Build Something A Few People Love

 “It’s better to make a few people really happy than to make a lot of people semi-happy.” – Paul Buchheit

This is a common saying amongst tech entrepreneurs.  Successful tech entrepreneurs have noted that something which a few people really love is always better than something which only a few people merely like somewhat.

This has made sense to me ever since I heard it.  It seemed like common sense: If you make something people merely like a little bit then if your product or service dies or disappears then no one would really care that much.  And if you make something a few people really love then it is likely that more people will think it’s “really really good” or just “really good”.

But I’ve thought about this subject a lot deeper and after reading some of Nassim Taleb’s* essays and books, I think I was missing a key insight.  The insight is that minorities, if vocal enough, often win and impose their beliefs and wants on other people who remain indifferent.

Let’s take the example of GMOs and Non GMOs.  If we have a family (mother, father, son and daughter) and the daughter decides she is staunchly opposed to GMO foods.  It is likely that the rest of the family will cave in and everyone in this family will start to eat non-GMO foods to placate the daughter.

As there isn’t a massive price and taste discrepancy between GMO and non-GMO foods the family doesn’t mind eating non-GMOs.

Now let’s say that this same family attends a party.  The host of the party will be informed that the whole family doesn’t eat GMO foods.  The host decides that it would be easier to make all the food at the party Non-GMO, rather than making separate dishes for this one family.  After all the price is pretty similar so shouldn’t effect the budget of the party by very much.

All of a sudden this large party of say 50-100 people are all subject to eating Non-GMO foods without even noticing and more importantly this large group of people don’t even care!

As a result of this party, local vendors will start to realise that they can increase their profits by selling Non-GMO foods.  As a result, a large part of society is made to eat Non-GMOs despite not caring much about eating GMOs.

There are two things at play here.  First the cost different between GMOs and Non-GMOs is not that much.  Also, there is an asymmetry present in this example: The people who won’t eat GMOs will not eat GMOs under any circumstance – they are staunchly opposed to it.  However, the people who eat GMOs do not mind eating non-GMOs.  When this asymmetry is in place, the minority can overtake the majority and impose changes on everyone.

Halal (Muslim approved food) is another example of an asymmetry.  Apparently a large proportion of the meat imported to the UK is Halal.  The asymmetry is present – non-Muslims don’t really care what type of meat they eat, but Muslims won’t eat anything but Halal.  The price of buying Halal meat will also be pretty much the same as non-Halal meat.

McDonald’s is also an interesting example, which is relevant to business.  Everyone I know of has had some sort of McDonald’s food at some point in their lives.  In fact when I go on holiday these restaurants are often packed with foreigners as a respite from exotic food or the possibility of contracting some type of food poisoning.  The fact is that society is largely indifferent to McDonald’s – no one really hates McDonalds – whether upper or working class, no matter which country they are from.  So, we can all agree that McDonald’s doesn’t make the best burgers in the world, but no one really hates them either, which means that people still go.

Now to turn this conversation back to business.  I am wondering whether this effect is what plays out in successful startups and makes business spread.  1 – Do they have a core group of people who love the product, 2 – Is there an asymmetry where people adopt a certain technology/service, refuse to give it up and therefore force people to also use the product or service and 3 – are the rest of the people who end up using the startup indifferent to adopting the change.

Thinking about different startups, I really do believe this is closer to the truth than I had originally thought.

If we take Google as an example.  I cannot even remember when I made the switch between Yahoo! and Google.  It just seemed to happen and I became just another user – I was indifferent to the change.  It is likely that when Google first launched, there were a core group of users that loved it and refused to use Yahoo!.  There was an asymmetry here – Googler’s refused to use other search engines.  The rest were indifferent and the switch to a different search engine was easy to make.  As a result Google spread, when people started to simply set the homepage as Google, no one was staunchly opposed to using Google/in love with Yahoo!.  This is probably how I made the jump without even thinking.

Moral of the story?  Make something people love!  This way, to create a massive success you only need three or four percent of converts to start using your startup instead of penetrating the whole market.

