care and then insurance companies to actually pay for it. So how does an early stage health tech investment approach compared to traditional tech, from your point of view that?

Anne DeGheest: 12:33

is a fantastic question there. I think the challenge of health care which, if you know how to do it, become the reason why you're successful and you create a barrier of entry is the ability of spending more time on the problem from the viewpoint of each stakeholders. What is the viewpoint of the nurse? What's the viewpoint of the physician? What's the pain point of the patient? What's the pain point of the person paying for it, which could be the CFO of a hospital or a payer or a farmer, depending on what the business model is?

Anne DeGheest: 12:57

And when I see the mistake a lot of people are making, which is that I'm going to develop this new disrupting technology and it's going to be so obvious the world will come to my doorsteps, and we all know that never happens In health care. There's so much resistance it's even harder. And then the other problem that there is in health care is that you cannot be too disruptive, because if you break the model there, there's huge resistance to change, or there is the power of the payment system, which is very difficult to understand. So in traditional tech you can break the models, like Apple has done multiple times in disrupt industries.

Rajiv Parikh: 13:25

Or you could break the law like Uber. Yeah, yeah, and when you kind of get away with it, because you're not killing people.

Anne DeGheest: 13:30

And if you, look at Microsoft, google and, in some way, apple. There they're trying to get into health care, the traditional health care, and they quickly discover that is very difficult to disrupt. So Apple has been really brilliant in the sense that they stay on the consumer health as opposed to the health care, acute care side. So the big challenge I think I always tell entrepreneurs don't tell me your solution, don't tell me your black box. Think about the black box as an input and an output. Tell me what's the problem. That's the input. Why is it urgent? Big deal, blah, blah, blah from all the different stakeholders. What's the output? What do they get out of it?

Anne DeGheest: 14:02

And if I still believe you have a good problem that's large and big and crying for a solution. You have a solution that if it does work, it is. Then you can tell me how you do it. And typically what you have is the reverse, and especially in Silicon Valley, with a tendency to fall in love, like right now. Ai is the new hype and I'm getting to be old enough to have lived for the internet hype and a whole bunch of other hypes and at the end it's just an enabling technology.

Anne DeGheest: 14:25

You have to go back to say people don't buy technology. They buy a solution to a specific problem, spend more time on the problem and at the time there's conflict of interest that you may not be able to get around it and then you should try and modify your problem that you're fixing or what you're doing there. But if you really spend the time there like Pixis, for example, is a company I was involved with and it was a doctor who had lost a patient due to medication error and he started a company to say, well, why don't we have like a co-dispensing machine at the point of care, at the bedside, that will dispense the meds so that there's no error there? And that's when they initially started to develop. And for a long list of reasons it doesn't make any sense for the pharmacist or for the nurses to have this co-dispensing machine. If you have 300 bed hospitals now, you need 600 carousels, you have to rotate every day. I mean a long list of reasons doesn't make sense.

Anne DeGheest: 15:12

So they were going to be shut down and so I was asked by NEA to come and help and I says you have the right problem, you have the wrong solution, let's spend more time from the viewpoint of the players, and the key player was not the pharmacist, it was the nurses. The nurses wants to make sure give me the right meds for the right patient at the right time without any hassle. And I know with the DEA I have to be careful with narcotics. I'm willing to do some extra steps there.

Anne DeGheest: 15:35

And so we took the concept of ATM for banking, which is remote inventory management of cash for the bank, and modified and say we're going to do remote inventory management of narcotics and other drugs that needs to be controlled and then move the inventory from the basement of the hospital was highly controlled but hard to get to to the floors, but with the extra controls. And now we had the nurse, who loved that because they were willing to punch a few things just to make sure the inventory was correct, to basically give them all the time when they needed the drugs, when the patient had to have it. And so that concept of understanding the workflow, who is in charge? And initially the nurse paid for it and over time the pharmacist paid for it. That's the magic, it's. I call myself a business architect. You have to build different models from the viewpoint of all the players.

Rajiv Parikh: 16:20

So I mean, that's the whole thing right, as part of that early stage to mid stage to late stage investing, right that somebody may come in initially with something that sounds really cool, but a certain early stage buyer buys it and then you're getting to a later stage and what you're talking about is the practices are about human lives, so it better be really urgent and painful for this solution to come in, because there's going to be skepticism. But it's not just the early adopter, it's also the people that are actually going to use the product later. That makes it something that you want to think through as an entrepreneur, certainly, but as the investor helping the entrepreneur.

Anne DeGheest: 16:57

Yeah, I mean people need to understand the viewpoint of the players. So, for example, if a nurse has to do something extra, you have to do something for the nurse. They're overwhelmed. I mean they get interrupted every six minutes.

Rajiv Parikh: 17:09

They have a super hard job.

Anne DeGheest: 17:10

So if you ask them to do something extra there, you better do something that's good for her so that she's your champion there, and if you ask the pharmacist to change what they're doing, then you better do something for them too. In this case, we make sure they didn't have any fraction there, and at the time it was like $10,000 per fraction per person. Oh my gosh, that was expensive. And so you really need to go deep dive and spend time with the players there. You know, observing them, following them, talking to them At the time, for example, I remember this is in the 80s when we tried to turn around Pixis is that I flew to Florida in the middle of July and August and one of the tradeshow that was for VP of nursing. I was the only person from industry at that conference.

Anne DeGheest: 17:49

This is a long time ago and I spent time with them and understood their viewpoint. I understand they challenged in budgeting and then there was being unhappy and not being able to find nurse and the turnover and the extra time. This is their real life. Then you put the value proposition down. This is I'm going to save you money, making nurse happier, and you take away that hassle. There's no brainer when you see it from that perspective. But you have to invest in learning their viewpoint and I think every problem as an entrepreneur you need to do that. Healthcare is complicated because we have this conflicting stakeholder. We have conflict of interest between them and you have to navigate. You know how you can make a win-win for each one of them, which may be extra features for the different stakeholders.

