Daniel: What's up guys? Hope you're having a great day. So I have been talking with several really great physician entrepreneurs in recent episodes, and today I'm excited to share one of those conversations with one particular physician entrepreneur who's really knocking it out of the park. . I think what you'll learn from her example is that physician entrepreneurship is about solving problems and facing fears and really leaning into them Today in the healthcare world, I know there's a lot of problems out there and, and a lot of 'em aren't getting solved, and so I think physicians are uniquely positioned to take back control from the healthcare system and to lead the charge on solving.
big problems that are out there. And I think really it comes down to physician entrepreneurship as a solution to some of these problems. So I think from, from listening in today, you're gonna really see that in my guest and hopefully come away motivated from hearing her story. So my guest today is Dr.
Renee Dua. Renee is a practicing nephrologist in Southern California. At a practice which she founded from scratch over 20 years ago along the way. been able to find the time and capacity to create several health tech startup businesses, including one that's grown to several hundred million dollars, and even more importantly, she's a mother to three children and a wife and business partner with her husband Nick.
So I really think you're gonna enjoy our conversation, and I'm excited to introduce that to you now. So without further ado, let's go ahead and jump.
Renee, how's it going? Good to see you.
Dr. Dua: Great to see you. Thanks for
Daniel: having me on. Yeah. Yeah. I'm excited. I have, I know we have a lot of fun stuff to talk about. I really look forward to talking about some of the entrepreneurship and business ventures you have going on. You got a lot of stuff going on.
It's really cool. a lot of great success. before we get into all that I'm really curious if you could share, like, kind of going back in time and maybe thinking about early in on your training, so you're a practicing physician now, but thinking back to like early or on in your training or maybe even early career like when you were at that point in your life and you were thinking about your future, then did you at that point realize you were gonna someday become an entrepreneur and have all these business ventures going on at that point in your life?
Or was it something different?
Dr. Dua: So, you know, I think I've actually always been a bit entrepreneurial and it sounds a little ridiculous in the ways that I was, you know, 30 years ago, right? To give you an example, when I was a resident and a fellow in training training to become a kidney doctor, you know, I was very enterprising about how I stored patient records or how I rounded, or the efficiency with which I got things done, you know?
I hated wasting paper even then, right? To give you an example, and by then we had, you know, we had blackberries, right? That was the the phone or, or even those little flip phones, and you could keep little records and notes, and I had ways of increasing and improving my efficiency or doing things a little better.
Even then, right? When I graduated from my fellowship at U S C, I did interview for jobs and I realized I would have a hard time working for someone else because I wanted to design a medical practice that allowed me to spend time with patients, improve their health outcomes, but not have to use, for example, paper charts and, be forced to spend five minutes with one patient and 40 minutes with another, or not be able to use some time having a phone call with a patient instead of dragging them in.
So I had those sorts of, you know, I illustrious thoughts way back when, you know, again, 30 years ago, I also didn't, I, when I started my own practice, I had no patience. I had to grow a patient base and I would do primary care call. So I would do emergency room call, which meant that any patients who came in that didn't have an assigned doctor, I accepted and I admitted to the hospital the next day.
And you know, when you do work like that it's grueling work, there's no doubt about it. But you learn a lot about how to take care of patients efficiently, who needs to be in the hospital, who needs help outside the hospital, which patients you can actually include in your own outpatient private practice.
And so I did a lot of those kinds of things to start my career. So I would say, yeah, I was never going to be an employee per se, of someone else's vision of how I wanted to see patients. I was always going to do, My way did I think I was gonna start companies that expanded through the nation and deliver hundreds of thousands of doctor visits.
No, , I didn't see, I didn't see that coming.
Daniel: . Yeah. But you had some of those, characteristics like you were saying, like you had, you were into efficiency and Yeah. Problem solving, and you had pretty firm ideals and you had kind of like a vision that was pretty strong. And I mean, those are solid entre.
Characteristics or traits or whatever that I think a lot of people have those and they don't quite connect it to entrepreneurship, especially physicians. There's a lot of, these characteristics that are common. I see. And and they're great. They're fantastic for entrepreneurship. But sometimes it takes a little bit of a nudge.
So did you get, did you start into private practice right away? What was it like for you Right after training?
Dr. Dua: So, so actually I moonlet through my entire residency and fellowship, we were allowed to do that then. So, you know, a lot of the credit for how enterprising or, you know, illustrious I might have been, how I've referred to myself came from those experiences.
When you graduate from medical school, you have a couple initials behind your name. When you graduate from residency and fellowship, you have a couple more years of experience. But it was the moonlighting that really gave me the confidence to say, Hey, I can try to do this on my own. I've seen people do it and I can do it.
So while I did interview at places like Kaiser or for other doctors, what I realized is I can figure out, you know, I, I'd saved a bunch of money for Moonlighting. I can figure out how to hire one person, and I myself can see patients in. You know, an office setting and, you know, rent some space and, and start off, you know, with one patient and two patients, and three.
So that's honestly how it started. The vast majority of my time in the beginning was spent on that er panel call, developing a practice where I grew. I mean, I still, to this day, and it's been, you know, nearly 25 years, I still see some of those same patients that you can imagine from that ER panel, right.
