Hillary Lin Interview Audio.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
John Shufeldt:
Hello everybody, and welcome to another edition of entrepreneur, where we help health care professionals own their future. Hey everybody. Welcome back to another episode of entrepreneurs X. Today I'm excited to have Hilary Lynn on the podcast. Hilary is a Stanford trained physician and co-founder and CEO of curio, which is a VC backed health care startup. Her research and clinical work has been focused on neuroscience, internal medicine, mental health and oncology. Dr. Lynn additionally advises other practitioners and startups in the health and wellness space. Her mission is to bring transformative, scientific, and accessible change to health care. Hilary, welcome to entrepreneurs. Happy to have you.
Hillary Lin:
Thank you so much for having me today, John.
John Shufeldt:
My my pleasure. So it took us a little time to coordinate this because I suspect you are incredibly busy with curio. Tell people what curio is.
Hillary Lin:
Yeah. So, curio, we're building semi-automated patient navigation through healthcare resources and breaking that down. What that means is we live in a world where health care is unbelievably complicated. And wherever you are in the ecosystem, um, that's true whether you're navigating plans like insurance plans or a single health care system, even figuring out what doctor to see, or even navigating information like educational resources. So we're tackling that problem piece by piece. And the first area that we're tackling is in the cancer resourcing space.
John Shufeldt:
Wow. You probably get these calls all the time. Well, particularly with what you do. But God calls all the time from people asking me to help them. And I'm always happy to because, I mean, I've lived in this world for more than three decades. And the problem is, it sucks. Even somebody who has inside information like I think I do, it still is extremely difficult to weave people through the health care system. Is that what curio does?
Hillary Lin:
Exactly. And you hit the nail on the head. The problem is the United States health care system is particularly complicated, I would say. But I am an immigrant from Taiwan where they have a universal health care system. And just seeing the comparison, we have far more a complicated system. But even in a relatively simple system where payment is relatively taken care of, there's little subtleties about understanding the culture around health care and how it's delivered, even how long you should expect to be, you know, inpatient, for example. That's a very cultural thing. So you have to have localized wisdom and knowledge as you guide people through a system.
John Shufeldt:
I'm about as less of a conspiracy theorist as you ever find, but I often think it's a little bit Darwinian, at least from the health plans, because in some respects, the less you access health, the less they spend. Years and years ago, I was opening up a new urgent care center in the early 90s. So there really wasn't any. And they and Cigna came back and said, you know, you think you're helping by deflecting people from the emergency departments, but realistically, you're just adding mouths to feed, and that just means higher costs for us. So we don't want any more mouths to feed. And it's so counterintuitive to me. So it got me thinking, like, do insurance plans really want us to find the care we need?
Hillary Lin:
Yeah, you are talking about something that is a little bit conspiracy, but also it's just a result of a entrenched system is how I think of it. And the analogy I might put on it is that everyone understands selling merchandise. Say you have a gigantic department store that sells items, and the old school way of thinking about it was, okay, we're just going to hide how cheap it is to buy these things ourselves and then sell at a markup. And that was not giving your customer full information. Lack of transparency and what we see in certain brands like Costco or something like that, is that you deliver transparency as well as increased value to your customers. And actually there's an appreciation of it, but you can only do that with quite a bit of foresight and planning. And the world we live in has both health plans as well as health systems. Working with an immense scarcity mindset. So we're in a world where both these classes of companies, they're desperately trying to make back some of the money that they've lost, especially post-Covid. That's we're near bankruptcy in a lot of cases. And so they're not able to think in that long term view. They're just like, how are we going to make it to the next year? And something I point out, I try not to be too loud about it, because I know that at the core of it, it's not exactly ill will that's causing this. It's just necessity that causes it. But there's a bit of misleading ness and even what some people might describe as fraud and how people are billing sometimes, or how people construe certain services, and that goes all the way on up to the government and as a result, through a cloud of obscured complexity, we end up with an immensely expensive system that seems not to deliver as much value as in similar countries.
John Shufeldt:
Yeah. Totally agree. So I'm sorry we jumped right into it. But let's back up because people are going to want to know how you went from physician to VC backed startup. So where was your undergrad?
Hillary Lin:
I was at Stanford. Okay.
John Shufeldt:
Uh, one of those. All right. Whatever. I saw Stanford once. I drove by it. Okay, then you went to Stanford on the ground and then medical school at.
Hillary Lin:
Yeah, and then residency. So I was there for 11 years straight. Yeah, that's very.