Good advice after all it seems!

* However, Mr Taleb was mainly talking about how this insight effects society, rather than startups and entrepreneurs.



















NHS Startup Part XVII – The End

Gosh, it’s been a long time since I posted about my startup.

I’ve decided that this will be the last blog post which talks about the minutiae of my startup and the challenges a new company in the healthcare scene has to face in the UK.

The reason this will be the last update is because the specifics of my startup are not helpful to other entrepreneurs / healthcare innovators out there.  The fact is that everyone will have to traverse a terrain which is different and face challenges which are different.  This I have come to realise is why so much advice surrounding entrepreneurship is so general.

“Solve a problem”

“Expect the unexpected”

“Provide value”

“Make connections”

These platitudes may seem clichéd and obvious, but they are cliched for a reason – it’s the truth and giving advice more specific is often not relevant or helpful.

Having said that here’s another update!

I Am a GP Partner Now

GP partners are owners of clinics in the UK.

This is a very privileged position I am in.  Basically I now have a test bed to test my application in.  I also have an allocation of money from the practice to keep building my app.  So, I am very lucky indeed to be have been given such a massive opportunity.

This is the best position a founder could be in!  Solving your own problem with outcomes which will be beneficial to yourself validates your idea for a business and ensures that at least one person will benefit from your product or service!

Keep in mind that 88% of founders fail because they fail to make something that people really want and will pay for.

To Spread or Not to Spread

The app is being used in a few test beds now.  As such I haven’t pushed for it to go into more and more healthcare settings.

The reasons for this is that the app has potential to become really killer.  But I need time to build the rest of the necessary features.  This will take 8 months or so.

It may seem risky to not keep pushing for it to go into more and more places, but there are a number of reasons why  think it’s a good idea to not spread to quickly in the healthcare space.

The first is that it’s very difficult to get into anywhere – but now that I am convinced that I will be able to get into more places, I need to make sure to not blow it by providing bad services or a crappy product.

The other reason is that when you’re creating enterprise software, the app itself is a small part of the whole business.  This is another reason why it’s a bad idea to learn to code just to make a business.  The fact is that people don’t just pay for an app (particularly in healthcare), but infrastructure, support, insurance, certification, governance etc etc.  Also, as you provide software to more settings and businesses, more code needs to be written to provide infrastructure for billing, handling new data and new protocols have to be written for implementation.  The legal implications and finances also becomes a whole lot more complicated.

Looking at it this way, I’ve figured that the best way to go forward is to really make an awesome product, get sales lined up and then launch in more places once we’re happy that we can deliver something remarkable.

The Future

The future looks good at this point.  I’m solving a real problem, we have customers, the scope of the app could make a really positive change for both patients and healthcare providers.

There will be plenty of challenges up ahead.  However, just because I’m not writing these in-depth updates doesn’t mean much for followers of the blog.

The fact is that anyone who really wants to do what I am doing can just read my blog and follow me.  As the whole blog is about entrepreneurship and healthcare, people will learn a lot more by reading and understanding the general view-point of an entrepreneur than to follow all the details closely.

Because let’s face it, how many other people out there are GP Partners and creating software for the NHS?

This Is What Starting A Business Looks Like

Starting a startup is hard work.  It’s a very different kind of “hard” work than what most jobs require.  It’s not as difficult physically, as doing something like construction and it’s not as intellectually demanding as something like medical school.  However it is emotionally and psychologically draining as there is so much uncertainty involved.

Not only this, but there is added pressure on the founders of an early stage startup because it’s testing whether their “vision” is real or actually a hallucination.  This can make them feel very bare and vulnerable.

I think the best way to describe what it feels like to be a solo founder is via this video:

Visionary?  Or Just having a hallucination?

First you have to be willing to put yourself on the spot, be willing to be ridiculed and possibly laughed at.

Very few people are willing to be that first person dancing to their own tune though.  Most people never even get to this stage and they fail because they didn’t even get started.

Then when you’ve finally proved that you’re not insane and that there’s a party going on which is going to make an impact and a positive change, people will join you – these are your early adopters and your co-founders.

