What It’s Like To Start A Business

I received a letter from a fellow healthcare worker the other day.

She wrote to me regarding a patient of mine, demanding that I “do something”.  Her letter was, to be quite honest, rude and uncalled for.  She knew very well that I had already seen the patient, assessed the patient correctly and that the patient had the ability to make decisions regarding her own medical care.

This isn’t an uncommon occurrence.  I spend a significant part of my working day telling patients and other healthcare professionals that nothing needs to be done.  And that often doing nothing is more beneficial than doing something for the sake of doing it.

But why are patients and people in general like this?  Why, for example, does a patient with lower back pain for a grand total of two days turn up at my clinic demanding an urgent MRI scan, which would bring no benefit to the patient whatsoever?  Why do they get angry and upset when I explain that physiotherapy and lifestyle changes are the way forward?

I think there’s a simple answer:

The patient is worried that they are going to die*.

And who can blame them for having this outlook?  Most people from a young age have been conditioned to think that death is lurking right around the corner.

The thinking even in primary school was something along the lines of: “If you don’t do well in school, then you’ll end up without a job, then you’ll end up homeless and then you’ll die a sad and lonely death.”.

Of course for the people who made it through school and are not dead – which happens to be the majority of mankind – the above line of reasoning is clearly false.

Yet the same thinking often persists and manifests itself in absurd ways later on in other parts of  their life.

riskysport

This is not what it’s like to start a business

I think a lot of people avoid going into business for themselves due to this reason.  Even though it would be better for themselves, their family and those they serve to go it alone, they don’t.  Or worse, they say “someday”…

The fear of death manifests, in the form of being someone elses devoted employee for the whole of their healthy adult life.  “I’m not a risk taker”, they tell themselves.

Look, I get it.  It’s fine if you are truly happy as an employee.  What I can’t tolerate is when people make up BS excuses for not doing something with no logical reason.

So how to think about things?  How do you decide what is truly risky and what isn’t?

The Two Types of Risk

I believe that there are two types of risk.

  • Compound Risk

This is the type of risk which builds up over time and then ultimately does result in poor life outcomes such as bankruptcy and death.  Ironically people take these risks all the time without any consideration for their ultimate effect.

For example the decision to not exercise today, or the decision to just have that pizza instead of sticking to the diet.  These types of risk compound over time and then one day give you a heart attack or stroke.

  • Simple Risk

These are risks that can be calculated and taken with no hidden / compound effects.  If for example you decide to buy a car with cash you can easily calculate if you can afford it and what type of risk a reduction in your bank balance will lead to.

The problem is that these two types of risk often become conflated. 

People think that starting a business is a “compound risk” instead of a “simple risk”.  When in fact starting a business has a limited downside and a possible large upside.  It’s a calculated, simple risk.  

Or people think that “eating one more slice of pizza “is a “simple risk” and not a “compound risk”.  They think that one more slice of pizza or drinking one more alcoholic drink is no big deal.  They fail to realise how the risk compounds with time and that that “one more” may lead to an unpredictable heart attack somewhere in the future.

This conflation of the types of risk is what’s happening in the patients who have back pain demanding that “something has to be done”.  They don’t realise that when a doctor has competently assessed you and has ruled out “red flags”, which could indicate a serious underlying issue, that the risk will not compound.  It doesn’t matter if you’ve had the back pain for a day or a year.  If the clinical scenario has not changed then the risk is still a “simple risk” and will not “compound”.

Yes, physiotherapy and lifestyle change is still the way forward.

*Usually men and women alike tend to think that they have metastatic cancer if they have lower back pain.  They fail to realise that they have developed the pain because their body is trying to signal to them that they have poor muscle development (usually due to being overweight and inactive).

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Are You Stupid, Mature Or Brave?

The only thing between where you are now and where you want to be are a series of hurdles.

Few people overcome these hurdles to reach the goal. Few people push through to become the person they want to become.

Stupid people start something while full well knowing, from the very beginning, that they’re never going to push through to the end.

Mature people realise that there are too many hurdles and don’t even start.

Brave people, the very few, decide that they’re going to fight to the end and reach the goal.