John Shufeldt:
Cool, by the way, I'm only saying that out of harassment and jealousy. Okay. You did internal medicine? Yep. What was your undergrad?
Hillary Lin:
I was a biology undergrad, and I'm also a little bit sad about it because I actually was so interested in too many things and became a biology major out of necessity because I was like, taking too many electives and I needed to be pre-med. And finally, the only major that I collected enough classes in to have the full major in was biology. But I have so many other interests. My original plan was to be a symbolic systems major, which is this obscure, crazy sounding major that is only at Stanford. Think it's old school basically is how I describe it to folks.
John Shufeldt:
Oh that's interesting. Okay, good. That leads me to my next question. Did you take business classes undergrad or entrepreneur classes? Undergrad?
Hillary Lin:
No, I didn't take any formal classes, but I was at the business school all the time. And the reason is Stanford is an amazing place. First of all, I came from a public school system from high school, and then I went to Stanford and suddenly I felt like I was in Disneyland for nerds. So that was cool. And they make it really accessible. So you can go to whatever graduate schools you want, and you can either audit classes. I chose to go the route of doing workshops. I did every single hackathon I could find, and I also joined a part time program called the Ignite Program at the business school. And that was a lot of fun, actually, against the advice of anybody who would advise you in medical school, I took one of the months they allowed us to study for the boards and did that program instead, and it was life changing. I loved it.
John Shufeldt:
So you have some entrepreneurial bent. Where do you think that came from?
Hillary Lin:
It came out of frustration. And I think my inner personality. So to draw it all the way back to my childhood, I grew up for part of the time in Taiwan, and I immigrated to the US when starting grade school. And around that time I realized that I had to take charge of my own life. And that was because, you know, my mom was also an immigrant. She was a single mom. And a lot of times in that situation, you end up leading the household as a child. And through that, it meant that I had to learn a lot about the world that you usually wouldn't have to at that age. And I also got used to getting my own way because my mom, she's very supportive, but she also relied on me to decide what to do. So I got that sort of obstinate bent from an early childhood perspective. And then when I started going into biology pre-med medicine, I became frustrated because it's a very traditional hierarchical structure. So I was just frustrated and very burnt out from the beginning because I didn't like listening to rules and following rules. And so I found myself leaning into this entrepreneurial spirit that was everywhere at Stanford.
John Shufeldt:
So suddenly a first born.
Hillary Lin:
Yeah. Am. Yeah. Yeah, absolutely. I grew up an only child. So yeah. Okay.
John Shufeldt:
So your first and last born. Okay. So you guys moved here when you were in grade school and yet you had that perspective that early. You better figure this out on your own sister.
Hillary Lin:
Yeah. Yeah, I was always curious as well. Which is why, actually, our company is named curio, but I think it's the seed. You need to have a bit of motivation and curiosity to get you started over the hump. And childhood was very hard. I still think back, of course. I've been through med school, I've been through residency, but perhaps the hardest time of my life was childhood. And because of that, I think I had to build up a lot of skills that have transformed into who I am today.
John Shufeldt:
You're sounding a lot like Albert Einstein. He had a difficult childhood, he was immensely curious, and he was kind of an obstinate non rule follower and hated hierarchies. You could be Albert Einstein reborn. I'm just going to throw that out there if you believe in that stuff.
Hillary Lin:
Oh my gosh. Well I'm going to lean into that I love it I think he's a great thinker and this is a totally different topic. But I think we don't give ourselves the space and bandwidth to think as deeply as great thinkers like Einstein. So yeah.
John Shufeldt:
No, totally. I mean, a theoretical physicist with just as mind analogies was just crazy. All right. So you do internal medicine residency. When did curio start ruminating around in your head and when did you take action on it?
Hillary Lin:
Yeah, this is a very long story, as I'm sure many people's businesses are. But my initial thought was in med school and residency. I recognized that we focus so much on the science and on medications and treatments, and finding the optimal treatment for a specific patient. And that's necessary. But a lot of the frustration I had was people would keep coming back with the same problem over and over again. So it felt like I was on this eternal treadmill trying to help individuals. And I didn't like that. And then second of all, a lot of people were still suffering. So you might solve this person's cancer, for example, for today. But then they have an existential crisis because they're dealing with a terminal illness. And I felt like we don't take care of patients well, emotionally. So at the back of my mind, I was always thinking, what is that? And how can we make that more tangible so that we can solve this as a problem? Fast forward into my first foray into digital health. I didn't start with curio. I actually started in a completely different space and colon cancer screening, and I explored a number of other areas like relationship wellness and also sleep health, and eventually landed on what is today curio because I saw the common theme between everything that I was working on was the emotional experience of a patient as they go through a difficult healthcare journey. So that's a long winded intro into how this came to be. And even when starting curio that evolved, there's three major life phases of the company curio. So if you believe in reincarnation of companies, we've certainly been through a lot of that too.