Rajiv Parikh: 18:27

I think you were at one point calling this the series B crunch, where you have the earlier stage ones and then you have the company gets to a certain point. You're trying to sell it to the market. It's a mid-delayed stage kind of companies. So you have to navigate that whole continuum as part of getting your product to market, and even you as the investor need to see that entrepreneur has that capability.

Anne DeGheest: 18:47

Yeah, I always say, for me, the definition of success is to find an entrepreneur who has a flexible mindset, and the reason is that there is no straight line in entrepreneurship. It's a whole bunch of zigzag with, you know, step upwards and then 15 step backwards at time, and so you need somebody who is comfortable to be able to make decision with 20% of the facts, because it's more important to move the ball and learn more, as opposed to people who are in big company who have learned that If you do that, you're going to get yourself far pretty quickly and you bid for, collect 95% and get consensus and all the things like that, which is a very slow decision process. In the startup, it's important to have something that works and getting feedback as long as the life of the patient is not on the line, and then you learn and you're just incorrect. It also means you need to understand that when something doesn't go wrong, it's not a mistake. It's not that somebody you know did something wrong, it's just you learn something new that you did not know before and you are just incorrect. So the leadership of managing those people and the type of people you are is very important If you get people with very analytical needs data, very judgmental there. They cannot survive a startup because you have too many of these change of direction based on your information there. So it's the culture that you create the ability to correct.

Anne DeGheest: 20:04

When you start, it's total chaos, because that's when there's one or two people, that's what it is. And then over time you start building some structure and you're trying to get organized chaos. And when you get to that series B we're talking about this is when you need to put more structure in place but still keeping that flexibility of adjusting and correct as opposed to freezing. And you see, a lot of company right now are blowing up and we saw the same thing during the dot com because there is a ton of money thinking they were scaling up and they hadn't fully figured out the cookie and the cookie model. And then they were forced by the investor because, as they pay huge valuations there and they have a lot of money, they say scale up, freeze the process and scale up.

Anne DeGheest: 20:40

And guess what, If you freeze the process and scale up something that's not hard in cement at the bottom there, it collapses. And selling to a hospital right now used to be a two year selling cycle. Now it's probably even longer than that. Payers have the same thing. Payers know one word no, they don't pay. We see the whole digital therapeutic.

Rajiv Parikh: 20:57

The first answer is always no, right, yeah, yeah, I mean, that's the thing, and the first answer is no, and you got to work your way through it and I think you even alluded to there was this moment where, up to 2019, and there was a certain market environment there, certain capital environment, it exploded in 2021 into slightly into 2022. Then it came crashing back down, right. So I wonder from your perspective because I know from your process you're very disciplined about how you invest or how you guide people to invest there's like this overhang where so much money got pumped in. I doubt the ideas were all of a sudden better in 2021 than it was in 2019 or today. Right, the funding level went up four to five X in the field and then it's come back down. So you must sense it and see it. Do you feel that there's after effects to it, and how does that play out in terms of the innovation that you see happening all the time?

Anne DeGheest: 21:47

This is what's called déjà vu. I'm French, I have to use that word, deja vu all over again. It's the whole thing from the internet all over again. There was the same craziness there. So, where people could do no wrong, they were being given $50 million check without really the level of validation you normally would have at valuation. That were very high. And now what they're discovering is that you need multiples of revenues to get to those valuations. But they don't have the revenues yet and those revenues are the selling cycle, especially in healthcare. So a lot of these companies are doing what's called bridges and extension.

Anne DeGheest: 22:17

There was a very interesting report that just came out I think it was the old Silicon Valley bank that 30% of the medical device were down routes and pretty much 70% were flat or extensions. And most people are not doing new investment. And so this is the chicken and egg problem we have lived in the past, which is that everybody is anchoring their existing portfolio companies. They are prioritizing and doing triage into. We have to keep them alive because we have so much money in. This is. We have a tiny bit of money.

Anne DeGheest: 22:42

We can let it go if need be, and the one we don't know. Well, we have to see how they progress, and the problem is that if company A, b and C, my judgment may be different than your judgment. So when a company is looking for more funding there, nobody wants to do a down route because their valuation is too high, because they could not grow the revenue to the crazy stuff that people were expecting. And so you see all this bad language called pay to play down route, full ratchets, all the ugly stuff that have happened in prior cycles they're all back. We had one deal there where we retroactively got full ratchet.

Rajiv Parikh: 23:15

I had never seen that before you put in a full ratchet after for anybody anybody who wants to know this as a as an entrepreneur who went through my company took a while. Of course, like all med companies take a while to get off the ground and, while they get funded, a while to build your product or get acceptance, etc. I went through 2008, 2000,. Which was miserable for my company and for anybody who knows. Full ratchet means you, as the entrepreneur, are screwed.

Anne DeGheest: 23:38

I'm not sure it's fully defined that way, but that's the consequence, okay.

Rajiv Parikh: 23:41

So for me as the entrepreneur, I was like oh God, I'm screwed, because what happens is a down route, means your valuation from the last time to this time is less, and who gets their money back first is the investors. The way these contracts are written and you can't really avoid it, that's just the game, and because there's so much risk, that's the way.

Anne DeGheest: 23:59

Well, if it's even worse than that, there is what's called liquidation preference.

Rajiv Parikh: 24:03

Yes, liquidation reference.

Anne DeGheest: 24:05

I can get two to three x my money back before common gets a dime.