When you started your project, your business, your university course, your fitness regime you signed up for a series of hurdles.

Being mature is fine.

Being brave is fine.

Being stupid is inexcusable.

If You Keep Doing More Stuff, You Will End Up Poorer, Less Healthy And Less Smart

Subtraction

I would say that around two-thirds of the patients I see in my clinic every day have problems related to something that they are choosing to do.

Chest infections caused by smoking.

Back pain as a result of sitting down all day and even after work.

Diabetes due to poor diet.

I seem to be locked in an eternal battle with my patients. I am continually trying to get them to come off of unnecessary medications, stop taking part in harmful habits and to stop taking antibiotics for viral infections.

Patients on the other hand come to me to take yet another pill for their ailments, seek yet another additional action they can take part in so that they can continue taking part in harmful habits.

I have come to realise that we humans find it much harder to subtract something from our lives than to add something to our lives.

It is easier to take a pill for high blood pressure than to stop doing the activities which has caused the condition.

It is easier to inject yourself with insulin than to stop eating processed foods.

I find it ironic how we take medications, often to mask our problems, which in turn leads to more problems down the line. It is clear that if we were simply to stop doing the harmful activity in question, instead of adding something new into our lives then we would benefit a lot more in the long run.

This got me thinking….

I have noticed that subtracting things from your life more often than not, leads to much greater gains than adding more stuff to it.

This is the type of logic that doesn’t make sense in a class room, but is empirically true.  Say for example you were tasked with building a wall.  In a maths book if a team of three people worked hard for 12 hours a day, you would be able to calculate how quickly each portion of the wall could be built.  Therefore if twelve people were put to the same task who could work at the same rate, you wold expect this team of people to build the wall at four times the speed.

In reality, if you were put in a team with eleven other people, with all the arguments, the organisational problems, the egos etc, it is likely that the wall would take much longer to build.  (If the government were put in charge with building the wall, it is likely that the wall would never get built.  I am sure there would also, at some point be allegations that the wall can be considered discriminatory against blacks/women/immigrants/insert a poorly defined group of people here…..)

I’ve been thinking of three examples in particular which I want to write about.  These three examples have given me more mental energy, made me fitter and made me financially better off.  I’m sure that these principles and concepts can be applied to anyone’s life.

The News & Social Media

Over the last couple of months I’ve stopped reading and listening to the news.  I haven’t used any social media since 2012 when I got rid of my FaceBook account, so I thought I was being smart by only using the Internet for learning, business and keeping up to date with the news.

It’s been an odd sensation since I stopped reading the news. I used to wake up in the morning, grab my smart phone and flick through a bunch of new sites. During lunch time I would revisit these sites to see if anything else was going on. I’d probably check again in the evening time at some point as well.

In total, I wasn’t actually spending much time a day reading and consuming news, but it did strike me at some point that I was not learning or gaining anything by reading it. This particularly hit me when I asked myself the question; “If I read last weeks news today, would I have missed out on anything at all?”. It became pretty obvious to me that the news is largely garbage.  In this respect it’s very similar to social media; It’s designed to cause an emotional (negative) reaction, it’s designed to suck out time and attention from its readers and it’s designed to keep you coming back for more for a quick dopamine hit.

At first I didn’t notice much of a difference in my life.  However, after a couple of weeks I felt a massive difference in my mind.  I found that my mind just had to deal with less noise.  I could stay focused on things that really mattered to me for much longer and I had much deeper insights about my startup due to the extra mental clarity.  In particular, my mornings now just feel much more positive and better.  It’s nice to not be bombarded with scare stories and the worlds problems first thing in the morning.

I now go to check out new sites just once a week.  And when I do visit these sites, I have noticed that I only read a tiny fraction of the stories, as most of it really is just non-stories aimed at getting you to have a negative emotional reaction.

There really is a case to be made about stopping oneself from visiting web sites which are known to be damaging to overall well-being and which we all know distract you from doing what you really want to do with your life.

Really worth a watch if you don’t agree with what I’m saying, because it seems that the ex-president and a previous executive working at FaceBook both agree.

Losing Weight

Here’s an interesting one.  Why is it that when people think about getting fit and healthy they immediately think about exercise*?