John Shufeldt:
You know what one person calls a failure? The other person calls a pivot. I've always preferred pivot. So what were the three phases or pivots?
Hillary Lin:
Yeah, the very first one was group coaching. And I like to describe the story as an evolution of myself and my wisdom as it's grown from naivete to a wiser founder. And so in the beginning, I was so passionate about community because I saw that most of people suffering comes from things like lack of community and loneliness. So group coaching was where it was at. I was convinced that we needed to solve it. As many people who have tried this know, there are reasons why group coaching is so difficult to succeed as especially a venture scalable type of a startup. So we ultimately decided that was a terrible business model. It wasn't working out even though we ran so many, I can't even count. And we had them in delightful formats, like we even ran improv style group coaching formats. And we had a lot of creative type formats, which I think did a lot for people's community and mental health support. It was lacking a good business model. The second model was we leaned hard into the mental health world and became a psychedelic assisted therapy and coaching clinic. That we did this over a Telemedical platform. It was really exciting.
Hillary Lin:
We built some technology behind it to help keep quality as we scaled, and that succeeded for a year. The reason why we continued on that wasn't for lack of success, it was a lack of a clear growth trajectory. Because, you know, when you're building a VC backed, scalable startup, you want to see that curve. And we saw that it was going to be very difficult in the time and place we are in today for that to happen by the time we needed in our life span. So we made the hard decision to pivot again into a SaaS model, actually. And we brought on a couple of extra teammates and we did have to let go of some others. So a lot of lessons there. But now we are a full fledged tech company. We are building technology products and working closely with nonprofits, patient advocacy groups as well as with patient services. So these are companies that tend to serve more pharmaceutical type companies and digital health and health systems. But as that semi-automated layer on top of a human workforce, we truly believe in augmenting teams and not adding to the manual labor force of a given company.
John Shufeldt:
So the second and the first pivot totally get it. Group based, particularly virtual, scalable and nearly impossible. Maybe possible. As far as psychedelic enhanced therapy. We're using oral ketamine.
Hillary Lin:
We were we were using sublingual ketamine. And we've got it down to a near perfect science actually. So that's something I'm really proud of. And we hope to bring that back in some format yet to be seen. We are actually exploring working with some psychedelic assisted therapy clinics in our new model. So what we did was really cool and I still believe strongly in the movement, but again, it was just a matter of timing and that's one of those difficult bets and calls you have to make as a founder is this whole movement is going in a positive direction, but is it going to do so in the amount of time that you need it to?
John Shufeldt:
Right, right. And how quickly do you get significant growth month over month as you know. Yeah. So now the new curio patient navigation through a SaaS model. Is it a. Driven.
Hillary Lin:
Yeah, yeah yeah. And you know, we are very upfront and transparent. We are not building a new I, we're not building an AI model in particular. What we are doing is we're utilizing generative AI to make more personal. We refer to the term hyper personalization is becoming much more popular in the industry. But hyper personalization to the point of near precision to an individual matching resources to them at the appropriate time in the part of their journey that they need it most. So to illustrate that a little bit better, health care is always a little bit behind the rest of the world in terms of adopting sort of trends and technologies. But the most recent version of personalization and customization of products to individuals has been segmentation. So you understand patient Joe lives in New York City, is in his 20s or 30s, works at a tech company, has multiple myeloma and you kind of understand multiple myeloma tends to look like this. You go through this diagnostic process, you go through treatment, you go through x, y, z. And so you build modular based pathways. For Joe, that is deeply flawed because as any of us who work in healthcare know, every single patient is so unique and everything they're going through is incredibly unique.
Hillary Lin:
So then what ends up happening is you throw humans at the problem. So you have social workers, you have palliative care teams, you have patient navigators, you have services support thrown at the patient to try and solve their individual problems. And that's if you're actually trying to solve that problem. Most of the time we're just we just kind of throw our hands up in the air and we're like, I don't know, figure it out. Go to this nonprofit's website and find your own resources. That's very challenging for people dealing with hard health journeys. So what we are doing is we're making it much more fluid and proactive to deliver resources to patients so that they don't have to do any of the work themselves necessarily. Or if they do, it's extremely easy. It's like anything else in tech, you want it to be extremely easy. And we are also building around the needs of those patient services personnel. So the navigators, the social workers, the patient support programs. So that's the kind of tooling and the adjustment to this entire space that we're working on. Interesting.