Rajiv Parikh: 24:08

Yes, so there's even more pain. There's so much pain in it. So the key, as Ann suggests here, is, when you go for your investment, maybe you go for a quote unquote more reasonable valuation so that later on, when things happen, you don't get slammed like this. Sometimes people announce victory for the valuation that they get and the valuation actually means nothing until the end.

Anne DeGheest: 24:32

I am totally 100% with you. I always tell the entrepreneurs success is defined with the common worst a lot of money. Because if you're worth a lot of money, preferred makes does very well. But success is not new valuation. Valuation has no meaning. It goes up and down like a yoyo and I think a lot of people are learning this the real hard way there. A lot of people still don't understand that.

Anne DeGheest: 24:52

And the other thing that also happened is the tech investors became as well as what's called tourist investor. Remember what I said at the beginning. There, their business models they're like the hunter versus the farmer. Let me explain that. So in traditional healthcare there pretty much every deal you will only know this succeed by the time you go for the FDA and you go to market and that's when you get acquired or you basically get some early sales. So you need all of them to make it because you have the full 50 million dollar investment by that time. There In the tech side that's the farmer concept you want yield of your crops. Everyone has to produce. The hunter approach is the traditional tech industry, which is 70% of my investment, will bust. I won't make any money there. I'm looking for that big LFN or that big Tiger which you're looking for, to basically pay for the rest of it. So my job is to continuously hunt for that big one or two that's going to give me that 20 returns. I justify the rest, and the rest I don't pay any attention to them because as soon as I put you into the category will not make 10 to 20 X. I won't pay attention to that.

Anne DeGheest: 25:49

In traditional healthcare you have to pay attention to all of them. So the type of investor you have is essential. You really want an, in the best of all case, on your board. You want people that are here to help you, and the way they help you there is that they have an operating background. So when you go for the ups and downs of zigzagging, they have been through it and they can tell the difference between it's normal versus something is really wrong here.

Anne DeGheest: 26:12

The second thing is that you want people who have an expectation, are aligned with you. If an investor comes in there to say, fine, I'll give you a 200 million dollar valuation there and I expect you to get 30 million dollars in sales next year, even if you have the cure for death, it doesn't happen that fast in healthcare. So you want people who are aligned, with what's called realistic expectation, because guess who gets killed? The first one after things don't go the right way is the CEO. They have a 50% life expectancy of 18 months after the service B. I mean, that's what some of my big VCs were telling me in the study that they did around here.

Anne DeGheest: 26:46

So you want people who are aligned. They understand what you're going through. They understand the business models you're going through. They know it takes two years to get to the payers, but then it's very sticky there. They know what type of data you have to collect to get to the payers there. They know that you just don't get a new code. I mean, the average code in healthcare takes five years to get to get coverage. And even if you get a code, that doesn't mean they pay for it, which is what digital therapeutics is learning right now. They're just all blowing up, some of them at 500 million dollars in fundraising, and this is a huge amount of money.

Rajiv Parikh: 27:17

And, like you say, even with all that money, it's a whole nine months baby, nine women.

Sandeep Parikh: 27:21

Exactly, it's your not.

Anne DeGheest: 27:23

It doesn't change them. They have the ultimate power.

Rajiv Parikh: 27:25

It takes time right. So you talked about all these amazing challenges that we have to deal with as the entrepreneur, but there's a reason you're doing it is because you want to make a difference in the world. So for you, you go back to your background. You have masters in business engineering. Then you got your MBA. Did you always know you wanted to be in tech, or did you always know that you wanted to eventually do something in health tech, or did you discover the passion as you went? By the way, you strike me as an always passionate person, so maybe you're always passionate about whatever you did.

Anne DeGheest: 27:54

Thank you, I should have you my PR person.

Rajiv Parikh: 27:56

I'm pretty good at that.

Anne DeGheest: 27:57

Well, I'm the ultimate. I was honored at the computer museum and they asked you to use one word for yourself and I said that's kind of an interesting exercise if you think about it. So, whatever came to your mind, that's your word, so I'll let you decide to share it or not. In my case, I came up with a word fearless, and what I learned is that I came from Belgium originally. There, and I was told women don't go to engineering school, and especially that one, because it was the best one. Of course, I immediately went there as a result of that.

Rajiv Parikh: 28:23

That, for you, probably was the moment. I'm a good career and I'm very good.

Anne DeGheest: 28:27

And then I was told don't go to Harvard Business School because that's not for you. At the time they were barely 9% women there at the time. So it was kind of early days and of course I went there. Then I discovered you all spoke English, so I had to learn English.

Rajiv Parikh: 28:38

At Harvard Business School 50% of your grade for any classes, your ability to discuss the case.

Anne DeGheest: 28:43

So there were some famous moments there where I couldn't explain what I was trying to say. So I literally got up, went to the blackboard and started writing all these things there. That had never happened before. I couldn't explain in English what it was. I was correct, but it was like people say, okay, who is she? And so my point of view is that I'm fearless and I've learned that at a time you can ask.

Anne DeGheest: 29:02

80% of the time they say no, but the other 20% that allows you to do things you didn't think you could do. So always try, because rejection is the way you respond to the situation there. So if you take that mindset and now you apply this to entrepreneurship, there is no rejection there, because you always learn something. When somebody said no to selling your product or getting fundraising, because as an entrepreneur, you have to continuously sell. You sell to other people to follow you, to do the job and, not having any idea if you can pay their salaries in six months, you have to basically sell to the investor. These are your first big customers. Then you have to basically sell to your vendors so they agree to work with you, then to the customers. I mean, it's a constant there. Every time you learn something. So if you take that mindset that every interaction, every rejection, every venues is a thing that you can learn from, if you have that mindset, then you can accomplish anything.

