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851 points swyx | 12 comments | | HN request time: 0.609s | source | bottom
1. gault8121 ◴[] No.25826932[source]
This article's thesis seems to be that medical professionals are not incentized to provide the best interventions, and as a result, wouldn't pay for this service. However, what the author fails to mention is the competitors in this space that are successful, such as Up To Date, which provides really high-quality research trial data: https://www.uptodate.com/home

Rather than building a product that informs medical professionals about effective interventions, I wonder if the creator would have had more success if he deeply explored what sources of information these medical professionals pay for now - do they pay for anything at all, such as UpToDate, and don't want to pay this because it's an additional expense? If the creator found which sources people are using, the creator could sell this database as a feature for these partners and widely disseminate this data through partner channels rather than creating a competing source of information. It seems to be a case of this being a good instance of a B2B2C model, where selling this service to other businesses that sell directly to medical professionals could be more viable than trying to sell directly to them.

Alternatively, if the creator wanted to sell to patients, rather than medical professionals, the blueprint here is all of the consumer reports companies, such as Wirecutter, which is one of the New York Times's most popular services. Here, again, a "Wirecutter for medical interventions" could be quite successful, and you could sell this service to media companies that provide consumer reports as a service that would bolster these companies.

It's bad the creator wasn't able to find traction, as getting more medical data into the hands of consumers could have a huge postive impact over time.

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2. dr_ ◴[] No.25827181[source]
A hospital system is incentivized in some ways to get people discharged as soon as possible and ideally with a good outcome. A service like UpToDate is one of the tools that may facilitate that by providing valuable clinical pearls to facilitate decision making. So it's not surprising that UpToDate is largely paid for by large institutions and academic medical centers, and not as much by individual medical providers.
replies(1): >>25828638 #
3. repeek ◴[] No.25827276[source]
I don't think he had the correct buyer either. While medical professionals may be the user, for this type of service you need to be selling into hospitals or health systems. They have the incentive for their providers, collectively, to improve the quality of care.

I doubt UpToDate makes their bones off individual subscriptions. The real money to keep a company afloat is from b2b enterprise contracts.

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4. viraptor ◴[] No.25827312[source]
There are also services in non-us countries like "How to treat" https://www.ausdoc.com.au/howtotreat Which are relatively popular and used by doctors. Although it's already edited rather than raw data.
5. Closi ◴[] No.25827393[source]
I thought exactly the same when they were talking about trying to convince doctors to buy it - surely they don’t misunderstand their market that much though?
6. gzer0 ◴[] No.25827470[source]
https://opensourcemed.com

It's a crudely built version of UpToDate from 2018 as it was on April 2018. Useful for 98% of the population still.

Edit: definitely works better on mobile, and the search needs to be fixed.. this isn't my website but a resource that I've been passed down/told about by medical students.

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7. foxylad ◴[] No.25828300[source]
Competition analysis should be number one on the "Before You Write A Line Of Code" list. As the author has found, the value proposition is also important, but looking at competitors offerings will often inform that too.
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8. gault8121 ◴[] No.25828617[source]
Yes, exactly - it's though big enterprise contracts that generate revenue, but they are hard to close as a startup. Selling this service to companies that already have those contracts is a faster way of creating value for those customers.
9. gault8121 ◴[] No.25828638[source]
Yes, that's an interesting point. It seems like an individual medical provider is incentivized for repeated care where a large facility is incentivized for a fast outcome.
10. gault8121 ◴[] No.25828671[source]
Wow, that's really interesting. Did UpToDate publish their entire content library as of April 2018 under an open access license?

There seems to be a ton of good data here that you could use to build some type of WebMD competitor.

11. closetohome ◴[] No.25828957[source]
Seems like taking a moment to think about monetization before beginning would have saved some trouble.

When you run a service that provides information you either make money through ads or direct subscriptions. And if it's B, you better have an airtight value proposition and an intimate understanding of your competition.

12. ◴[] No.25829221[source]