Improving NHS GP Access with AI and Automation

[Gaia — 00:00] Hi, I'm Gaia. [Angelica -00:05] I'm Angelica. [Gaia -00:07] Today we're speaking to Pete, co-founder of Health Tech One, a UK-based startup which unlocks access to healthcare and is working with 24% of NHS GP surgeries. Hi, Pete. [Pete — 00:10] Hello, on intro, thank you. [Angelica — 00:14] Thank you so much for coming today. [Pete — 00:15] Pleasure, thank you. [Angelica — 00:17] So tell us, what is, what is your business? [Pete — 00:20] Ah, so very interesting. I think if you've been in England, you've experienced the GP practice, you go up to the reception desk, they're often very busy, stressed. But, you know, behind the scenes, there's lots of things happening, like a huge team behind there. They're working constantly on admin and obviously serving patients. And I had the chance to enter that space. So my co-founder, his family runs 4 GP practices, and during COVID, I expand a bit more later, we had the opportunity to lift the. Curtain of a GP practice. And that's when you go from patient to maybe problem solver. And I thought, oh my goodness, the systems are really, really old. They are using lots of paperwork processes. We're trapped in the 90s, is how I imagine it. This kind of team that are just there looking after people. Honestly, it's working. Like late, working hard, you get abused actually often uh as a staff member and you're underpaid, overworked, [Gaia -01:06] Abused by the patients or by... [Pete -01:11] Yeah, so it wouldn't be surprising that a stressed patient comes in and you know, totally understandable, right, you've been trying to get access, there are barriers, whether it be language or not getting the appointment, uh and the frustration builds and you're in a public setting often. [Pete — 01:24] You get these bouts of [Angelica -01:25] When you're in physical pain [Pete - 01:26] Physical pain, emotional pain, and you're scared, yeah. Um, yeah, there are safety buttons in the GP practice and the worst moment is when you hear someone hit it and the whole team has to come down and protect. Um, anyway, it's gone down a quick. [Angelica — 01:27] Well, it's still, it's still, it's, it's good to talk about these things though, because it's still, you know, that's not something which I would think about every day, right? So it's still good to give space for that. [Pete — 01:54] Yeah, I think people often see the receptionist who doesn't give you an appointment. If you pause and look inside and behind the scenes, it's a brilliant team of people working really hard and doing their best actually, and then you have lots of empathy for them. Um, so what we did, we stepped in and yeah, we saw lots of problems that we had the skills to solve. Uh, one key thing, so our roots are based in automation, like, simply put, there's so many tasks you have to do non stop, and year on year as people get older, as the system gets more complex and there's more to do, people have to catch up. And that means lots of manual repetitive admin work as an example. Oh, if you've registered at a GP practice, if you imagine maybe a year ago or two, it's a piece of piece of paper on a clipboard, so you have to skip work a bit, go in. You know, draw on that, yeah, pass it over and then wait 6 weeks. [Angelica — 02:39] I remember doing that in COVID.I remember having to go to, so I'd moved houses in COVID and I remember having to go to my local GP and it was, you know, the print was sort of half printed. I couldn't really read where to put my name and then 3 weeks later, I might get an email saying you've been accepted or whatever. [Pete -02:53] So yeah, no news is good news. It's a bit painful. Um, but the the real practicality is that that piece of paper is put. On a desk somewhere, it's backlogged, it's not the first thing you do. [Gaia — 03:04] I'm just wondering, how is it possible that this wasn't addressed earlier on, because automation, surely filling in a form online before you show up is a quite an obvious solution. [Angelica -03:08] Seems quite a natural thing. [Pete — 03:13] Yeah, you should join the team. In other words, yeah, we, we stepped in and thought, how come we're using 90s tech and we're not doing anything new here. Over time, yeah, I can explain the factors, but. [Pete — 03:30] Yeah, there's a huge gap and for us it was, there are clinical systems that have been there for a very long time. Uh, it's like Mac and Mac and uh Windows, so there's two main clinical system providers for the whole of England and they take up 95%. In other words, not much innovation, there's only two main systems. Uh, and it's actually quite hard to innovate. Like we were privileged enough to have