I've they've been alive and they've followed me through my career. So, in the beginning, it was a lot of the grunt work of building a practice that then needed things like QuickBooks and an office employee manual and you know, benefits and, and advertising and marketing and credentialing and contracting.
So in the beginning it was a lot of grunt work and a ton of mistake making, right? So many mistakes. I mean, I, I can spend. the hour we have together sharing the number of, you know, completely idiotic things I did too. But it was a roundabout way of getting to a practice that, you know, I saw patients in three or four times a week in the afternoons when I was done rounding on patients in the hospitals in the morning.
And it became very busy, particularly because number one, I was the only female nephrologist, the only female kidney doctor in my entire neighborhood, which is alarming. And also I am fluent in Spanish and kidney disease really affects the underserved profoundly. So I became very busy because of those two qualifications.
Daniel: .
Yeah, I can imagine. And your neighborhood is pretty big, right? Humongous. The San Bernard, I think of my neighborhood as, yeah, my neighborhood's like 15 houses, you know?
Dr. Dua: Yes. The San Fernando Valley is a huge part of la and there are in, now there are probably 84 kidney doctors in, you know, a 10 square mile area.
84. Wow. That's a lot. That's basically one on every other, you know, every two corners, right? Yeah. And even still, I'm one of probably five women. Right. So, you know, I think there's a lot of data and literature that shows that when patients are taken care of by women, their outcomes are better, which is actually newer data.
But the Spanish was a very quick way for me to grow my practice because many of these patients were seeing doctors who could not communicate with them without a caregiver present, or frankly just went in, had no clue what was happening, and left. and that unfortunately is how kidney disease progresses.
So it helped me grow my practice a lot.
Daniel: Yeah. I, I think it, from a business I guess terminology standpoint, it's like you kind of found your niche and I would agree. or your unique skillsets that tied in with your expertise. And, were able to really leverage that for the benefit of the, you know, good of the people that you were serving and that, that's right up the alley of entrepreneurship.
It's also another, yet, another thing that I think physicians have a unique you know, they're uniquely positioned for is that there, there's this expertise that's already been developed. Yes. And everybody has their own additional flavors of expertise added onto it. Like you're, you were just describing some of yours, but everybody has.
Their own little unique spin on expertise in addition to just knowing how to practice medicine. Yes. That makes you even better positioned to be able to do this whole entrepreneurship thing. But as you said, it's not like all roses and sunshine. It's like mistakes and failures. And one of my favorite books is It's Failing Forward is what it's called.
You know, I think in a perfectionist, we kind of live in a perfectionist culture, it feels like. And I think it's challenging sometimes. And I think particular with physicians, it's maybe in training emphasize You know that failures are not accepted or unacceptable. And I guess, you know, in, in a patient care situation like you want to do that's right.
The best possible thing, at all times. So you do have to have high standards but there has to be some. in business. It's like learning comes through trial and error and, and failures and making mistakes. Did you, was it, did that catch you off guard at all? Or were you kind of already positioned with, you know, your lean towards this and or was the vision so strong that you were able to just power through all these failures?
Dr. Dua: No, I mean, it's, it, when I make mistakes, it catches me off guard today. Right? It's still something that bugs me. I try very hard not to make mistakes and I think us doctors, when we make mistakes, we can hurt people, right? So it's an ingrained part of our genetic code that we don't wanna make mistakes.
We're afraid of mistakes, we're afraid of failure. You know, since we were in third grade, we were trying to get good grades so that we could become doctors, you know? We had to get high. There was no opportunity to fail. And those of us that made it through into college and through medical school and, and our practicing doctors, the vast majority of us, Of course there are always those brilliant people who were number one in your class and they never put any effort.
And you know, they're all plastic surgeons now and, and that's wonderful . But those of us who, you know, were not that smart, but were capable and hardworking, you know, any failure could have cost us the road to be becoming a doctor, right? And I think it is very hard to have the confidence to fail.
And it's also very expensive going to medical school. I went to a private, very expensive medical school. I walked out with a lot of loans and it isn't, it's a lot of privilege I come from too. I, I wanna be clear about that, right? I come from parents who had money who said, okay, you know, you don't have to pay us back.
And I was moonlighting, so I was paying back my loans, right? I, I could do that. it takes some guts and some courage. But I also had the opportunity to fail forward. To your point, not everybody gets that. I had it and I took advantage of it. Right. So I, I think that's all important for you to know it, but it, it's very hard to make mistakes, you know, when you are, even, even in my last company at Heal, I was so, you know, if, if you were to ask people who worked for me, I was so annoying about certain things because I was like, if we don't answer this question from a patient a, on a ticketing system, right?
We used a, a ticketing system to deal with patient support requests. When we make patients wait, they could get sicker and they could end up in the emergency room, or worse they could die. So there has to be like a constant effort to do great work. And when you're not in medicine, that almost seems kind of, paralyzing and exhausting, right?
It, it, it seems like I had almost too much work ethic, but it came from this place of worry for patients, right? And so, any mistake I make it, it's what is the ramification of this mistake? what could go wrong? Let me think about it very thoroughly before I make this, make this change or make this move because I could hurt somebody.