Rajiv Parikh: 29:51

Is that why this notion of sales and this is something a topic we've talked about in other of my podcast episodes, so this is great that you're talking about it Is that why you went into marketing and sales out of business school, because you felt like I needed to hone this capability?

Anne DeGheest: 30:06

No, no, I did not have a grandiose plan to save 6 million lives. Let's say this way I had no idea what I want when I came here is that I got open discrimination in Belgium, and so I said I should try to see if I can stay in America. So I took a job. I got like 10 offers but one was with a green card. So I said, okay, I'll go there. And that turned out to be a company called Raycam and I started there and I put me in finance, quickly discovered that's not where the action is and I said I want to be in sales. I said we've never had a woman in sales. This is a Fortune 500. So I said, fine, I'll be the one. So then they gave me. This is kind of how you can take lemonade and make into something.

Anne DeGheest: 30:37

Very valuable is that they put me in an area, which was the early day of the computer and telecom industry, where I had no customers and no product to sell Not much, let's say this way. So I couldn't screw up. And then my boss was just leaving me alone because I was an embarrassment that he had the woman in sales. That turned out to be the blessing of my life, because since I had nothing to do. I went to all the trade show of my customer, which was the IBM, the RON, the National Semiconductor, and I took to the marketing people to say what is the biggest problem you have with your product specs right now? That creates problem for you to sell the product, which nobody has ever asked them that. They told me they had the problem with certain things. So then I went back to engineering and I said listen, you know who I am.

Anne DeGheest: 31:17

I had broken English, so my English was still not perfect. I said but I'm working with your competitor on this new technology that's been used for NASA or the military, which is what Ray Kim was at that time. We think that it's something interesting. I know you're very busy, but is there somebody under you that would be interesting to talk to me? Of course, they always say yes to that. Then I showed up there and then this was the time when the 49ers were very successful and they say who is this woman? They let me wait into the reception for half an hour or something like that. Then I said oh, did you see Joe Montana? By the time I was finished I was a whole tour of the place and they told me all their problem. I went back to R&D. I designed product and I went back and sold the product. It was forced to learn that the hard way, by myself. That skill set is what I use the rest of my life.

Rajiv Parikh: 32:01

So that your ability to throw yourself into a problem, not being afraid of being thrown out and then asking questions along the way and then discovering as you go, having an open mind and discovering and then bringing that problem back and being persuasive about it, then the other thing you're learning in sales is that, especially in tech sales, is that people don't buy based on specs.

Anne DeGheest: 32:22

they buy based on who you are and if they trust you, if you speak their language and you speak about their pain point and they're going to take a risk with a product that's still unproven. In my case, I wasn't even building it. You says I will be there. So every time there's a setback, I was always the last person to get the shipping because I was the annoying woman. So I had literally I was driving down I see the Convalidated, with my truck, loaded with all the parts that Rome wanted to wait because we shut down the production line of Rome because they hadn't built the product fast enough. You go out of your way to do everything you can for your customer, their loyalty and their trust. I never discussed the price of the product until I send a purchase order.

Rajiv Parikh: 33:00

Because you were here and you felt the need and you felt you had built up the need so strong.

Anne DeGheest: 33:04

Yeah, I mean that one is a funny story I can share it. So at the time a company, raychem had bought another company that had waterbed heater. So they had this technology where they could change the polymer property to generate heat. I says if you generate heat you change the conductivity of the material. That more you can have like a fuse that turns on enough. But when the fuse blows up you have to replace it. So if you have a telephone switch in small to medium-sized businesses there you don't want to have your design with all the fuse in the front. That's terrible design. Plus you need to send somebody to fix it when the telephone line goes back. So I says why don't we have a resettable switch that you can bury it in the back of the design? That concept.

Anne DeGheest: 33:39

I was capturing the value of the whole workflow just with that one little product there. I was replacing a five cents part with a five dollar parts but the value was that I was enabling them to sell millions of dollars in the market. That was unhappy with the fact that the design was not manageable for a plug-in play market. I understood that because I talked to the marketing person. I said what is your problem? Then I basically took to the engineers to find out what the reason of the problem was. Then I took to my engineer.

Rajiv Parikh: 34:04

Then you took it all the way.

Anne DeGheest: 34:05

Is there a technology we can modify? So we use waterbed technology to sell to the telecom industry a resettable fuse?

Rajiv Parikh: 34:11

Now I see the roots of it. So that's why, eventually, you coined the term health tech, because you saw the ability of using capabilities or developed technologies to solve bigger, more interesting ones, so that in Nelcor you had a similar situation with the nurses and how people are managing health care. Then you also see that in a lot of the other companies that you were either an executive in or in the ones you're funding.

Anne DeGheest: 34:34

Yeah, you're totally right. That's why you asked me earlier. Mindset is to be curious and continuously try to put yourself into the shoe of the person that has a major role to play in your business model there. Show empathy and spend time with them. Talk to more than one Just to make sure that you have diversity there. Then it becomes obvious. Very often people cannot articulate the real reason of their pain or they take it for granted. Like in anesthesia, people assume that 50,000 people every year should die from anesthesia errors. Now we show that now there's a solution to fix it. But we had to be very gentle when we went to market, not to blame the anesthesia. It was on their fault. They didn't have the technology at that time. Now it was there and that's how we became the standard of care in two years, which is unheard of Just incredible Now. We worked really hard for that. We did a lot of things to make that happen.