family ties into a GP practice, to even have the conversations, the time, and just shadowing. [Pete — 03:55] I mean, I can't see how any other innovator's gonna be able to say, can I have 4 hours a day for a few months, nonstop and sit in the practice and chat, they're just way too busy. So we had the privilege of being able to step in. [Pete — 04:08] And have these sort of like Men in Black passes where we could go into any room, speak to any person and ask any question and solve any problem, which is a real privilege, meaning we could observe, learn and build something. So that, that even takes like a few years, I'd say to build up, but we just could get in immediately. [Angelica — 04:20] And so what's your relationship with the government? Is there any relationship? [Pete — 04:31] Um, we're building that actually. So what we started with is just quite like, um, techie style, just build something that people love. So build a product, listen to problems, listen to iterative feedback, and just build it in. Uh, and then over time as you get bigger and bigger and bigger, you get noticed by bigger and bigger organizations. So the NHS isn't this one, only this one org at the top, it's a policy setting org and multiple layers of many different organization types like groups. Groups of 11 GP practice, groups of 4 in a neighborhood, even bigger neighborhood and bigger. [Gaia -05:00] So GP practice is basically like a franchise and it has its own CEO, its own leader. [Pete -05:05] Yes, yeah, maybe the one thing to lift on the curtain is a GP practice is actually a private enterprise, so they are a private company that can earn money. Uh, they hold a contract, so, uh, a list of requirements and quality measures they need to adhere to, but it's a, yeah, they can make money, money from it. And then. [Angelica — 05:26] Sorry, I'm a bit confused. So where, so it's a private franchise, yet it's public. How does that work? [Pete — 05:36] Yeah, so think of it. As, um, corner shops, so sometimes you get independent corner shops, and that's a family run business. And the comparison there is like a family run uh doctor and the secretary is the wife. That's very common actually. Um, and then you get these corner shops that are franchisees, multiple groups, maybe 4 acting like a super group. And then you do have these huge groups, say like, I don't know, Tesco Express and a huge entity of many, many GP practices. And they're all different types of just businesses, right? So one is a single owner, one is 4 in 1, and one is like 20 in 1. And what they do is hold this national contract with the NHS and that is public money, right? So if they deliver services and you can imagine on the contract, these are the things you need to do. You need to hire like doctors of a certain credential and hear your opening hours and do things this way. You hit that contract and it also explains how you make money. But that is the public money flow, so it goes from Department of Health er down eventually into GP practices um. So when you enter, actually there is a patient sort of motive, like these are GPs fundamentally, not business owners. They want to do right by the patient, but there is a business ed to it, which is we need to survive, we need to, you know, make things run, and we're willing to innovate if it makes things better. [Gaia — 06:52] How strict are these contracts? So the, the basic guidelines that that the government sets, how much room do they leave for innovation? [Pete — 06:57] Um, that's a great topic, yeah, so pretty strict on care delivery. Uh, Definitely, quality is important there. When it comes to innovation, often what they do is say you must pick up a certain type of technology. So this is one example, I said the clinical systems, right? You must use a well fleshed out clinical system. I'm paraphrasing a bit there. And the clinical system needs to hit all of these checkboxes. Well, guess what, there's only 2 systems in the market that can do that. And it takes a lot of work to build that. Another version of that may be you need to use a cloud telephony service, right? You must use digital phone calling, uh, but you can pick your provider. So often they list out different, uh, like descriptions of tools you can use, and then innovators can say, look, I'm, I'm the provider, I can do this, I can do that. Sometimes in a rare case they can say. And they've done this quite close to our space, er, they said you have to use this product. And that example is the national registration form. So we do national registrations, we built our own form, but sometimes they have the power, the government, and other, other ways of saying you must use this product. So innovation