Right? I think that philosophy, it, it evades our life. And it, it really. Doing what I did, especially gutsy to some
Daniel: extent. Yeah. It creeps into other areas and it you know, I think it's also, I mean, if managed correctly, I guess it's a positive, you know, because accuracy improves and there's a lot of benefits and that come from, especially when you're dealing with a life and death situation.
You gotta, you wanna have high standards. Yes. But it can, on the flip side, I think it can become paralyzing. And what's interesting to me is the system that, of healthcare right now, I think a lot of what is. Paralyzing physicians in the big, and I, when I say the system, I mean like the big monster healthcare system.
Like a lot of physicians are, you know, burning out and having trouble and, you know, not really loving their work or maybe even hating their work. And I think a lot of a, of a part of what is paralyzing them is this whole idea of like not wanting to take risk and maybe lean towards perfectionism.
And it's kind of like anchoring them even harder to this system of healthcare. You know, that. Is actually causing them to reduce their levels of healthcare in some instances. Like it's making it harder to deliver quality care. Yes. But it's just, I think it becomes with awareness, it seems like you're pretty aware of this kind of thing.
And I think when it's dangerous is when you're not aware at all.
Dr. Dua: Yeah. I mean we also, in medical school, we are not given any training on running a business or frankly, forget about running a business. You took out all these loans, they have to be paid back. Right, right. Even the understanding of how that affects your credit if you can't pay them back or the kind of stress I have friends, I mean I've now been in practice almost 20 something years.
I have friends who have still not paid off their. That's astounding. Yeah, that's crazy. You know, that's crazy, right? And I'm talking, I had about a hundred thousand dollars in loans. I have friends who had $300,000 in loans. When you start your life with that kind of weight on your back, the risk taking becomes a different conversation.
So we don't learn how to manage money. We don't have people who we, we are taken advantage of by, you know, people who think we are going to make a lot of money. And nobody goes into medicine to be rich. Even in places like plastics where, you know, you're dealing with a very unusual clientele who could sue you or whatever, Lord knows where that could go, right?
Or the competition alone. It is really a thing of a courage and guts. And I'll also say right now 60% of doctors finish medical school and go and work for somebody. Right. Simply because they don't have the courage, the guts, the know how the interests, whatever the reason is. And tho those 60%, they are, they become a part of a.
and the, you know, what is known very well at Kaiser is the golden handcuffs. Kaiser says, you have to work here for seven years and we'll pay off your medical school loans. But for those seven years, it could be that you're seeing one patient every 15 minutes. You have this, you have, you know, Kaiser in some places can be really great in other places.
People don't, doctors don't last more than two or three years, right. Because of their own retention issues. Or Optum, which is effectively, you know, collecting doctors in every, I mean, it's wild what UnitedHealthcare is doing to hire doctors. So I think that we go out and we become a part of the wheel because of our own inability to understand, or our, our inability to have the courage or take, you know, take the opportunity.
I think it creates burnout, but it also creates a. Y this golden handcuff problem where you have no choice. You have to pay off these loans you have to provide for your family, and here's the job that's going to pay you now that you're this far in the hole. Right?
Daniel: Yeah. I was, I was interviewing Dr.
Jordan Creme you know, several episodes ago, and he's, he was a hospice physician and wrote a book about end of life. Yes. Kind of his experiences with people late in their life. One of the, his OB observations was that one of the biggest regrets people have late in life is that they didn't lean into those big scary things that they knew potentially could be good things, but it was too scary to do, and so they just didn't do it.
That ends up being a lot of people's biggest regrets. Yeah. And so it's like, you know, You don't wanna have regrets. And so you've taken some of these risks and I mean, like you've started some companies and I know you've had some mistakes along the way, but what was your first big risk that you would consider that you, I mean, you kind of started a risk with starting your practice, but was that, would you consider that your first big
Dr. Dua: risk?
That would be, that would be my first for sure. That would be my first issue. Did
Daniel: that feel big at that time? Humongous. Cause you had the student loans and you're like, I don't even have patience.
Dr. Dua: Exactly. I don't have patience. I have loans.
Daniel: Were you single at the time? Yes. Okay, so it was just you, you were kind
Dr. Dua: of like, it was just me.
So I had, that was, the good news is I didn't have children or responsibilities, that were at home per se. But I did buy a condo. You know, somewhere in there I bought a condo and I did that because I didn't want to keep paying rent and I was moonlighting and I wanted to start building some kind of, you know, portfolio, some kind of equity in something.
So I, I started this practice and I think I, I would agree that was my biggest risk. I think the other big risk about it though, was I was so young. I was the only girl. And I was up against what I thought were big head honchos. You know, there were these men who had been in practice for 30 years and they had already built their networks of referral sources.
And I had to effectively go and sit in the, we had doctor's lounges back then, right? I had to go and sit in the doctor's lounge and try to convince people to change their referral patterns. And another thing, I mean, as we're discussing generalizations about doctors, they don't like to change their habits, right?
They're comfortable with Dr. X seeing their patients. They know the note they're gonna get. They know that doctor's not gonna refer their patient to another doctor that could cause them to lose their patient. You know, there's, there's a lot of language in practice, in, in the practice of medicine that takes a human being and makes them a thing that has.
