It is easy to be wrong about personalized medicine, and the mistakes teach the most.
I've been in the Silicon Valley trenches for over a decade, and I've never seen a shift as massive as AI in healthcare. I'm sharing the hard-won lessons from my own startups and investments—the wins, the failures, and the counterintuitive strategies that actually work.
What I've Learned From 29 Companies
A few patterns in personalized medicine come up again and again.
The founders who handle personalized medicine well understand that most founders overthink this and underspend on execution.
The Counterintuitive Truth
In personalized medicine, the best practitioners often do less, not more.
The lesson: most founders overthink this and underspend on execution. It sounds simple. It's incredibly hard to execute.
What I Tell Founders
Before deciding anything about personalized medicine, start with three questions:
What's your timeline? Because the right approach for a company with 6 months of runway is very different from one with 3 years.
What have you already tried? Most founders have tried something. Understanding what didn't work is often more valuable than knowing what might.
Who on your team owns this? If the answer is "everyone" or "no one," that's your first problem to solve.
These questions seem simple but they reveal a lot about where a company actually stands.
This connects to broader themes around medical AI, drug discovery AI, AI radiology, clinical AI, AI mental health that I've been thinking about a lot lately.
Final Thoughts
There are no shortcuts in personalized medicine, but there are smarter paths.
The strongest teams treat personalized medicine as a competitive advantage, not a checkbox. They invest in it early, measure it obsessively, and never stop improving.
If you're just getting started with personalized medicine, don't be intimidated. Everyone starts somewhere. The key is to start with the right mindset and the right framework, and then execute like your company depends on it. Because it probably does.
Frequently Asked Questions
Q:Do all experts agree with this view?
No, and that's fine. The best ideas in business are often contrarian. I share my perspective based on my experience and data, but I encourage you to seek out opposing viewpoints and form your own conclusions.
Q:What experience informs this perspective?
This perspective comes from over a decade of building companies in Silicon Valley, two successful exits (RemoteTeam to Gusto, MovieLaLa to Gfycat), and investing in 234 startups including Anthropic, OpenAI, and Scale AI. I write about what I've lived.
Q:What's the most common pushback you get on this?
People often push back by citing exceptions or edge cases. And they're usually right that exceptions exist. But building a strategy around exceptions rather than patterns is a losing game for most founders.