in the NHS is a really interesting subject because it is very hard. There are incentives to like standardize. You can imagine innovators go in many directions, they find all lots of different apps. But that's the tension with the national body where they want to standardize the experience and make practices do the same thing er cos it's easier and more efficient. And the NHS is a very efficient healthcare system, like compared to other countries. It delivers a lot on a really like thin budget. So in terms of like using uh technology and pushing it to it's max, we're we're definitely stretched. Kind of good and kind of sad in some way too. I wish there was more innovation, so I guess part of doing this is let's bring people to health tech, like there's definitely loads of great fun things, lots of great people, and we need more innovators in health tech. [Angelica — 08:49] Do you think there's loads of space for growth in health tech? [Pete — 08:54] You mean for companies or for individuals. [Gaia — 08:56] I was like if I wanted to go into health tech as a career. Do you think there's loads of space for growth there? [Pete — 09:05] Oh my goodness, yeah, yeah, and it's so damn rewarding too, yeah, um, my brain is so plump with knowledge of this healthcare system and. Though it's going through a rough time now, the NHS is a great example of a healthcare system that can support a society. Often it's seen as a sticking plaster, but [Angelica 09:20] Interesting, yeah, because I feel like, you know, the sort of populist mentality of it is that. It's just a sinking ship. It always has been, always will be. But then if you look at it more globally or look at it in Europe, where do you think it stands and why do you think it's such a good structure? [Pete — 09:30] It's because it's so inclusive and it doesn't leave anyone behind, right? So yes. If you've got a non-urgent issue, it may take a while. Mental health waiting lists are incredibly long, but if there's an urgent surgery that you need or a condition that's quite severe, you'll, you'll get seen to, right? And you won't be left behind like other private insurance systems in other countries, right? Um, so part of the goal for Health Day One is like can we help it survive a bit longer. And build sort of like structures. You know, our technology helps a GP practice be a bit more resilient. If we're doing work for them, it means they're not doing the mundane, boring, repetitive, soul crushing work. They're moving on to patient care and looking after and thinking ahead or even like having a break. So yeah, we worked in automation, now we're improving access to like appointments. So ultimately. A lot of healthcare delivery is you get that appointment that you need and that's a bit of an admin task too, lots of people kind of decide how you get an appointment. [Gaia — 10:36] So what are your benchmarks when you're assessing patient care and what, what are your main KPIs? [Pete — 10:41] Hm.There's definitely just getting the right appointment the first time, that's generally our sort of vision. So speed is part of it, um, quality, and quality also includes appropriateness, like there's. Over triaging and under triaging, in other words, if you, all you need to do is pop to the pharmacy and pick up some vitamin D or it's a minor ailment, go to the pharmacy. You don't need to get an urgent on the day GP appointment, which could be used for someone else that may have been useful. So yeah, there's definitely getting it right and the quality is. In the person you get them to and the time as well. Um, yeah, appointments are like key to the country and a lot of them are kind of contrarian belief is that they're locked in the system, right, as in they're inaccessible, they're behind systems, there's lots of barriers or patients don't know how to get them. We often think of there being like three services, your GP 111, and 999, and actually there are hundreds of services, so we can be part of the solution in helping you get you to the next step. Um, in terms of learning, oh my goodness, like healthcare systems are so interesting, um, and ultimately you're helping society, uh, like move forward, so yeah, it's so rewarding. Once you're in, you can't get out, that's what they say. [Gaia — 11:57] So do you, do you often speak to, to the patients of the services of the GP practices that you service to try to understand what they are looking for specifically? [Pete — 12:18] Um. So part of our sort of origin story is that we started in a small dark room in a GP practice in Stratford, uh, and then we started growing into that room. The 2 people became 5, became 10, and we wanted to stay at home. So yeah, this is my