Right. And how you treat that thing with value is a part of a business cycle that it, when I talk about it, I kind of feel gross. I mean, again, to this day, right. We're talking about business, but humans and their inherent value on how they make you money is not really what a clinician should be thinking about.
But that's what these referring doctors think about, right? That's how they think about it. I had doctors would, who would tell me, you know, primary care doctors, well, if I refer you a patient, you should pay me. Right? And I was like, oh, what? You know, you should wanna work with me because I'm gonna take great care of your patients and they're not gonna wind up on dialysis.
Daniel: Right. Yeah. What happened to the
Dr. Dua: Hippocratic Oath? Exactly. Right. So, and not, you know, the Hippocratic Oath. I mean, Lord knows we've got plenty of examples of people who don't understand what they promised to do, but you know, What about like not breaking the law? What about Yeah. You know, Yeah.
The floor, the right, you have a license. I mean, you know, we think about all these bodies in, in, in medicine that allow you to practice medicine with credentialing and contracts. I mean, so many of them are just about making jobs and there's so much nonsense until you have the one jacka, sorry, you know, who breaks the law Right.
And makes a, a mockery out of protecting human life, you know? So I remember going up against, All these, and, and they're all men too, right? Many of them who had known me since I was a kid, you know, they were friends with my parents in the sit, in the, you know, in the community. And they were from the same, I'm from India.
They were from the same culture. And so they were like, how does this kid have so much guts, you know, to stand up against us and try to get us to, she has no experience, but yet she wants us to give her our patience and she may not know what she's doing, or they're jealous or they're late, you know, whatever.
Right. So that was, I, I thought it was really a gutsy thing. The other thing that I did at that time that I thought was gutsy was I started as I started growing, I started requesting opportunities to be a part of hospital administration. So I wanted to head up the peer review experience right. As I started seeing doctors and how they practiced, I noticed, wow, these, some of these patients are not getting the standard of care.
We're missing opportunities to give IV fluids and someone's going into worse kidney failure, right? Like these things need to be standardized in a hospital and from things like peer review and quality control to actually becoming chief of medicine and managing all of those doctors, right? Many of these things actually hurt my private practice so much because these same doctors that didn't want to change their referral patterns were also like, I don't want you reading my notes.
I don't want you seeing how I practice. I don't want you telling me the standards of care, right? Who the hell are you? You know, you're a shrimp. I don't, I don't wanna have you telling me what to do. So those were some of the other things. And I was fearless, right? I, I distinctly remember having these conversations with my father and mother, and they would say, you know, take it easy.
Why are you so gutsy? Right? What? Just, you don't have to do all this. And I, and I was like, you know, you should. Believe in me, like, back off, let me, I wanna be fearless. I wanna see what happens here. You know, where was that coming from? I think culturally, you know, again my parents by the way, are both extremely entrepreneurial to their credit, right.
But I don't, I think they didn't want me to get hurt, you know, frankly, they didn't want me to be a doctor, right? They were very much like, this is a dog eat dog occupation. Especially if you want to go into private practice, and we don't want you to get hurt. We don't want people to hurt you. We don't want people to think you're foolish.
We don't want people talking poorly about you. We wanna make sure you get married, right? And I, which, you know, 25 years later, like, that's what you're worried about, you know, . But the, these, these were all interesting. Parts of my own upbringing that I'm sure many people in the Asian community for sure have heard and listened to.
Right. Where my parents I don't think it's that they didn't believe in me, but they were worried for my
Daniel: success. They had good intentions. Do it. Yeah. Yeah. Did, how did it make you feel when those other physicians were treating you like that? Did it fire you up at all, or was it you know, neutral or did it negatively impact you?
Dr. Dua: I think I was a little intimidated, to be fair. I was, you know, I was a little intimidated by you know, the snickering in the hallways and the nasty comments. And again, remember there were no girls. There were no girls, you know, there, you know, we talk about things like sexual harassment. I had plenty of.
Yeah, plenty right. Enough to go around. You know, the plenty of get me this, aren't you the nurse? You know, here are my charts. Go put them away. Right. Plenty of that, you know. But, so I think that was a little intimidating. And I, I had it in fellowship and residency too, so it's not like I wasn't accustomed to it, but there was some little part of me that was like, put your head down, do your work.
Something's gonna change, right. I mean, 25 years later it's a little better. Not much pathetically, but it's a little
Daniel: better. It's slower than it needs to me. It's,
Dr. Dua: you know, a joke. Right. But we don't, you know, us girls don't have enough male allies Right. For many reasons. But I think I, somewhere I was like intimidated by pursuing my ultimate goals of building this practice that would get, would pick up and get very busy.
Daniel: And you just kind of worked through it and. ,
Dr. Dua: what choice do you have? Right. You've got a, you've got a rent, you've got someone at the front office answering the phone has to be paid. Her life depends on me. You know?
Daniel: It's interesting that you described that as your big, huge risk.
