The decisions you’ve made so far have gotten you to where you are.  

However, the decisions that you make now, going forward, don’t need to be and in a lot of cases should not be influenced by what you’ve done in the past.  

Every decision is an opportunity to stand still for a second, look at where you are currently and decide “Right now, what’s the best way forward?”.  


How To Hack Motivation

Entrepreneurs are often described as being highly driven, relentlessly resourceful, focused and unstoppable.  It seems that a lot of entrepreneurs play up this image and talk about how they worked harder then their competitors to get to the top.

Will Smith encapsulated the entrepreneurial spirit perfectly in the following quote:

“The only thing that I see that is distinctly different about me is I’m not afraid to die on a treadmill. I will not be out-worked, period. You might have more talent than me, you might be smarter than me, you might be sexier than me, you might be all of those things you got it on me in nine categories. But if we get on the treadmill together, there’s two things: You’re getting off first, or I’m going to die. It’s really that simple, right?”

Determination and drive are clearly important, but how can “ordinary people” cultivate these characteristics in themselves?  How do ordinary folk with a 9-5 job, a family and rent to pay get started on their entrepreneurial journey.  There seems to be a big leap from just being a driven individual to being successful in life.

Well for those of you who are interested, I think I’ve found a hack!

I’ve been thinking more about this recently as my girlfriend has just passed one of her final exams, which means she is very close to becoming a senior physician now.  I have also now passed all of my exams and am a senior physician.  Interestingly enough, we both have startups as well.  I have an early stage health technology startup and my girlfriend has a non-profit startup which is launching a cancer screening programme in Africa.

So what’s the deal?  How come we are leading such fulfilling, exciting lives while a whole load of others out there want what we have, but never seem to quite get there?

(Just as an aside – I don’t think it’s because we’re particularly smart – I know loads of people who are smarter than us!)

I think that having “drive” and accomplishing things actually just comes down to organisation and prioritising what is really important to you.


How do you spend your time?

If you look at the above chart (credit to Stephen Covey who created it!), it shows that there are four “quadrants” where people spend their time.

  1. Quadrant I = Important & Urgent = The really important stuff you have to deal with immediately
  2. Quadrant II = Important & Not Urgent = Stuff that won’t have an immediate impact on your life right now
  3. Quadrant III = Not Important & Seems Important = that phone call you have to make, or getting down to the bank at some point….stuff that really isn’t that important, but which people generally prioritise higher than they should.
  4. Quadrant IV = Not Important & Not Urgent = Wasting time.  Most people spend most of their lives here

The fact is that most people spend most of their time in Quadrant III and Quadrant IV.  I’ve noticed that my girlfriend, myself and all the successful people we know spend as much time as possible in Quadrant II.

Working out, exercising, eating right, working on your dreams, dedicating yourself to an activity – these are the most important things you could do in life, yet most people choose to spend their time elsewhere.

Most people waste too much of their time on pointless activities such as watching TV or browsing FaceBook (Quadrant IV).

Most people fear things too much.  Therefore they dedicate a large amount of time to things which really aren’t important, but seem important (Quadrant III).

Quadrant III and Quadrant IV is where most people live life.

My girlfriend and I both passed our final exams by NOT going to study groups, by NOT wasting our weekends with other doctors preparing for their exams, I skipped my preparation courses for my final exams as I was meeting with important business leaders those evenings, I attended the minimum number of teaching sessions to pass my postgraduate training and so on.

In other words we didn’t let our fear of things which seemed important (but really weren’t) to get in the way of what’s actually important to us – our dreams and ambitions.

Of course this was a big gamble for me.  My exams cost £2,000 ($2,600) to sit.  If I failed one of my exams I think I would have had to take out a loan from the bank to sit the exam again as money was so tight when I launched my startup.

So that’s the hack!  

I honestly believe that we’ve gotten as far as we have, not because we’re exceptionally smart or “driven”, but because we prioritise what’s important to us.  We know exactly what we want out of our lives and we execute the plan on a daily basis.  Most successful people do the same.  They define their Quadrant II, they identify with it so strongly that they grind and hustle until they’ve accomplished what they want to.  They don’t just wake up one day as incredibly “driven” people.  They just know what they want and go after it – everyday.

The main obstacle for others out there is not that they don’t have drive but silencing the part of their brain that makes them preoccupied with Quadrant III and Quadrant IV activities.  They are a waste of time and although most don’t realise it, these are the activities that eat away at dreams…day…by…day…

NHS Hacked! The Great FHIR Wall Of The NHS Is Broken.

It’s ironic how badly the NHS has been affected by ransomware.  I’ve been having talks with people about this a lot recently.

Right now my startup is jumping through hoops to comply with (outdated) data compliance issues and get access to the NHS N3 network, which is supposedly the NHS’ secure server system.  The actual fact is that N3 is just like any other network infrastructure which is connected to the internet.  And thus it has many access points.

It’s clear to any outside observer how insecure the whole thing is.  The Information Governance aspect of creating software for the NHS is just a case of paying some lawyers thousands of pounds to create documentation.  A money making scheme…

Others who I’ve spoken to, who already have access to N3, are saying that once you’re on N3 it’s very easy to move about from one organisation to another, hack data and plant lots of back doors.