Rajiv Parikh: 35:17

So do you feel like you led yourself into these, or was there some point in your life, like you've been a CEO of your own advisory firm? Was there something that sparked you in terms of an advisor, that you worked with, a mentor, or were you just generally? Was this something your parents did? Is this what got you to these amazing moments in your life?

Anne DeGheest: 35:36

I quickly learned that when there's a wall in front of me, hitting myself against the wall multiple times doesn't really help, and I had to go under the wall, blow up the wall, jump over the wall or do things that are non-traditional there. And I started that when I was really young. I think I was like seven years old and I was born in February there, so I would have been six months before, six months after, you know, in the age of the things. I went to school early, so I was always the young body in the cream. So they had decided they want me to repeat my second year of elementary school or something like that. And I said, no, I didn't that back raise, I just wasn't working very hard, and so they pissed me off so badly. I says I want to continue, but they forced me to go in different class. So for the first time in my life I worked and I had like top percentile there. And then they said you see, I told you I was smart, and then they brought me back to my old group and then I cruised again, and so I had this moment when I was really young to say that it's up to me, these people aren't fair and that's the way life is getting used to it and I understood their role and what was the criteria for me to get what I want. I wish to go back to my friends and you know I showed them I could do that.

Anne DeGheest: 36:34

When I finished high school, I had the same experience. I wanted to go to this university to get his engineering degree and I was told by my professor that this is not where women should go and I should be a social agent or something like that, and I said I will embarrass them. I said that's bullshit, that's not, that's my life, I'm not there. And so I went there and they scared me enough because this was a program there where in the first year we had 500 students coming in and they basically eliminated 90% before the exam in June. It was just like machine gun types in mathematics, physics and chemistry and if you didn't have the average there.

Anne DeGheest: 37:05

So the first time I worked and for the first time in my life I ended up being this what's called a sectional value on the normal curve distribution there, like the one I was of the chart. But I'd never been in that situation before because before that was just cruising, and I learned that when I apply myself and I'm driven there and I could do amazing things. So I started believing in myself and then I did the same thing to go to Harvard Business School. I said this is not where women should go, especially because I had no English, and I managed to track down all the professor from Harvard Business School where in Europe I'd contact them in France and Switzerland and says listen, you don't know where Belgium is, but I need your reference there and it was so amazed by that they let me in without speaking English.

Anne DeGheest: 37:42

Then I got a phone call.

Rajiv Parikh: 37:43

They're like look, if she's gonna go this far, she's obviously gonna change the game here. That's probably in their head. They're looking for leaders, right?

Anne DeGheest: 37:53

So they're just looking for someone else, but they're looking for people who just don't get stuck in the same pathway and everybody else. If you think about people who are successful in whatever, it is not only entrepreneurship, but everything else in their life is people are looking left, looking right, looking in front of them and just say, okay, this is not working. What can I do differently, as opposed to feeling sorry and putting blame and anger which we have, unfortunately, a lot in the US right now is that people are trying to find for a solution and be creative about it, and the more you're successful, regardless of what the challenge is, the more you believe there's always a way out of this mess.

Rajiv Parikh: 38:23

So was there like a parent, a mom or dad? That was all about this. I love how you say well, I was cruising, and then when I had the opportunity to jump or when I got punched, I decided to punch back even harder, right by jumping ahead and showing them what you could do. Was there someone in your life like that? You saw that and you say you know what I'm gonna model that?

Anne DeGheest: 38:42

Yeah yeah, it's an interesting question. My mom during World War II. She wanted to go, after the end of the war, to that specific university. So I went to, which is very prestigious, and they told them that you know, all the soldiers were coming back from the war and was only men. Only men were allowed to get in that university there.

Anne DeGheest: 38:58

So she tried to take some of the free class, because it's a public university there, but she could not pass the exam and get the degree. So she was always frustrated by that really open discrimination she had. So when I expressed the desire to do the hard stuff which is Latin mathematics and trying to go to that school and all the other things like that, she was very supportive, despite the fact that people telling me I shouldn't do that. You know my own professor would tell me I shouldn't do that. You know I was not my role, and so she was supportive to say whatever you want to support you, she didn't tell me to do that and I think she was when I finished, summa Cum Laude, number one of my promotion there five women, that's so loud.

Anne DeGheest: 39:32

She was probably, you know. Part of that was to try to show that you know, thank her for what she had done there. So what I learned is that it's all comes from within and you need some good mentor who was supporting you. But at the end of the day, it also to be driven from inside yourself and be accountable. If things don't go your way which, God knows, I had a lot of things that didn't go my way you just take a pause and find out what did I do differently, what should I do differently the next time? You know what are the lessons learned, as opposed to blame, feeling sorry for yourself or whatever it is. So I think that's just an attitude in life. That's why I call this the flexible mindset, and that's for everything in life.

Rajiv Parikh: 40:07

You know what what you talked about actually motivates my wife. I get to see her every day like this because she's also an entrepreneur, and the biggest thing you can do to her is tell her she can't do something, and she will then find a way to bowl you over and knock you over. I see this energy in so many amazing women that we talk to, and we actually have a quiz for you. Yes, you're entering my zone now, since you are such an advocate of people who are making a difference, and many of them are women, and so Sunday's got a whole game for you. We have a game sort of based on.

Sandeep Parikh: 40:36

You know women entrepreneurs listen my wife as well is starting her own business. Can't wait to share this podcast with her because what you've already talked about is so inspiring and we hope to sort of pass that on. Part of this is like about the current setup and the current situation for women in the US in particular trying to start businesses, and in our research about you, it's been clear that you've been very passionate about clearing a better path for female entrepreneurs. So here's a little multiple choice game to help educate our listeners on the state of female entrepreneurship. Are you ready? Yeah, okay. So question number one what percentage of small businesses in the United States are owned by women as of the latest available data? Is it A, 10%, b, 25%, c, 40% or D? Just shy of the percentage of people who don't use their gym memberships?