I think people, if they looked at like your resume, they would be like, oh man, this company you started later that did you, you know really well. Like, that's gonna be your big risk. But in reality it was like, you know, you started a small practice, you know, that didn't have a lot, probably not a lot of zero to one.
Yeah. Right, right. That first step probably was one of the biggest. And you had debt at the time.
Dr. Dua: Yeah. That was hard. The scaling of the company, you know, by that time I had a husband who I always say took a chance on me. Right. He heard an idea. I had to Scale back. I, so I, I should give some context.
When I met my husband and I had already been practicing for quite some time. I was crazy busy. By the time I met my husband, I
Daniel: was So your practice we were just talking about had grown.
Dr. Dua: That's the one. Yeah, yeah, yeah. That's the one. I was so busy that I would get complaints from the parking lot valet, the attendance that your patients are waiting in the parking lot because you don't have enough room in the office.
Right. In your office. And this doesn't work for us. Right. I had to go and get a bigger office space and, you know, take rent out on a bigger space, which sucked. I wasted so much money. But I was so, so busy and I met my husband and we started trying to build a family and I had a come to, you know, come to Renee with myself to say.
You are, I was having a lot of trouble having children. You're having trouble having children. You're not really a great wife. It's impacting your practice. What, what's gonna give here? Right? What's gonna give, you know, I didn't wanna give up on my patients. I didn't wanna lose this great, you know, partner.
I had met and married and I definitely wanted to have children. So we, when we started having kids one night, we had a crisis and we, we went to see a pediatrician at 4 45 on Friday in our neighborhood. And she said to me, look, your son is really sick. I don't know what it is. I can't help you. The office closes at five, go to the er.
Right. So I went to the er and in my mind I was thinking you couldn't, this doctor couldn't spend 15 more, you know what the, what? These are my people. Like you can't spend 15 minutes with me, you know, to help me. I'm panicking. My son had a very high fever and he was born prematurely, you know? So it was a lot on my mind.
So I went to the emergency room of one of the hospitals I moonlighted at, I moonlight at, waited eight hours. Saw a friend a physician, ER physician who was a friend, who was like, Renee, you're a doctor. You know, why are you here? You don't know how to take care of this. And, you know, I said to him, I don't want to be a doctor to my mom, to my kids.
I want to be a mom to my kids. By the time we got seen, it was hours and hours. By the time we had gotten seen, he was better. His fever, you know, he had def best so, , my husband drove me home. We were both frustrated and upset. We had an other kid at home, right, with a brand new nanny. And we, I said, you know, I recognize that I could do better here.
I, this is on me. I could have done better. And what I need is some kind of app like Ubers go on and off. Uber drivers go on and off and they see, they take rides whenever, you know, they're available. I can see patients when I'm available. If you wanna build me an app, my husband's an engineer. If you wanna build me an app, me and you, we can see patients when I'm available and I can back away a little bit from how busy I am as a kidney doctor, right?
We can do house calls in, in our neighborhood, and that's the story of how we built Heal. What I think is so hilarious about what I'm telling you is I used to think. , I was very busy and I was, you know, overwhelmed by how hard it was to build a private practice and the intimidation of dealing with all these jerks.
And I used to think that was hard until I saw what Nick built me, and we scaled that company to 13 states and 300,000 house calls and 130 doctors that worked for me. And, you know, that that was busy
Daniel: actually. You're like, whoa. Really hard work.
Dr. Dua: But interestingly, it was my private practice and the belief that, that Nick had in me that gave me the confidence to fail forward in, in some of those
Daniel: things.
Yeah. Yeah. That's such a good foundation to go into. Yes. Because a lot of it is similar skillsets. You're kind of playing on a bigger playing field there, was it a, so you had this idea and. You know, your husband was supportive and that's huge, I think, and I think a lot of times people have these really good ideas that could potentially be like home run and they have negative Nancy's around them and they're like, nah, you can never do that.
Or blah, blah, blah, blah, all this kind of thing. And that's just a killer for that kind of, and, and it's just, there's no chance. But it could have been a home run, but you. Good players on your team, you know, with your husband and particularly, and he kind of fanned the flame and that started at all.
And then did it take some time and just, or was it just explosion from the get-go, like super fast growth as soon as you got the, he developed the app, right? So
Dr. Dua: yeah, he and a friend developed the app. I mean, you know, it wasn't super fast at all. And, and I will say the US doctors, we, you know, we have a very high divorce rate, right?
We, we don't necessarily choose partners. Well, and you know, with Nick, it's the most important decision in my opinion that you make in your life as your partner if you choose to have one. And I made a, a very good decision, a very smart, frankly, the best decision I've ever made. And I did have a partner.
Not only was Nick an equal partner as a, you know, parent and whatnot he was an equal partner in founding a company. What Nick's specialty is, is business development and fundraising. We built that app, we pitched that app to a couple celebrities, right? People like Lionel Richie and and so on. And within a week and a half we had a million and a half dollars in funding.
For a company to scale. I took a look at what Nick D did in that app, and I said, Gino, this is so sophisticated, it's so easy to use. Yeah, I could be doing house calls with you and I could scale back being a nephrologist. But the fact is, every person should have primary care in their home. Nobody should be going to a doctor's office on Friday at 4 45 being shuttled to an ER with their sick child.