John Shufeldt:
So I was just sat on a panel yesterday, and I was shocked to listen to this moderately long debate about, do you need to tell the person that the person they're interacting with is not actually a person? It is a bot. And I said, of course, you absolutely have to be transparent that this is generative AI. And there's a lot of discussion that, no, they shouldn't, because if people thought they were talking to a bot, they would stop and they wouldn't utilize the service. Where do you land on that?
Hillary Lin:
Yeah, I believe in transparency. So I do think that you should tell a person. But on the other hand, I also think using chat bots solely might be a bit overused. And what I mean by that is take us for example. We are using generative AI, but not in the plain most common form of it, which is as a chat bot. We use it to power our searches to make it much more personalized and more appropriate to the user. But the input, and you might have seen this in a lot of products that are coming out. It's arduous to talk to a bot. It's arduous to talk to a person. Actually, even if you're listening to long intake conversations, it's just like question, answer, question, answer, question, answer. And in reality, people don't want to do that all day. It takes forever. There's better ways to drive data collection. And so that's the creative spin that we're putting on. But going back to your original question, I think transparency is key. I also think that patients don't mind so much talking to a bot if if they know and they're still getting value from it, they will continue talking to the bot.
John Shufeldt:
Yeah, they were particularly talking about it in older population and they were addressing mental health issues and loneliness. And I totally understand their point. I just think that when it comes out and it likely will come out, that people will feel deceived and taken advantage of and and that will make it more difficult. When did you start curious? Are you at the J-curve inflection point now or are you sure?
Hillary Lin:
Hope so. We sure hope so. The original curio came out in the deep pandemic, and I have this entire story about how our team came together. Actually, it's such a weird, unique story because it was in deep Covid, but because we pivoted this year, we are still very much a young company, so we aim to make 2024 our year in terms of rapid growth. But we are currently in pilot phases right now.
John Shufeldt:
Is it B2B?
Hillary Lin:
Yes it is.
John Shufeldt:
B2b is the other be health systems health plans.
Hillary Lin:
We work with a number of players. So patient advocacy groups, the larger ones for example, who need navigational support. And we also work with health plans. We have broached the conversation with health systems, but not yet partnered with one yet.
John Shufeldt:
And the idea is to do it on a per member per month sort of basis.
Hillary Lin:
We have a utilization model, but it's tiered, so it's not exactly 1 to 1. But yes, essentially so. Mm hmm.
John Shufeldt:
Do you anticipate taking risk in it? In other words, will you reduce Ed visits. Will you reduce nosocomial infections? I'm making it up obviously. Is there a risk play here?
Hillary Lin:
Mm hmm. We're excited about risk plays and value based models, but actually it's not going to probably be any of our early contracts, because what is valuable in those types of models is having the data and the traction to back it up. So those will probably come into play more in our future contracts.
John Shufeldt:
Interesting. So end of this year early 2024 is basically MVP validation. And then how's the rollout looking for 2024. Do you have a sales team lined up. How do you anticipate doing that?
Hillary Lin:
Oh, we are early company and we believe strongly in founder led sales. So it's largely the founders doing the sales today. And we also view our early customers as our collaboration partners. There are co building partners. So in a lot of ways we don't view it as a traditional sales pipeline that will come once our system is completely set in moulded and mature. But for this early period as we are getting started, it very much is a co-design co build.
John Shufeldt:
Very good. And do you anticipate taking anonymized patient data and then making that available to folks who want to use that to better their service product or what have you?
Hillary Lin:
Yes, and we do that with full transparency and opt in from the patients who are involved, because, again, I believe strongly in transparency. And I also think we live in an age where privacy is harder and harder to get. But our main targets, once we have the data systems in place, are most likely going to be payers as well as pharmaceutical manufacturing companies.
John Shufeldt:
And is it all oncology patients or ultimately do any chronic illness or anything for that matter?
Hillary Lin:
Our vision is to be for any healthcare condition, but today we are focused on the oncology population.
John Shufeldt:
And then Hillary at this point, what's the competitive landscape look like?
