fantasy vc - grand rounds


Continuing a series on startups I'd put a bet on if I could.

A few months ago, my friend James joined Grand Rounds. Most of Silicon Valley spouts a fountain of bullshit claiming change-the-world status. This team actually does it.

Consider this: 

  • It takes a very long time for studied, tested, proven and well known advances in medical and surgical practice to actually become conventional and prevalent—as in, a decade or more
  • The industry, as a whole, is set against advancement because advancement usually means more precise diagnoses and less money due to fewer surgical procedures, even though quality of life improves
  • There is no way to connect those who need information about new discoveries, new test, new procedures with those who lead the field and discovered the advances—people go to the doctors and practitioners they have access to
  • Those PhD/MDs doing the research, creating the studies, going through FDA approvals and fighting to make a better life for all of us want to accelerate the process—they’re desperate to get the life-saving discoveries, tests and procedures they’ve developed adopted by the world
  • What is a second opinion from one of those experts worth?
  • What is it worth to us, as individuals?
  • What is it worth to the companies that fund their own insurance programs (every big one)?
  • What happens when $1M worth of unnecessary procedures and hospital visits are replaced by a $10,000 outpatient visit? How much is that worth across an insured employee base? What if that happened a dozen times a year? A hundred times a year?

10% of the cases drive 66% of the costs for employers, and employers don’t have the right tools for resolving them. Obesity or smoking cessation programs are great, but the reality is that a small number of truly complex and expensive cases emerge in the workforce every year and account for a majority of a company’s overall healthcare spend.

As I’ve said, there are two ways to disruption: either you disrupt by doing something new or you disrupt by changing the supply chain, removing middlemen, disintermediating or consolidating intermediaries. Grand Rounds short-circuits the supply chain of medical information. And by so doing they’ve already saved lives. How many other startups can you say that about?


None of this is to say that they're guaranteed success. Or won't get crushed by entrenched interests. Or even scooped up before they become too successful. Just that I would've placed that bet.