Then before you know it you’ve got a whole business dancing to the tune of common interests and values, working towards a common goal.

How To Tell When You’re Speaking To A Manager

“I’ll Try”

“I can’t promise”

“I’m not sure what my boss will say about that”

“That’s not possible”

“We can’t do that”

“It’s against policy”

“I can’t make someone else do their job”

Managers avoid accountability and often believe they are powerless to make an impact in the world.

Leaders however, seek out to be made accountable as they realise they can have a large impact in the world by working with those around them.

“Hey….What Languages Is Your App Written In?! What Should My App Use???” Here’s The Definitive Answer!

Entrepreneurs often discuss this topic ad nauseam.  It’s often a tell that the entrepreneur in question has no idea about tech and is just trying to sound well-informed.

My advice is this: If you are not technical then don’t waste more than thirty minutes of your time worrying about what language your app should be written in.

Here’s the lowdown on what non technical people need to know.

The most common server-side languages are PHP, followed by Ruby and Python.  If you’re making an app for an Apple device then you’ll be using Objective-C.  Android uses mostly Java.

Your data gets stored on a database (this is the reason why when you refresh your page your Amazon account doesn’t disappear, as your data isn’t stored by the browser, but on a database somewhere).  The most common databases are MySQL and NoSQL.

Some people like to argue saying that one language is better, faster, easier to code than the other.  Some people say that Ruby is the quickest and therefore you should be using this for your app.

So what should you use to make your app?  Well I would say to decide, you first need to become aware of what you are actually trying to achieve.

As an entrepreneur all you should be worried about is getting your product out, scaling and then being in a position to hire more people.

Basically if you are making an app, every order of magnitude you hit will require a huge build to cope with demand.  The code used in your MVP won’t be able to keep up with 10,000 active users at the same time.  It will require another large build.  When you reach 100,000 people you’ll need another big build.  In essence, if you are aiming to go big, then you’ll need to hire people to scale (this is also one of the reasons why if you’re not a coding ninja already,  you shouldn’t learn how to code to build a business, as it’ll take you 10 years to gain mastery in this domain).

And this is the reason why you shouldn’t really care about what the actual languages being used in your app are, but how easy it is to hire people who can code in those languages/technologies.  

PHP is by far and away the most popular server-side language on the web.  As of today >82% of the web uses this technology.  Compare this with 0.5% using Ruby and 0.2% using Python.  (You can see the stats on this web page: Click me!)

In terms of databases MySQL is the most popular.  (Click here for a breakdown of database use: Click me!)

So this is my point.  If your app uses the most popular languages then you will be able hire anyone from anywhere in the world to build and iterate for you.  It also drives costs down.  If you choose much less popular languages such as Python and Ruby then you won’t be able to scale, you’ll have a much harder time to find someone to hire and it will cost you more.

Try to avoid fads.  A lot of startups are using things like MongoDB, for their databases, but there really is no point.  MySQL does everything you need.

And what about people who say that it’s much quicker to build in Ruby / Python?  Well if you’re making a MVP, the difference in time is minimal.  The outcome and what your app will be able to do will also be minimal.  So basically, it’s a non issue.  What will be an issue is that if you use languages which are much less popular, you will have a much more difficult time scaling and hiring.

I also believe that this reasoning should also guide you with regards to what languages you should pick if you want to learn to code.  I can’t believe the number of people who don’t know Javascript, PHP and MySQL.  They’re shooting themselves in the foot as they will inevitably have to return to these at some point if they’re serious about code.

Should You Start A Business?

In my experience most people start a business to become rich.  However, during the course of starting a business most founders realise a deeper meaning and purpose in themselves.  Most of the time people who start a business realise that they actually started a business not just for money, but because they had a yearning for something more.

But, just because people want a deeper meaning in their life or want to have an impact in the world doesn’t mean that they should start a business.  The two are mutually exclusive a lot of the time.

There is only one reason that you should start a business:

If you are unable to create a product or service through any other means than by using commerce.