Hillary Lin:
It's varied, so there's a lot of people, depending on how you describe curio, who you could say are similarly spaced. I wouldn't say that anybody is doing what we're doing because it's a new capability based on new technology. But for example, in the cancer navigation space, time care and Jasper come up quite often in general navigation, there's all sorts of people that you might consider. Competitors could dive very deeply into it, but they're segmented into their respective industries. What we are building, however, there's no one quite like us because we are very much that tech layer that sits on top of navigation, and we can be utilized in a lot of different settings. So I haven't come across a clear, you know, comparison to us quite yet, but you probably run into a lot of companies who who say similar things.
John Shufeldt:
Yeah, totally. Do you anticipate embedding it or having it sit on top of the cerner's of the world should interacts with the EHRs?
Hillary Lin:
Yeah. So EHRs and CRMs or similar are our eventual integration. So that's right. So wherever you're storing patient data that's where we'll sit on top of in some cases it's an in some cases it's something like Salesforce because you're more in the non-clinical world. But broadly speaking anywhere you're storing data records about patients.
John Shufeldt:
Very good. Give me the idea or give me your idea for what do you think the trajectory for curio is? When do you think it's going to be a sale to a larger strategic? Is it going to be an IPO? What do you dream about?
Hillary Lin:
Oh, well, the dream is an IPO. And to be a highly successful company that continues to build great partnerships. But recognizing too, there's a lot of fantastic outcomes that we can aspire to. I think integration into to a well-designed health system and the definition of a health system is changing day to day, like we have the traditional health systems, like hospital systems that we think of, but now we're seeing like corporations build out their own health systems. We're seeing pharmacy health systems, we're seeing tech companies build out health systems. So there's a lot of eventual destinations that we could land on that would be huge for us.
John Shufeldt:
What's been your biggest aha moment throughout this? You're pretty unique. I mean, you went all the way through down this biomed path. You did some oncology research along the way, but now all of a sudden you're an entrepreneur speaking entirely different language, two entirely different group of people. What was your aha moment for all this?
Hillary Lin:
Maybe it's not a moment in time, but maybe the lesson that keeps hitting me in the face over and over is to swallow your frogs, do the hard things, and I'll give a few examples of that. When I first started curio. I was so frustrated with health care that I wanted to build outside of it, and that's why we were doing group coaching. We were doing a wellness product that was not regulated. I felt so strongly about that for such a long time. And then I realized that without being in health care, you don't have the same impact and you also don't have the same willingness to pay. There's a lot of reasons why you go into health care. So to swallow that frog and do the hard thing to enter a regulated space was what brought us to our first successful version of the company as a tech enabled clinic. And then doing the next hard thing was, how can we do B2B sales? Because, you know, even in a tech enabled startup, we were DDC, and that seems a lot easier to a person starting company. Everyone's like, I understand consumers, I am a consumer I want to build for consumers. So that seems easier. But being a B2B company is quite a bit more intimidating. But we know from looking at other examples and learnings, that's ultimately how you build moats and relationships in a way that builds a long lasting company. So then we learn to eat that frog, and then we're doing that. We're learning that. So maybe there's not a specific moment, but I keep running into that lesson over and over again. It's like whatever you are avoiding, just get it over with and do it because you will be thankful for having done that hard thing.
John Shufeldt:
Yes, Marcus Aurelius, you know, the obstacle is the way. Yeah, it totally is true. Your path usually lies past the hard things and it's always a blessing. But man, it's a total bastard going through it. Yeah, yeah, this has been phenomenal. Where can people find out more about you and curio? Because I think there's been a lot of people who hear your story and what you're doing and want to jump on board or want to be you when they grow up.
Hillary Lin:
Oh my goodness. I hope a lot more practitioners out there, physicians, other health care workers do take the entrepreneurial leap because we need more clinicians who are innovating. You can find more about curio at everything. Join curio. So join curio. Com at Join Curio on everything from LinkedIn to X to Instagram to Facebook. That's our handle. And you can find me on LinkedIn. That's probably the fastest and easiest way as well. I'm Hilary with two L's and Lynn.
John Shufeldt:
Right. And we'll link to this in the show notes for everybody. Hilary, thank you very much. This has been amazing. I always leave these inspired wanting to change the world. So I suspect others do as well. So thank you.
Hillary Lin:
Yeah I hope you and everybody else does it. Thank you.
John Shufeldt:
Very much. Thanks for listening to another great edition of entrepreneur to find out how to start a business and help secure your future. Go to John Shufelt Webmd.com. Thanks for listening.
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