Nobody should ever have to go through that. That's a miserable thing to do. We should take this app. We should scale this company. We should take insurance, right? And we should take care of people. And so that million and a half dollars in funding that we had once the app was functional, allowed us to build a d.
Hire, you know, an an engineer that would build software right around that app and, and start allowing us to dispatch me to doing those house calls. And I made a doctor's kit and I had little supplies in that doctor's kit and I made Nick Drive me, right? I had to teach Nick how to do vitals, you know, , like, all it, it was a very exciting process.
But the thing is right now we talk a lot about healthcare because we are in the, still in a pandemic and, you know, billions of dollars have flooded. Health Tech. When Nick and I built Heal, it was 2014. 2015, nobody knew a pandemic was coming. And the only people that really wanted house calls, the only people that wanted to uberize or democratize house calls were rich people who were like, yo, yeah, I want, you know, I golf a lot and I need to be able to, you know, get around my primary care doctor.
I just wanna see an orthopedic surgeon. And I was like convincing someone like that, that everybody should have the benefit of care at home is hard. He's already rich, he doesn't care. You know, if everybody can have a house call, he wants the house call, right? So funding that company was very, very difficult.
We applied and won. Something called the Montgomery Summit, which here in Los Angeles was a competition, a pitch. And we won, I think like half a million dollars or, or less maybe, you know, a couple hundred thousand dollars. And so many people were so excited by what we were building from that pitch. That money that Montgomery Summit money turned into an a rolling note, which we managed to get about 13 million of funding into.
Right. So that's a lot of money on a, what was then a pretty great idea thanks to someone like Nick, right? So that's very important, you know, very important part of our partnership there.
Daniel: So he was the one that kind of quarterbacked that pitch.
Dr. Dua: And that's right. I, I was on stage, I was pregnant, , I think I got pregnant in, you know, right away.
2015. I had another kid. you know, we, we pitched and it was Nick's. Smart fundraising skills that, that grew that pitch into what honestly turned into a Series A in about a year and a half of trying to run heel. From there, you know, we had to get in network with insurance companies. We had what's called realtime eligibility.
You could scan your insurance card. We, you know, and, and we would tell you your house call would be the cost of your copay. Why not use it? Right. You didn't, we had a, a very cheap cash pay price, but we had the ability to use Anthem by then. So you could use your anthem insurance now, I think it's now called elephants or something.
You could use your insurance to have a house call. We had asked and begged and begged and begged and got Google to give this to their employee. Right. Google at one point was driving 18% of our growth. So we, with that money, we were able to do a lot of interesting things in the state of California, expand through LA launch in San Francisco and San Diego.
That's what we did with that money and that got us under the guise. And the, and the got VCs interested in us so that we were able to continue pitching and continue getting investor capital. Cuz of course house calls are a very expensive house. Calls through software is a very expensive endeavor.
Daniel: ,
and then the pandemic hit. And I imagine that's a well positioned business for a global pandemic. Not that, I mean, virtual business, the ability to have tech in general was accelerated in most instances. That's right. That's, and that's what happened for you guys too, right? . Well,
Dr. Dua: so what was interesting as we developed Heal was we were thinking, again way before the pandemic about how do we.
We can't constantly send doctors for house calls. It's too expensive, right? Yeah. How do we, how do we get people off the house call and into the video, you know, into the camera? And so what we did was almost like a Geek Squad experience where we would deliver that first house call to a very thorough visit.
And then we had built software that did one-touch telemedicine remote monitoring, right? We had won the c e s Remote monitoring award or the c e s Innovation of the year. I don't remember what it was called, but we had remote monitoring. So we would take a family and say, here's how to use the heel app, push here.
Here's how we can see you on video. In a month, let's go over your labs on video. Right. We would also say, you know, you're we were here to see junior, you know, he had a fever. Here's a thermometer, it's Bluetooth connected. Take junior's temperature over the next five days, and we're going to see how the temperature looks and make sure that the temperature's going down or the blood, the, you know, we could do that for older people with their blood pressure and their blood sugar.
And then we could say, looking at that data, let's do a video visit and go over your vitals. Right? You need to have better blood sugar control, you know, you're eating poorly, or whatever it was. So we had already created systems to have virtual visits with our patients after those house calls, again, way ahead of a pandemic.
When the pandemic hit, because we had already put all of this in place, we were able to, on a turn, on a. Just overnight, I will never forget it. Overnight we went virtual, right? We called every single patient for the next several months and said, your visits will be virtual, right? We can't come because we're afraid we'll spread covid and we wanna just get some more information before we start delivering house calls again.
Daniel: . Yeah. And that, that everybody became overnight, like down with the virtual . It was we, because that's how our business was. We were trying to kind of push Zoom, encounters before they were cool, like nobody knew what Zoom was. And they're like, what do you mean? Like, don't, can you zoom me an instruction manual?
And all that stuff, right? And then it all happened and then everybody was like, yeah, we'll zoom, or you know, they're asking us if we zoom. I'm like, what in the world is Yeah. Happening? And then it just, Everybody's now, you know, to this day I think Zoom is here to stay and it's kinda like the the next big thing.