co-founder's family GP practice. And don't forget this is a GP practice, so downstairs every morning when we walk in. It's the waiting room and you go in and people are waiting and often it's quite busy and. [Gaia — 12:36] how long ago was this? [Pete — 12:38] Oh, this is like 5 years ago. [Angelica -12:39] During COVID? [Pete -12:40] Uh, yeah, 2021, so kind of, and that's the reason why we got brought in, it was we're doing great things in tech. Come have a look at uh our practice because we need some help. But yeah, we stay close to patients there cos. They're just downstairs and we don't want to leave, so our startup is neighboring the GP practice and we're connected on the 2nd floor, so there's like a corridor that connects through and it keeps us routed because on the ground. [Gaia — 12:46] Oh, literally on the ground, yeah, on the ground. [Pete — 12:46] Yeah, anyone that joins the team does a week on reception. Uh, so they get it, right, and get it isn't just the process or the systems or all the sort of academic knowledge, it's the empathy for the patient and also for the team. And when you have a deep care for someone. Ultimately you do more for them, right, so it's so purposeful to see that you can help. [Gaia — 13:19] How do you integrate that in your automation system, the concept of care and empathy, because that can be quite hard when a system is so digital and to a certain extent, like you're not seeing that person physically. So it can feel like you're being ignored or like you aren't really being understood. [Pete — 13:39] Um. So far we just make things fast and clear and transparent. And well designed, and that actually goes a long way. You compare it to status quo and a second thing that we automate is lab reports, so you might get a blood test a GP asks you to do, uh, and then no news is good news. Right, you don't get text messages, you don't get anything. Uh, it's a bit scary. So what we do is we process it quickly, so the anxiety is less, uh, and you get a text message and it says you're fine, you're normal, actually you're not normal. Let's, let's talk to you about next steps. And that part of healthcare, I feel like is the. Biggest piece, right, obviously humane and empathy and we can add that in, but I think just getting things done well and quickly is the biggest trust factor in healthcare. And people need to kind of build their trust again. You know, I think a lot of people have lost trust in the system, so just delivering on time and well is part of that. Yeah. [Angelica — 14:20] I know we kind of spoke about it earlier, but how did you get to where you are now? What was your sort of career evolution and was there a sort of moment that you thought, right, this is what I need to do, this is a vocational path I need to follow. [Pete — 14:25] Right, it's a long line of, yeah, like going far back. [Gaia — 14:16] Yeah. [Pete — 14:16] Oh, cool. [Angelica — 14:31] The reason I asked this, I find it so interesting because it's never, it's always a butterfly effect, right? It's never like you wake up one day and think I'm going to start a healthcare startup. You know, it's a whole series of things that had to happen in order to get you to where you are now. [Gaia -14:33] I think it's also encouraging for the audience when they listen to it. I think. Realize that you know if you're in a dead end job it might not be a dead end job, it might be something that leads you somewhere. So it's just for our audience. [Pete — 14:54] Totally love that. Yeah, so I, I always knew I wanted to actually let me rewind a bit. So on my career. A lot of it is inspired by mum and dad actually. So I grew up in a takeaway and from the moment I could help, I helped. So maybe it's hard in the past and as a child it was difficult and embarrassing. I wanted to go play football in the evenings and go out on weekends. Er but what I did was support the family. Uh, but what was built into that was just natural business acumen, right? I was doing like the books, I was meeting customers, I was solving problems and doing those admin bits. And it was very much like entrepreneurship out of necessity. That's difficult, right? Whenever you're forced to do something you don't want to do, it's just not fun and it causes stress. I go and study economics, go into finance, follow the path, do something stable, and 3 months into my job, I speak to my, I passed probation. [Pete — 15:57] And my mum's in IKEA with me, just looking for some furniture, and she's like, how's it going? You passed probation, well done. Uh, what do you really want to do? And by that point I looked at the top of the leadership tree and I thought, oh, I don't wanna be up there. And I don't wanna walk