Why is it that people think about exotic diets?  Avocado and poached eggs on rye bread anyone?  Or how about a gluten-free, vegan “cake”?  No thanks, I don’t like to eat sissy ass food.

I think that it comes back to adding more things to your life, because it’s easier and somehow it seems “more right” to do something new when an existing diet isn’t providing results.  However, the reality is that subtracting bad foods from your life is actually the easiest, best and the most realistic way of losing weight for the majority of people.

Food is such a personal thing.  I wouldn’t expect anyone to enjoy my diet as much as I do or stick to my diet.  The food we all enjoy is likely a combination of social, cultural personal influences.  And it’s silly to think that you can adopt a random persons diet, be able to stick to it and enjoy it for the rest of your life.

Alan Aragon is a well-respected nutritionist who has coached many superstar athletes, including people like Pete Sampras.  The first chapter in his excellent book was: “What if Everything You’ve Been Told Is True?”.  He was trying to point out that for the most part, we all know what healthy food is.  We all know that a chicken breast is healthier than a french fry.

Here’s how to subtract food from your diet.  Some of my patients with a clinical diagnosis of diabetes have managed to completely stop their medications due to this simple method.

  1. Make a list of foods you enjoy eating, that you currently eat.  It’s very likely that there are a ton of foods that you eat that you know are healthy and that you can eat more of.
  2. Eat more of these foods!
  3. Eat less or get rid of the foods you know are unhealthy.
  4. Keep the healthy foods stocked up and get rid of the unhealthy foods at home to make sure you’re not tempted to just have a quick bite of something unhealthy.
  5. Eat healthy foods for 80% of the time and enjoy bad foods for 20% of the time.  The easiest way to do this is to be looser with your diet for one or two meals over the weekend.
  6. Enjoy the weight loss!

One very easy way of knowing if a food is healthy is if it is a single ingredient food that you can point at and name what it is.  For example: “That’s a piece of fish, that’s a potato”.  If you can’t name the food in single ingredient terms then it’s likely not healthy / is calorific.  For example bread and pasta are made up of lots of ingredients – eggs, flour, milk etc.  When foods are processed like this, they become calorically dense and usually end up being pretty bad for you.  For example, two slices of bread is usually 300-400 calories, which is the same as eating 400 grams of boiled potatoes.  Meaning that you would struggle to eat enough boiled potatoes to put on weight.  Single ingredient foods by their very nature have a comparatively small amount of calories for the quantity you can eat!

Subtractive Business Ideas

It never ceases to amaze me how good business ideas all seem to be subtractive.  I have noticed that my own healthcare business is subtractive by its nature, which may go some way to explaining why it has so much traction in such a short period of time.

This is what I mean by subtractive businesses / technologies / services;  They make life simpler and easier than before.  They uncomplicate processes and procedures.

Let’s take Google.  What did people do before Google was around and people needed information?  The used to go all the way to the library and go through books trying to find that single piece of data that they were looking for.  Or they would go and have a look at their own books.  Google is subtractive in that it has massively subtracted the effort needed to find data and it has made it much simpler to find the information that we’re looking for.

Uber did the same thing.  At the click of a button a taxi will appear.  No more trying to find the number for the local taxi firm, no more trying to figure out what the address of your pick up location is, no more wondering how much longer you have to wait for your taxi and no more worrying about having cash on you to pay the taxi driver.

Amazon.  At the click of a button you can order most of the commodities that you used to have to make a trip to the store for.  At the press of a button your chosen item will appear at your house in a day.

When most people try to think of what the future will look like they start to think about flying cars, talking houses and electrified pants.  Most people take the same perspective when they try to come up with new business ideas.  They start to have ideas which are “additive” instead of “subtractive”.  The best business ideas always go more along the lines of “There is this problem, which I could solve in a better and easier way, which people will give me money for.”

If we look at the successful businesses throughout history and the businesses which are going to be big in the future they have been and will be subtractive in their nature.

*Unless you are an Olympic athlete or a marathon runner, going to the gym and working out really won’t burn many calories at all.  Any fit person will say something along the lines of “abs are made in the kitchen” or “80% of results are from diet”.