In other words, you start a business when you have no option but to do it yourself, because no one else can or will.  You do it because you want to see a change and the only option left is to do it via commercial means.

If you can do it by other means then it’s a good indication that you shouldn’t start a business as it would be more time efficient, less costly to get to your outcome.

I have seen too many entrepreneurs start a business because they wanted to get rich and therefore they come up with a business idea that actually sounds plausible.  However when examining the idea and their motives further, it becomes clear that the best way forward would not be via commercial means.

In enterprise software a good question to ask is:  “Would partnering with incumbent company X mean that my startup will do better?”.

If the answer is yes, then you have a bad idea for a startup or the incorrect intentions.

Because if partnering would be so beneficial, then it’s likely you aren’t working on something which is trying to change things.  It probably would have been cheaper and less time-consuming to just partner up from the get-go or become an employee for incumbent company X.

Every successful company has a similar story of having to resort commerce to create change. 

Steve Wozniak wanted to stay at HP, but left because they didn’t have the resources to help him create his products.  Richard Branson created Virgin Airlines because he thought that airline service sucked and didn’t have the flights he wanted.  Elon Musk made SpaceX because NASA weren’t making any more advances in space travel.  The list is endless.

In all of these cases choosing commerce to make progress and change things was the only option.

This is why starting a startup is so inherently hard.  The good startups are trying to change things.  And changing things means stepping on other people’s toes and causing a ruckus.

It’s counter-intuitive but it’s a sign that you’re on the right tracks.

This Is Why We Can Change The NHS

The people at the top of the NHS, it is widely thought, have it so easy.  If they just had the sense to engage with the public and front line staff then they could make things better, cheaper and more efficient.

The people on the front lines of the NHS such as junior doctors, nurses and physiotherapists also have a widely held belief – that they can’t make change happen.  Patients are mostly the same as well.  “What can I do?”  they say.

If only patients and staff could yell at the people at the top and tell them how hard they have got it, the thinking goes, then maybe change would happen.

How can staff and patients possibly create change when no one listens to them?  When they don’t have any money?  When they’re just a tiny cog in the system?  When speak of innovation and creativity is often met with fear and disdain?

If this is the case then only the people at the top must be able to create change, they say.

The fact is that the people at the top realise that they have a budget where they have a whopping 1% devoted for software and 0% for innovation and creating change.  If the people at the top decide to innovate and blow some of their budget on something new, then it better have a big impact, it better be nationally scalable from the get-go and it better deliver on all the outcomes promised.  If they don’t deliver on this impossible promise then it’s their head on a pike!

You see, the people at the top are paralysed.  They can’t do anything because they know too much about the wrong kind of things and they are risking their livelihood if they put their name on something that doesn’t work.

The patients and front line staff, the ones that pick themselves to make meaningful work are the people who will create change.  The problems and barriers we face are not nearly as big as what the people at the top face.  This is a lie that front line staff and patients tell themselves, as taking responsibility for something much bigger than their role is a tough pill to swallow.

When I was a Junior Doctor at St James’ Hospital in Leeds, I had the great pleasure of working with the late Dr Kate Granger.  She started the “Hello My Name Is….” campaign.  The reason she started the campaign was because she had terrible experiences of doctors not introducing themselves during her illness.  On one occasion the doctor that told her that her cancer had spread left her “psychologically scarred”.

She went on to say at a speech:

“I had been moaning to Chris (Kate’s husband) about the lack of introductions from the healthcare staff looking after me. Being the practical optimist that Chris is, he simply told me to ‘stop whinging darling and if it is that important to you do something about it.’ So we did.”

It wasn’t Kate’s responsibility to do the campaign.  No one gave her authority to start a campaign.  She simply didn’t have to do it.  But at that moment, she picked herself and decided to make change happen.

She didn’t know that her campaign would end up being endorsed by the then Prime Minister, celebrities, about half a million NHS employees and result in her being awarded a MBE.

The reason why the NHS is so broken is because there aren’t enough people like Kate who pick themselves.  But anyone can pick themselves.  And it’s as simple as saying “I am going to make change happen”.