Anne DeGheest: 41:20

Well, if you incorporate small businesses which are not venture back types, but you know, it's all in 40%.

Sandeep Parikh: 41:26

Ding, ding, ding. Exactly right. The landscape of US small businesses rapidly changing, with approximately 42% of all businesses being women owned. That's right. So the last two decades have seen a more pronounced increase in the US. This kind of surprised me. Women went from owning about 26% of businesses in 1997 to over 40% now, so there's been a nice growth. And from what I read as well, that COVID-19, the pandemic, had a role in this growth. With a bunch of women facing job losses or seeking greater work-life balance, they turned to starting their own businesses, and half of the new businesses formed during the pandemic were started by women a substantial rise from 29% in 2019.

Rajiv Parikh: 42:01

That's an incredible leap.

Sandeep Parikh: 42:02

That's wild right. So one for one. Anne's doing great. Question number two according to research, women led startups generate how much more revenue per dollar invested compared to male led startups? On average, it's already given that they generate more. How much more Is it? A, 10 cents more, B, 63 cents more, c, $1.17 more or D enough to buy a latte in the Bay Area. More, which is, I believe, 12 dollars.

Anne DeGheest: 42:26

I'm not sure what the sense is. I know it's 20% more. I don't know how you sense. I don't know how. Is that a dollar investment?

Sandeep Parikh: 42:31

So per dollar yeah, or per dollar. It's per dollar invested. How much more do women led startups make than men In revenue?

Rajiv Parikh: 42:39

Oh, in revenues.

Anne DeGheest: 42:40

They have higher returns and higher return on investment for the investors, that is for sure, and it's around 20 to 50% depending on the sectors.

Rajiv Parikh: 42:48

Got it. Well, guess what?

Anne DeGheest: 42:49

And it's the same thing for public company, by the way, if you have a woman on the public board and I don't know if that's your next question there those companies have higher earnings and higher pre-racial.

Sandeep Parikh: 42:57

That's right. So it is 63 cents more. So here's the idea is that startups funded by women are efficient at turning investment into revenue, generating 78 cents per dollar invested, compared to 31 cents per dollar invested for those founded by men. So that's where that came from. But I think the point is investors, stop taking your golf date with Ricky and Barry. Start smoozing their wives.

Anne DeGheest: 43:18

I mean, the other reason is, before you ask your next question is that remember what I said earlier women have better empathy in putting themselves into the shoes of somebody else. That's what they do in a family very effectively, and they're also better listeners. And remember what I said you need to spend time with your customers and ask a lot of questions and listening to what they don't tell you. That's how you identify the better problems. So they have, I think, slightly better skills in that area there.

Anne DeGheest: 43:45

The second part of it is that we work twice as hard as the men, and so therefore, we have a bigger output. We want to show you something. We want to prove the world, because we have a lot of open barriers against us. So you find that those people they were the leader of these startups they're there. They have an incredible productivity through it. They also are able to rally teams because we have a lot of this empathy and listening skills there, which, in a startup, is very important there to understand all the different frustration people are going through. So therefore, they're able to have probably a better culture.

Sandeep Parikh: 44:12

Makes a lot of sense. So here's the flip side of it. For question number three, what percentage of venture capital funding globally goes to female founded startups? I'll give you my multiple choice A, 2%, b, 15%, c, 35% or D. Roughly the same percentage as people who enjoy pineapple and pizza.

Anne DeGheest: 44:28

So the question is that is that the women's CEO, or there's women in the management team, or the woman is a founder, there's a male CEO. I mean, how do you define this?

Rajiv Parikh: 44:35

Women founders.

Anne DeGheest: 44:36

So as women see you at 6% and that has gone down in the last few months. If the woman is a founder and there's another team of a whole bunch of other male with that, he could be the CEO and all of that and that number is higher. I know because if you look at the NASD, which is the venture industry, there it's 6% are women's CEO and if you were woman founder it should be bigger than that. Now it has been going down honestly in the last few years. But at the peak I mean 26% of our portfolio of women's CEO. But that's not intentionally, just because we're agnostic.

Rajiv Parikh: 45:04

That's because you're actually just looking at what is going to drive a return and a response.

Sandeep Parikh: 45:08

Well, I'm going to believe in over wherever I pull this. Yeah, I don't want to have data. I can't go on data. 6% I want to take in over this pitch book data.

Anne DeGheest: 45:17

That's in Forbes, yeah, and then you have to be careful with pitch book, because pitch book only take company of a certain size. That gets certain size funding.

Rajiv Parikh: 45:24

That's right.

Anne DeGheest: 45:24

And there's a lot of women at the angel and seed level there that are not on pitch book. I mean their data there is not as good as Series B.

Rajiv Parikh: 45:31

I think the bottom line is it's too low.

Anne DeGheest: 45:33

Yeah, no, I mean we're wasting half the brain of the US.

Rajiv Parikh: 45:36

That's the bottom line.

Anne DeGheest: 45:37

And I simplify a few of it.

Sandeep Parikh: 45:38

This is when the data shows that revenue and profits and ROI generated by female led companies is significantly higher. It seems like the data shows that more investment should be flowing that way. All right, this is a final question what is the top ranking US state for women owned businesses in terms of overall numbers, employment and revenue? Is it a California, b Florida, c, georgia or D New York?

Anne DeGheest: 46:00

Hmm, that one I don't know, I would bet California.

Sandeep Parikh: 46:03

Yeah, that would have been my guess as well. The answer is C, georgia, georgia.

Anne DeGheest: 46:08

Well, are we talking dry cleaning or are we talking text?