that ladder up there over 30, 40 years, however reliable that walk is. I don't wanna do that. Um, what do you want to do, says Mum, and I say, I wanna build a business like you. Um, and she says, you know what, if you build a business, I'll put every gram, every second, every pound behind you. So go do it. And that's when I thought, oh, you have so much belief, obviously mums have so much belief in their children. [Agelica -16:10] Naturally! [Pete -16:10] Naturally, that I was like, I need to believe in myself this much. And that's the moment that weekend I thought I need to speak to my CEO. I need to send him a message and go for a coffee, and that coffee was, I, I want to leave. [Gaia — 16:21] How old were you at this point? [Pete — 16:22] I think 21. [Gaia — 16:25] That is 21, yeah, 21. [Pete -16:26] Yeah, God, yeah. So young. [Pete — 16:33] Oh really, it's a long journey. Um, yeah, I, I, I prepare that weekend. I'm looking at the objections and I'm imagining that my CEO's gonna throw me around and say, what on earth? He spent 3 months here and I thought he's gonna screw at me. [Pete — 17:01] And he, I have the chat. [Gaia — 16:43] 3 months isn't long. That's like, that's like a tiny little blip in time. [Pete -16:48] Yes, it is. So to figure that out so quickly is, yeah, unusual. Is some sort of gut instinct, like day to day. Is there a misalignment, even if it's small. And I guess I search for alignment across so many things in my life. I often think of like mental, emotional and spiritual alignment. Yeah. And yeah, any one of those out of place and then you can feel it day to day. So I think I felt it. Yeah, I thought he was gonna screw at me and he goes, no worries, go do it. Um, you're a balloon, I'm a balloon, and I'm not gonna tug on you. [Gaia — 17:16] Did he actually say that? [Pete — 17:18] Yeah, I'm not gonna pull your balloon down. [Gaia — 17:21] That's beautiful. [Pete — 17:27] So let's, let's rise up together and I'll see you at the top. Um, so yeah, incredible first sort of, you know, boss to have. And he says, you know what, and these are the people you need to meet. Cause I, I told him I wanted to build a tech startup. So there's definitely something around tech. [Gaia — 17:39] You didn't get the health bit yet at that point. [Pete — 17:39] Not at all. [Gaia — 17:39] But you just knew tech. [Pete — 17:39] I knew it was startups and tech. [Angelica — 17:39] Why, why? What gave you that inkling? [Pete — 17:49] I think something around community, like looking at those people, at the things they do, like building new things very fast and seeing it impact our lives was quite clear. My brother also, there's a bit of an age gap, but he got the newest gadgets and the newest computers and internet when it was first out and all those things, so tech was always like imbued somewhere in me uh and fast growth actually. I looked at where can I learned the fastest, tech, that was it. So I decided to go into this big. Area, this foggy area of tech, um, and he's like, if you wanna go into tech, here are 3 people you need to speak to and I'll do a personal intro. So I guess that's a moment of like. You know, the spiritual part is there's, you know, progress using hate and then there's progress using love. And here's a case where he's like, I'm not gonna compete with you, I'm not gonna pull you down. I'm gonna hold you back or, you know, resent you. I'm gonna love you and do this and do more, so it's very abundant thinking. Uh, anyway, so that starts my kind of 10 year journey. Is it 10 years, 22 to now. So maybe like 6 year Journey of like I'm gonna learn as much as I can because one day I'm gonna cash these chips in and just build a tech company. And that's, you know, the career sort of three liner is I work in many different industries like. Uh, marketplaces, prop tech, uh, eventually landed at Monzo in FinTech, and I work in many different roles, so product management, head of growth, uh, and also I thought, oh, you know how to manage a team in terms of product, uh, you know how to sell, you don't know how to code. How can you be in tech if you can't code? So I decided to learn how to code and. Did hundreds of hours of learning, I got my first engineering job, eventually end at Monzo. And I'd seen companies of size like 1, 10, 100, 1000, and by that point, I remember, yeah, my first boss's wife was mentored me a bit and she said, there's a moment where you jump, and if you're in the learner mindset and you stay in there, you will always continue learning and you won't have the courage to jump. There will always be more learning on the other side, so jump. Don't think you keep on have, you have to prepare, prepare, prepare for the right