What does this mean for budding NHS startups?  

I think that much like any other NHS issue which comes to the public conscience; an overhaul will be due.  This may mean that any startups who have already engaged in the process of getting access to N3 will have to pay even more to jump through more compliance protocols.  This obviously won’t make things safer, but will look good for the NHS as the public will see that something’s being done.  

My advice would be that anyone already engaged in the process should try and get access within the next three months, which is definitely doable.  Otherwise you may risk having to jump through the extra hoops with no support from the NHS.  

Go Big!

Time is a precious commodity.  I would say that busy people realise how valuable and finite time really is.  There’s so much to do in a startup that it makes you hyper-acute of every hour of every day.

I’ve felt like I’ve been “through the looking glass” for quite some time now.  In my previous lives as a medical student and then as a junior doctor I often felt that I was detached from society due to erratic shift work and chronic sleep deprivation.  I would sometimes observe normal people going about their regular day and think to myself “what do they do with all that off time?!”.

Since starting my startup, I’ve now started to think this way about other doctors as well.  Now that we’re all “Senior Physicians” we have a lot more free time than we did as junior doctors.  I’m busier than I have ever been and most of my colleagues are now starting to tone down their work schedule and get on with doing normal “life things”.  Some of them are moving into larger houses, or getting their kitchens redecorated.  These are things which you’re expected to do once you make it to seniority and have more money coming in.

A lot of the doctors I know are interested in my startup and they seem wistful that they haven’t done something similar.  I always explain that I am not special by any means and that anyone can do what I am doing.  However, I think most people don’t like to accept this.  Most people tend to have the same attitude to doing something big with their lives as they do with fitness – they have the “some day I’ll do it” attitude.  Usually people only come to understand that it’s too late when their in their 60’s, tied down with loads of liabilities and have diabetes before they realise that their opportunities in life have passed them by.

What I find interesting is how effort is created equal.  The effort it takes to get fit or to start a business is the same raw effort it takes to organise a party, redecorate the kitchen or buy a new house.  It’s difficult to say why more people don’t take control of their lives and accomplish that big dream of theirs.  I suspect there are a myriad of reasons why people don’t, just like how people give a myriad of reasons to not exercise and get fit.

“Effort is equal” has become a bit of a mantra in my mind and it’s steered my startup correctly so far.  There are a ton of decisions to make in a startup and there have been days when we have restructured the revenue model two or three times!  But when it comes to decisions about the direction of the company we’ve noticed that it’s often best to pick the harder option.

If effort is equal as we believe it is, then you might as well pick the perceived harder option, because it will be just as hard to accomplish as the perceived easier option.  We’ve realised that not only is effort equal, but very few companies pick the “harder” option to execute on.  Whenever we pick the harder option it puts us in a category of our own and this results in less and less competition.  This has resulted in our product being completely unique in the market place.  Because we’ve had the guts to go big and tackle larger problems – problems that other companies have been too afraid to go near in fear of failure – we’re getting more and more momentum.

Inventor Or Entrepreneur?

A common theme in this blog: Definitions are important.

A lot of entrepreneurs I meet conflate these two terms in my opinion.  Entrepreneurs are not inventors of technology.  Entrepreneurs are problem solvers and sometimes we use new technology to solve problems.  But we don’t go out to make new technology for the sake of making new technology.

Inventors make new technology for the sake of making new technology.  They often don’t think about how what they are creating can be used in the market place to make a profit.

I recently had dinner with a scientist working in a startup.  He’s got millions of pounds of funding which is a dream for him because it means he can do what he loves all day – continue to work on his inventions and carry out studies.  He’s a very happy man and is very content with the amount of money he is being paid.

I was blown away by what his small team of people are accomplishing.  It’s basically a transdermal medication medium.  This means that he’s very near to figuring out how to put a number of medications into a spray so that people don’t have to take oral medications or intravenous medications.  This would be revolutionary.  The number of drug errors that occur, the difficulty of getting intravenous access in the hospital setting, the amount of disease that is spread via needle sharing / using needles more than once in developing countries would all be solved.

Here’s the thing.  He has backing from a bunch of entrepreneurs in America (I won’t name names, but two of them are well known billionaires) who have very little knowledge about the science behind what this team has actually created.  These entrepreneurs are the people who are going to capture most of the value that is being created.  The scientist may never get really rich.

This illustrates how the world works.  Entrepreneurs are the ones who capture the value and get rich.  Inventors generally don’t tend to get rich and get used to make other people rich.

History is littered with inventors who didn’t get rich even though they may have contributed a lot to society.

Einstein hardly captured any of the value he created.  He was upper middle class at best.

Tesla died poor.

Thomas Edison was poor.

The list of successful inventors who died poor is endless.

This is why conflating the two terms is so dangerous.  Inventing something new isn’t where the value is.  Using inventions to solve problems in the market place is where the value is.

I think that this conflation of terms is one of the main reasons why inventors and technical people get confused and don’t end up rich.  They think that just because they can create an app or make an invention that they’ll somehow get rich.  This isn’t how the world works.