Why health care founders are playing a different game than tech founders

This article is authored by Alka Goel and Mansi Aggarwal, founding partners, Alkemi.

In pursuit of the vision of Viksit Bharat@2047, healthcare in India is receiving sustained policy attention, with government initiatives increasingly focused on strengthening research infrastructure, expanding the network of accredited clinical trial sites and building domestic capacity for innovation. These investments point to a healthcare ecosystem becoming more focused on research, innovation and capability building.

Health care. (Photo:Fortis Healthcare)

For health care founders, building a good product is only the beginning. Speed is good in tech, but in health care we need proof and restriction. The founders have to take charge to prove that their goods are risk-free, in line with regulations, and help patients. They also must win the trust of doctors, hospitals, insurers, and patients. A product may be innovative, but its real test is whether people trust it enough to use it.

This makes health care startups different from conventional technology businesses from the outset. The product is only one part of the proposition. Clinical evidence, regulatory approval and credibility can be equally important in determining whether an innovation is adopted.

The decision-making chain is also more complicated. A founder may develop a solution for patients, but the person using it may be a physician, the institution buying it may be a hospital, the payer may be an insurer, and the regulator may determine what can be offered and how. Each stakeholder has different priorities. A doctor may ask whether a solution works in clinical practice. A hospital may look at workflow, safety and economics. An insurer may focus on outcomes and cost. Patients, meanwhile, want to know that the solution is safe and worth trusting.

This is one reason health care sales cycles tend to be longer. Adoption cannot be driven by marketing alone. A health care founder’s go-to-market strategy must account for who makes the decision, who uses the product, who pays for it and who carries the clinical responsibility. Relationships with physicians, hospitals and other institutional stakeholders can, therefore, matter as much as customer acquisition. The objective is not simply to put a product into the market, but to build enough evidence and confidence for the market to accept it.

These realities also change the founder’s journey. In the early stages, the priority may be proving that a solution works. But validation is only the beginning. As the business grows, founders have to think about consistency, quality, regulatory compliance, distribution and whether their processes can support expansion without compromising patient outcomes.

This is where health care investing requires a different lens. Financial projections and market size remain important, but they cannot tell the whole story. Investors need to understand the clinical problem, the regulatory pathway, the evidence behind the product, the incentives of different investors and the realities of health care delivery in India.

This is where sector expertise and operating experience can make a meaningful difference. An investor who understands the healthcare ecosystem can ask the right questions early, identify where a business may face friction and help build the partnerships needed for adoption. Operating experience matters too. Health care companies often need support not only in raising capital, but in sharpening their go-to-market strategy, managing capital carefully, strengthening processes and preparing for the next stage of growth.

The difference becomes particularly clear when a healthcare company moves from validation to expansion. Growth cannot come at the expense of clinical quality or patient trust. Expanding across hospitals, cities or patient groups requires systems that can maintain the same standards as the business becomes larger.

Health care founders are, therefore, playing a different game. The goal is not growth at any cost, but growth that can stand up to scrutiny from regulators, clinicians, institutions and patients.

That is why health care investing cannot be reduced to putting capital behind a promising idea. It requires patience, sector knowledge and a willingness to work alongside founders through the challenges of building a health care business. The strongest businesses will not necessarily be those that move fastest, but those that can prove their value, earn trust across a complex ecosystem and grow without losing sight of the patient.

(The views expressed are personal)

This article is authored by Alka Goel and Mansi Aggarwal, founding partners, Alkemi.