moment. [Gaia -19:55] You're postponing postponing, procrastinating, yeah. [Pete -20:00] And that was the moment I thought I've learnt everything I can. I'm one of the fastest growing companies, er very high quality work. Let's go. Um, and so starts my journey with Raj, where, you know, our friendship comes back together. Essentially, yeah, Raj and I grew up together in secondary school. Oh yes, Raj is my co-founder. We met online playing games at school. [Gaia — 20:15] No. [Pete — 20:15] Yeah, well, [Gaia — 20:16] what game, what game? [Pete — 20:17] Uh, Halo 3. [Gaia — 20:20] Yeah. I have heard of that. [Gaia — 20:20] Oh my brother shouts out, loves video games. [Pete — 20:21] Right. Things can spawn out of that little video game reality. Oh no. [Gaia — 20:25] Bonds that are built, like, yeah, it's, it's just so fascinating because you're, you're speaking to someone for hours. [Angelica — 20:30] You can't relate to this at all. You can't. So it's like, it's so interesting to see it. Oh yeah. It's a very unique ecosystem. It's, it's quite fascinating, honestly. [Gaia — 20:35] Yeah, yeah, yeah, yeah. [Gaia — 20:44] Didn't you not ever think about video game design? Like, obviously that's completely different. As a career thing. [Pete — 20:44] Yeah. Oh yeah, totally. Yeah. Maybe it's like a boy's dream. [Pete — 21:09] The boys are like, oh I love games, I wanna build games, really hard industry, but yeah, that, that's a cool interception of, uh, you know, art and science, so lots of spaces like that and maybe one day, you're making me think about it. Yeah. [Gaia — 21:24] I think back to this conversation, call it Gaia. [Pete — 21:27] That's a very cool name by the way. [Gaia — 21:27] Oh mythology, Greek mythology. [Pete — 21:27] Yeah, about Earth. [Gaia — 21:27] Yes, Earth, right. Mother Earth. [Pete — 21:27] Yeah, Titan Abundance. Abundance you get anyway, yeah. So Raj, met him playing video games. Oh yes, so we went to the same secondary school, we met and played games. Online, but we weren't in the same classes, the same form. So we kind of like play online, but in real life, we wouldn't really cross over. Right, so you can imagine a bit of a distance. And over time we get closer and closer, so we had mutual friends, that brought us closer. And there was one trip where all of these mutual friends decided to go on a. [Pete — 22:03] Long cycle to Amsterdam and we weren't very good friends at that point, Raj and I, but for some Reason everyone dropped out, so it was just me and Raj. [Gaia — 22:03] It's almost like, you know, we providential. [Pete — 22:03] It is providential. [Gaia — 22:03] You think so, yeah, they're trying to set us up on a date or something and they all just drop out. [Pete — 22:10] Yeah, very formative ups and downs, a journey of ups and downs and. [Angelica— 22:12] Well that's testing, that's like a, that's like a sort of real world. [Gaia — 22:29] Um, testing environment before starting a business together, right, because it's stressful, you're tired, you don't really know where you're going, you've never done this before. It's all new, literally new terrain. You've got it. So like, not only literally are you experiencing it, it's almost like a virtual reality. Yeah, prior to starting the business. [Pete -22:28] Yeah, it's like, you know, when partners go on holidays and they really figure out lots of things they didn't know before. Definitely a crucible. Yeah, ups and downs, like I won't tell the full story, but yeah. We get lost, we miss the camp spots, we break an arm, we lose our bikes. [Gaia — 22:50] You broke an arm. [Pete — 22:50] Uh, no, Raj broke an arm. Um, yeah, we arrived in Amsterdam and got a bit too, yeah. Anyway, uh. Just had a bit of fun. But yeah, like ups and downs and what more is there than in human relationships when there's like a gap that opens up and you work together to close that gap. And we often describe our relationship as a helix where, and I think many relationships like this, right, as long as you are wanting to work together, you can bring that helix back in. So this kind of helix interwove more and more as we went on holiday together, live together, fluctuates, fluctuates for sure. Um, and eventually we start our first company together, and Health Tech One's actually our second company together. Um, where I spawned out the COVID, uh, coronavirus, we had the opportunity to work in a GP practice, and that opens up all of this Health Tech One stuff, and that's where I cash everything in, where I'm like, OK, cool, let's go. Got the skills, we've got the time, let's build the product, let's sell the product, let's scale the product, and yeah, absolute, yeah, the funnest thing ever. Yeah. [Gaia — 23:38] And your mother was, wasn't hesitant at all when you told her that was, that was it. [Pete — 23:52] No, I feel very blessed to have parents that are so open-minded. They're a bit older, which is quite interesting cos you'd think they're a bit more closed-minded, but yeah, super, super open, very privileged to have them. Obviously at difficult times where you're like, I'm gonna quit my job. And you know, I'm a software engineer at a great company. [Pete — 24:27] They're like, they're like, are you crazy? You're a bit crazy. [Gaia — 24:07] Yeah, I can also imagine there's an added pressure because you're, you know, they've, they've given that to you as a gift and then you need to make use of it and you need to make sure that it becomes everything that you want it to become. So there's a lot of pressure there. [Pete — 24:19] You've touched the core, yeah, so, you know, I looked at say their multiplier, what they started with in this country and they came in in the 90s. And over the course of maybe 30, 40 years, how far did they go? And it's not add 10, it's times 10 or 20. So I'm thinking, OK, well they've brought me to 2 degrees and all this backdrop and all this privilege. What's my times 10, what's my times 20? And that's a bit of a pressure at times. [Angelica — 24:40] I say that's a lot of pressure. [Pete — 24:43] Yeah, but when you accept it, and I think I've, you know, I've really processed it, and this is like the full circle moment where they may have done things out of necessity, like build a business. I have the privilege and choice to do the same thing. But with a different sort of purpose and out of choice. So now I'm building a company out of choice and then everything aligns right where you know, I know what I'm doing it for and you know I'm not being forced to do it and it makes every single day like fine, you know, and no misalignments, you wake up every day ready to go again. So yeah, always finding that alignment and trying to make it work. [Angelica — 25:24] Yeah, it's interesting. I was, I was watching a podcast the other day actually about doing work from like out of love and like from a spiritual angle out of something which you know is going to bring good. And the person on this podcast was saying exactly that, like every day you wake up and you just know it's gonna work out because you're doing it for the right reason. Do you feel it's sort of like that? [Pete — 25:46] Yeah, totally, yeah, I think that's the privilege of. Entrepreneurship in some way, like if you get it right, you get to choose, uh all those alignments, right, what works, what doesn't, what you accept, what you reject. You know, Building a company is often building a culture and for us it's, we can pick and choose what we think is right. Um, so yeah, a lot of our cultural values come from Raj and I and how we worked in the early days in our flat together. Um, yeah, but you know when you work for someone else, you know, that's someone else's vision, someone else's path, and you're following that journey. Which can be fine if you know why you're doing it, right, and you've got the precision of understanding what you're getting into. This is the corporate game or it's not, and I'm going to do this for 2 years, but I'm going to get paid more, whatever trade-offs you want to make in your life. I don't, don't really mind as long as people know precisely the motivations. But in a space of a startup when you're building from scratch, there's so much you can build. You can build visions with your team as well. Build culture and that evolves over time and build products and relationships. It's. Yeah, it's just, I froth it, it's the best space. [Angelica — 26:41] How would you sort of compare the two structures that you're in now and what would you say the corporate game is? [Pete — 26:52] Um, well, I've only had maybe 3 years in a sorry, 3 months in a quarter, so I avoided that very quickly. Um, I can make some loose, loose comparisons, right? Yeah, definitely I think, um, with startups they're nascent and they're new and they're built on optimism. And they're often not trying to like early stage startups anyway, they're not trying to scale or build stability and predictability. They're really looking to like find a new thing, which is very, very exciting. I think in more corporate settings, you know, scalability, control, uh, decision making control as well needs to be stable and held, which means there's not much room for creativity, I think. It's more of a control control structure of people as opposed to. You know, giving them the agency to break the system, it's actually inverse incentives in startups. You're trying to break the norm, be optimistic