But so y'all, you're still involved in the company now or are you exited during that process?
Dr. Dua: Playoff Moz, Nick and I, so we accepted about 200 million in venture capital into Heal. And the most recent was a Series D from Humana, which is a very large Medicare insurance plan. And, Humana's looking now to acquire the company.
So when they came in and they started really managing the operations they made a few changes. For example, they didn't wanna see children anymore. They didn't wanna operate in the state of California anymore because they don't have a big footprint here. And so, Nick and I had a talk with them and said, look, you know, we understand you have a lot of money in the company.
You wanna operate it the way you think it should be operated. But you know, there's very little for us to do here, right? We want be founders. We want to take charge and ownership. So we'll be advisors for a little while and we'll step out and, and do our own thing. And that's what we did about a year and a half ago.
and now, It's likely that Humana will acquire that company, which is great. It's wonderful news to have an exit. And, you know, those patients will hopefully continue to get great care in the states in which Humana's operating Heal. And then Nick and I stepped away to do something else, something a little different, but still in the health tech
Daniel: space.
Yeah. So that's your latest thing you got going on. you wanna tell us about that? Sure, sure.
Dr. Dua: So in the next iteration of what I wanted to do, well, I shouldn't say in the next, in the, in the same vein of what I've always wanted to do. I like working directly with patients. I think that to really have transformative care, For patients, you have to work with them directly.
You can't necessarily go through an insurance plan or a hospital system because unfortunately, the incentives for great care are perverse, right? Hospitals and insurance plans have to answer to shareholders and people who want to see money on the books, right? Unfortunately healthcare is expensive and it takes a while to make money.
And so what I've always been focused on is how do I help the most patients directly, even at Heal? We were, before we were in network with insurance, we were a direct to consumer product. We, we still were upon me leaving. So at this time, I've also been a caregiver for my parents who've been going through quite a bit physically and mentally.
They say often, Renee, I need my medications filled. Renee, can you come with me to this doctor's appointment? Renee, you know, I need to get labs done. Can you help me look at my labs when they're resulted or whatever. And my husband kept seeing all the jobs I was doing, all the tasks I was carrying out every single day for my parents.
And I said, you know, I need to automate myself, right? So many of these things do not require a human being, making appointments, refills, reminders, you know, vitals that you can share, data you can share. Why is a human doing all of this, right? I don't need to be the interface. And Nick said, well, you know, why don't we build that next, right?
Why don't we do that? And he actually called the company Renee , right? Because in his mind and in mind, everybody should have a Renee that coordinates and consolidates all this care for their loved one, right? So, Renee, is about to go live in the next several weeks. It's actually a product together by Renee, where we have a free app, completely free for partners, right?
I live with my mom, or I live with my husband, and he has some medical problems, and I wanna see what's going on with him, right? He can take his vitals, he can show me what medications he takes. It's a very slick piece of technology where you can take a panoramic view of your pill bottle. And from there we can extract all the information, the name of the medicine, the date of the refill, the number of times it should be taken, set up all your reminder.
the fact that you probably take that medication for high blood pressure, make sure you check your blood pressure to make sure that medication is working. It's all, again, coordinated and consolidated based on one photo of your pill bottle. Right. And then reminders of you are high blood, you have high blood pressure, and you're also overweight.
Are you a candidate for medications to help you lose weight? Or your blood pressure doesn't look well controlled? Would you like us to help you make appointments or, you know, find you a specialist or whatever. So very much a caregiving assistant, right. To consolidate and, and care for these tasks that are done.
Thousands of tasks that are done in between all these doctor's appointments.
Daniel: . Yeah. That, that sounds cool. That's sounds not very traditional medical. that's more of a. What I would consider a solid tech, solution. And healthcare has a lot of old school stuff going on, and that's part of the benefit of those kinds of things and opportunity that exists there.
So it sounds like a lot of your ventures have been really, I guess all of 'em have been like, you solve these problems or challenges that it existed you know, in your world and you ca you came up with a solid solution and, you know, put it out there in the world and that became your endeavor and, and essentially you're helping solve these big
Dr. Dua: problems.
Agreed. I mean, I, I like solving problems. I like seeing it work. I really like helping patients, right? The, the, I still see patients to this day. The kinds of patients I take care of. They're at the mercy of the healthcare system. Many of them are, you know, at a fourth or fifth grade reading level, they don't speak English.
Most they have someone who's caring for them, but that person has a job. That person has children of their own. They're really almost the forgotten amongst us, right? They're getting older. You know, they're not health literate necessarily but they do have a smartphone, right? And they do use WhatsApp or they do use Facebook Messenger.
And so there are little, they understand what YouTube is, right? So there are little things that you can do for them. That help them to feel more involved in their healthcare and share information. And I love seeing that. I love seeing that happen. I love that when they get that intelligence, when they get that information, when they get that data, they actually act on it to do better, right?
When they know why they take a pill and how many days to take it, and they're given a reminder that a refill is due and it can be delivered, they'll take their medicine, right? They just need a little helping hand. And I like that hand to hand combat that software can bring, right? This run around. I didn't want to build a medical practice again.