Sandeep Parikh: 46:10

Or Idaho, nevada, south Dakota, rank among the top states for women owned businesses in terms of overall numbers, employment and revenue. So the explanation is that these are especially interesting stats because you might assume that highly populated cities like Chicago or New York would have more female owned businesses due to the sheer number of people living there, but in reality, it appears that the less populated cities and states have more women owned businesses and that those businesses are successful in terms of revenue and employment.

Rajiv Parikh: 46:34

I think the coolest part is what Ann talked about, where you have a process with health tech investors whereby you actually are very upfront with people about what that process is like and maybe you could just give like a couple minutes in office of it and the outcome is fantastic because about 28% from what I saw are women founded and run startups and 23% are diverse.

Anne DeGheest: 46:57

Yeah, I mean. So I'm a woman and a minimum you know. So basically I'm unbiased, and so the group somehow gel. Very similarly, you know, similar people attract each other, and so if you look at the group, 33% of our members are female, which is also unusual, and I think over 48% are non-white men. Amazing Diversity there.

Anne DeGheest: 47:16

But that was not intentionally. That's just the type of people who are attracted to basically take risk and try to move the needles and change things, because that's what agile investment is. It's a really high risk and knowing that most of the time you're going to lose your money. And so the other thing our processes were very transparent. If you go to the healthtechcapitalcom website, everything is there the deadline, the dates. You know our process type of question we ask.

Anne DeGheest: 47:38

The one thing we do that's very unusual is that whenever you do fundraising, you never get feedback, and maybe, reggie, if you had that experience you talk to them, they seem interested and then they disappear. You don't know if they're in high-wifing golf and they don't get your email. So they just hate you, you hate your guts, but you have no feedback. It's like a black hole, and so my experience is that half the time, people don't know how to communicate their vision and their story, as opposed to the problem in the business model itself. So when they present to us for the company who gets selected to pitch to us, we give them the feedback on how we heard them, how we assess them when they go through the due diligence process, even if we turn them down, I spend some time afterwards to say this is how we perceive your product risk, your market risk, your team risk, your funding risk and all that. It's our perception. We put you on a low to medium. We get very specific on some of the issue related to business models and we got some great feedback because people say thank God, I get people telling me how they perceive and at the time it's communication style.

Anne DeGheest: 48:34

At the time it's not really understanding. You spend too much time on the technology, not enough on the business models, on who is going to pay, especially in healthcare. It's a big problem Not understanding that your regular treatment may be more challenging than you think it is and whatever all the challenges are. So we invest in businesses, problems and solutions. We don't invest in technology and a lot of entrepreneurs pitch technology. So we give them the feedback because we're trying to be helpful. We want them to succeed, even if we ultimately did not invest at the time. And the reason why that's important? Because at the time they figure this out and then they come back to us and they know who helped them, and so we try to be value added. In the process. We also have been very respectful, because we all have been begging ourselves for money, so we want to be treated the way we were not treated, and so we give them 15 minutes uninterrupted, which is a pretty rare gift if you have done fundraising.

Rajiv Parikh: 49:21

That's amazing.

Anne DeGheest: 49:22

And then we ask them some questions there. We send them questions ahead of time. We don't try to do got you and show how smart we are. We know we're smart. We don't have to show that we want to help and we want to basically give the best opportunity for the person to present themselves and, ironically, with COVID now we use Zoom.

Rajiv Parikh: 49:39

You're probably even more efficient.

Anne DeGheest: 49:40

We are much more efficient and it's so easy for the entrepreneur. They don't have to slap themselves across the country to see us.

Rajiv Parikh: 49:45

That's pretty amazing. I think that's a real gift, that process that you've created and you're clear about what's going to happen, because a lot of times it's just a black box. You send over an executive summary and it's a nightmare. So it's really great that you do it. So I have a couple more questions for you, and one is my daughter has a biomedical master's degree. I talk to her, you talk to her. Maybe you could share if she's looking at the next cool trend that she should go into, because I believe and I hope one day she becomes an entrepreneur like her parents. Where would you guide her? She already has a person who she could talk to, but where would you guide her Because there's so much amazing innovation up?

Anne DeGheest: 50:24

Yeah, I mean, a lot of people are falling in love with technology. I supposed to fall in love with the problem. I cannot repeat myself there.

Rajiv Parikh: 50:30

So right now we have all the problems. To find a problem.

Anne DeGheest: 50:32

Right now with GPT, chat, gpt AI, blah, blah blah. And I said that's just an enabling, a better enabling technology there. Go about. What's the problem you're trying to solve? I think, if I'm talking about the world, I know in healthcare we need to move people outside the hospital into the home to basically allow them to manage themselves better. Prevent, you know, catastrophic situation, avoid the hospital there as much as you can. Here's the problem. The payment system is exactly the opposite and every time we try to change and get value proposition there, where we show we have an impact, these people cannot get paid. So if you basically look at this as a big picture, which is, how can we enable people to be more consumer driven healthcare and from a big picture point of view and somewhere Apple is doing a lot of that, but they're just stopping at a certain level in the severity and take a piece of it and be very focused. Will it be brain cancer there? How can we help these people there? Or something about dementia at home or whatever Then do a deep dive into what is wrong and some are fixable and some are not fixable.

Anne DeGheest: 51:29

If there is no code and for whatever reason, there is going to be really hard time. Take an easier problem. Don't get yourself, you know, beaten to pulp. So I will say go understanding from a micro point of view what is a big problem that, for whatever reason, people are not addressing. Then spend some time on what's the right technology to help you do that. You can always hard technologies. You cannot have somebody to tell you what the problem is. That's your job.