to break the status quo, but in a corporate structure there's less of that. The DNA is much more stabilized the core, right, which fundamentally brings different people into the mix, so. In startups you get very ambitious, striving, smart, talented people that are open and caring, often, or you know, you need to find the right people. I can definitely attest to that, but I imagine corporate structures you get all types. It's everything, so you get a different type of culture, maybe a bit more diluted or and startups it's very um. Yeah, you get these very weird characters that are really optimistic and very, very fast and yeah, cos they have to, yeah, it's difficult. [Gaia — 28:20] Do you ever struggle with feeling like your sense of self is too tied to what you do? Like your identity is in your work. Does that weigh on you emotionally and and practically as well? [Angelica — 28:36] Just to add to this as well, because we've spoken to some founders who basically say that it's been very emotionally tiring for them because they would equate their identity to units sold. So when units sold are low, their identity feels low. When units are high, they feel high. Do you experience that or no? [Pete — 28:58] I don't. Maybe because things are going quite well. I think that's a privilege. Like when things are going poorly, I think I can definitely, I can change. I'm also quite a resilient character and I think I'm living my best life and it's a privilege and a luxury to be building a tech startup that's doing well. So I'm definitely in that. Other category. [Gaia — 29:09] And I guess you just have it for the right reasons as well, because I can imagine what founders do speak about is building for the wrong reasons, basically building for like clout or building for just money or building just for freedom, which are all like fair, like you need money, you want to feel freedom, you want to feel like you're contributing something. But then I guess the longevity game is. [Angelica — 29:51] Yeah, it's building having the right motivation. But then the thing is, because you're working with patients and people who are sick, then there's so much on the line for you as well, emotionally. And has it ever happened to you that you, you felt tied to any given patient and something goes wrong or someone that you've seen when you were like going into the rooms in the practice, then get sick? Like, how do you cope with that? [Pete — 29:51] Yeah, it's, It's the truth, right, so anything high stakes, high importance is going to need high intensity of some sort, and we found a bunch of people that do care about that. You know, if this was selling lemonade stands in the summer, in the summer at, you know, at a park that's different, but here we rise to the occasion and go, yeah, what we build it helps patients, and that's motivating and we'll do our best job and that pushes us to do great, so. We're lucky that our higher purpose is patience and their health and giving them access, like there's not much else I think. There's obviously other parts that are purposeful, but yeah, if it's like Bitcoin or selling a direct, you know, other company, a product and shipping that across the world. We have an easy, easy mission that is much more, we we believe is much more meaningful, so the higher purpose in healthcare is just so, so damn like human. And that's why I say once you go into healthcare you can't really leave because once you have that feeling of helping someone and going through high stakes and working incredibly hard and caring deeply and getting someone what they need, oh, it's like there's not much else that's better than that, um. You mentioned like people or founders that tie themselves to the company. Yeah, there's definitely this like ego piece, right, like what's your purpose? Are you trying to get status and wealth or fame? And if you tie that to your company, then that can become quite unhealthy. Whereas a company's really a vehicle to help people that are passionate solve a problem. So if you make it too much about yourself, that can also crumble. That's just general life, isn't it, if you get too egotistical, that'll go too far. Um, so yeah, I, you know, you have to have some right amount of like ego, of course, you need to be slightly delusional and resilient to get through a difficult phase and to continue. But there's definitely the other side where it goes way, way too far, um. Yeah, I've been lucky to be able to align everything. Again, you see this concept come up again and again, but it just means, yeah, great purpose, and the ego's in the right place and you know, everything else falls into place too. [Gaia — 32:21] Thank you thank you so much, Pete.