That is very difficult work. I still have some, you know, P T S D from having all those doctors and NPSs and PAs working for me. It was an enormous undertaking. Right? Not to say I wouldn't do it again, but I needed to use software to scale more. That was important to me this time. So let's see what
Daniel: happens.
Yeah, no, I mean, it sounds sounds like a cool idea. And I think entrepreneurship, that's the cool thing about entrepreneurship is you can, I mean, you can kind of like create anything. I mean, you, you start with a clean slate and you can also evolve over time. And most of the time it's not, you know, perfect from the get-go.
It's, you know, you're kind of doing tweaks and adjustments along the way and, you know, that's just part of it. So I'm curious as we start to wrap up is this, do you feel like this, you're like, really. You know, doing what you love now, like how would you describe, like your current state professionally right now?
Are you like, you know, hitting it, you know, in terms of love and work? Are you, do you still feel like you haven't met, you know, your goals or you, you know, I'm curious about the current state of how you feel about your professional success. Cuz on paper it looks like you're crushing it and that's how I would describe it.
But I'm, I'm curious from your
Dr. Dua: view. Yeah. So I'm like one of these annoying people that's never satisfied. , you know, I kind of,
Daniel: I was predicting this.
Dr. Dua: Yeah. I mean, again, doctor right. It, it's so happy boy I did it. You know, it's who we are. But the short answer is no. I have an an enormous amount of stuff I wanna do.
The, the good news is when I worked at Heal, I considered Heal a child, right? I was pregnant or feeding somebody through that entire experience. And then I had Heal and I grew that company and I. . I didn't wanna let it go. it kind of sucked the soul out of me, you know? on this new venture, I had been very good about setting some limits, right?
I had been very good about taking care of myself, making sure I sleep, making sure I exercise and eat right, and take good care of my kids. You know, I'm, I'm around I can work from home, right? That flexibility is very important to me. I'm home when my kids get home. I didn't grow up like that. I didn't ever see my parents, so I knew that I wanted to be a different kind of parent.
When I became one. So those are some of the good things. Some of the negatives is are it's very hard to make changes in healthcare. The powers that be are so powerful. Right. They have so much control and it's not in their inter it's sick care, it's not healthcare. Right. It is interesting to companies when you are sick because they can take advantage of coding your visit a certain way.
Yeah. Making more money and, you know, the whole thing is so grotesque. Right. It's so disgusting. Right. But it's the reality of what healthcare is. At least in America. Right. It's a, it's a for-profit game of greed. And so it's very hard to make changes and I'm one little person Right. With a little bit of guts, you know?
so I, I think there is a lot to do and I don't know that I'm so optimistic that I'll get a lot done. Unfortunately, especially when you have all kinds of nonsense that's happening. Like you've, you read about Silicon Valley Bank, right? Yeah. Whatever incompetence that was based on, right?
You heard about Theranos, right? All, all these things. There's not one health tech company that's actually improving outcomes. Not one, not one. I mean, that's a joke, you know, what are we all doing with that? Billions of dollars, right? All Covid showed us is we don't take good care of people, especially when they're underserved.
And so VC is in banks and private equity poured billions of dollars into what? Right. Starting with Livongo being acquired by Teladoc, only for them to write the entire thing down, which will happen to almost every acquisition you see happening right now, you know, whatever it is, hitting the news.
Right. So I think that it makes it very hard to make changes when there's so much foolishness and greed and
Daniel: I think that's also like motivation though for physicians listening, I think are super smart and problem solving. Like I think they probably could relate to a lot of the skills.
Yes, you have. And that is like desperately needed in the world of like business, not just medicine. And part of the problem is the business people now run the medicine. Yes. And then they're screwing it up. That's right. And so we need more physicians to get in the business. And get, have influence over that because they're clearly like not doing a good job of
Dr. Dua: No, no.
And in health policy, right? Yeah. And in health policy, because you know, what you see when you, when you see that Medicare allows you to make profits off of being sick when you're a Medicare advantage plan, which itself is sort of a folly thing. You know, we're, we're having the wrong conversation, you know, so I think that that is where I'm a little more pessimistic, but I haven't given up.
Daniel: Yeah. Well, I think you're doing great things. I think you've already done great things, and I'm sure you'll do lots more in the future. You've, you've clearly got a lot of good stuff going on, and the most impressive thing is that you've been able to work in the balance and some of the things that you would consider, like the family thing, that's huge.
Being able to change course, like it's very difficult to change. From the habits that are established from your childhood into your own parenting. Right? That's incredibly difficult. So yes. That I think is super impressive. Why Thank you for that, from my view. So keep up the good work. I'm sure people will be interested in kind of how things are going for you, especially with this new venture.
What's a good spot where people can find out what you're up to or kind of what's going on or different businesses that you have going on? Yeah,
Dr. Dua: well, well sure. I mean, I can be emailed anytime at renee, r e n e e renee.com, same spelling. And then our website
[email protected], r e n e e.com.
So yeah, anyone should feel free to contact me. I'm also on LinkedIn and I can be easily accessed there as
Daniel: well. Nice. Well, Renee, it's been fun. I appreciate you coming on to chat about your experiences. Thanks. The opportunity. Thank you.