Rajiv Parikh: 51:52

And would you find that in a bigger company? Would you go to a earlier stage company or just have that mindset of asking questions and being open to problem creation? Is that the way to think about it?

Anne DeGheest: 52:03

Yeah Well, that's a different question because I think when you come out of university you haven't really learned the real world. I mean, somehow then they give you facts and numbers, but not necessarily how to work with other people and get things done through other people there. So what's nice about a big company for a couple of years is that they can teach you the industry. They can teach you how to do things. You may decide to break those things afterwards, but they tell you they're good at teaching you the real world. It's called the master in real world evidence and do that for a couple of years. And some big company have structure to do that.

Anne DeGheest: 52:35

Try to do as many different jobs you can figure which one is yours. In my case I did finance, manufacturing, sales, marketing basically, and I was lucky that my first company allowed me to expose to all those different you know specialty in five years. So that was a blessing. And then when I figure what I liked, then I start hunting for a startup, because by that time I had value to bring. If you go to a startup out of university, what you bring to the startup, you're smart. But that's kind of a normal criteria. That's not enough and there's nobody to teach you anything, there's no redundancy in the system, and so it's very important in the early years that you have somebody who can teach you the business of working with other people to get things done.

Rajiv Parikh: 53:13

That's really amazing. That's fantastic advice. I wish I'd take that advice. I actually went towards big company and then went smaller and smaller every time I went. I definitely advise that path.

Sandeep Parikh: 53:22

Yeah, I went the opposite way and I also advise that path.

Anne DeGheest: 53:25

You did it the hard way. Yeah, I did the hard way.

Rajiv Parikh: 53:27

Unfortunately, you took some of my advice. So if you were to pick one thing you'd love to do all the time beyond the job that you're in. You say you're in an alternate universe and you get to do something new and different or really focus in on something. If money is no object and I'm not saying money is an object for you, but if money is no object you have art. You have beautiful art. I know you're into ballroom dancing, I know you're into bridge. You love to help entrepreneurs, start-ups, technology, innovation. But if there's something beyond that or even outside of that, what would you like to do?

Anne DeGheest: 53:57

Well, when I was younger I wanted to be an astronaut, but I quickly discovered that a Belgium female with glasses was kind of a big no-no. I did get the submission paperwork, I did look at it Of course you would, but I had kind of these magic things. I had to be US, male and no glasses, so I couldn't change that. So I mean, I've always liked to explore and be at, not at the bleeding edge, but just before the bleeding edge. That's a good question. I think if you're in your 20s, your 30s, that question would be answered differently than if you're getting later on. So I don't know, I have to think about that.

Rajiv Parikh: 54:30

Well, ann, I got to say you've been a great guest. You've given us so many amazing nuggets of insight. It was just a thrill to be with you today. It's always a thrill when I get to sit and chat with you, but this one is a special one. So thank you so much for sharing your advice, your insight, your experiences. It's just fantastic.

Anne DeGheest: 54:49

Thank you for the great question and, sandeep, I still challenge you sources.

Sandeep Parikh: 54:53

By all means, I'll get you their emails. We can go after them.

Rajiv Parikh: 54:56

We're going to have a source war.

Anne DeGheest: 54:58

After this I'm open-minded. I just happened to be right and you were wrong.

Rajiv Parikh: 55:01

but that's okay. Let me just start with that at the outset.

Sandeep Parikh: 55:07

Perfect.

Rajiv Parikh: 55:08

Thank you so much. Thank you everybody. That was an amazing conversation with Ann. She definitely nails the title releasing your inner tiger so inspiring. I love her descriptor about being fearless. She would coast until she got pushed and then she took it to another level, whether it was in second grade, whether it was in high school, college, business school, going into companies. She just had this fire about her that stems from her mom, actually, and that enabled her to see things in a different way and bring it all the time.

Sandeep Parikh: 55:46

I just love that she was also fearless in her empathy, because I think the scary part about being apathetic sometimes is that there's humility to asking people about hey, what are you struggling with? What's the hardest thing that you're going through right now? What are the problems you're trying to solve Instead of coming in with well, this is the problem and this is how it should be solved. It's this approach to listening and really kind of-.

Rajiv Parikh: 56:06

I love the way you put it. Just because someone's bold, it doesn't mean they won't listen to you. So bold doesn't mean you bowl people over. That means you actually open yourself up to them. Right, there's a boldness in listening.

Sandeep Parikh: 56:19

There's a boldness in being empathetic. I feel like she just absolutely embodies that to the extreme. In a way that's like wow, that is the most powerhouse empathy I've ever seen in action. It's really cool To me. It's transformative. In thinking about the businesses that I'm working on, just thinking about it from the perspective of really trying to identify those problems, really coming at it from a place of what are people, what are my customers, what are my viewers, what do they really need and how can we help solve that. It's really cool, really inspiring. It's inspiring.

Rajiv Parikh: 56:54

I mean, for me, I thought I was a pretty good listener, but the way she puts it together and the detail she goes to in taking that forward, that's the part that I learned a lot so much from just like you. It's just fantastic. All right, thanks for listening. If you enjoyed the pod, please take a moment to rate it and comment. You can find us on Apple, spotify, youtube and everywhere podcasts can be found.

Sandeep Parikh: 57:15

This show is produced by myself, Sundi Parikh in Anand Shah, with production assistance by Taryn Talley and Jesse Deep, and edited by Sean Maher and Matt Greenleaf.

Rajiv Parikh: 57:29

I'm your host, Rajiv Parikh from Position Squared, a leading growth marketing company based in Silicon Valley. Come visit us at position2.com. This has been an effing funny production. We'll catch you next time and remember, folks be ever curious.