On learnings from REACH Diagnostics

5 minute(s)

It's been almost six months since I first left for Boston to join an accelerator program for my business, REACH Diagnostics. It was a rewarding personal and professional experience, and I'm jotting down my top takeaways to keep in mind moving forward. This is mostly an exercise for myself, but I figured I might as well publish it.

Action beats strategy

While in India running the business, we had allocated some time to developing relationships with local hospitals. They were a key channel partner to a) to advertise our business to their patients, and b) help us create an effective mobile diabetes monitoring solution. Because we had no local network, we spent weeks trying to connect with people on LinkedIn, guessing email addresses for cold outreach, and working through third- or fourth-degree connections. Over the span of several weeks, we made no progress at all.

Finally, we decided to get out of our apartment, take a rickshaw to the biggest private hospital in Mumbai, and walk in. We were stopped by security in the first 10 seconds - but as I tried to explain what we were doing there, a doctor passing by overheard me, pulled us aside, and gave us the contact information of the person we needed to talk to. We had a meeting with him the next day.

A similar strategy landed us our first meetings that led to partnerships with the IDF, Joslin, and other key players. I used to think that "good strategy" was critical to getting things done, but learned quickly that taking practically ANY action (and course-correcting quickly from there) is almost always the right approach.

Nobody knows your business like you

In our first two weeks in the accelerator program, we pitched our business to a few mentors and advisors. We used a proven presentation: the same deck and script that got us into the accelerator in the first place.

We got shredded apart less than 5 minutes in, and didn't even make it to the second half of the deck. The audience learned that we hadn't invented the technology we were using - just repurposing it in a new way. To them, this meant we had no proprietary advantage, and they didn't hesitate to communicate their disappointment and disinterest. My team and I completely deflated, and all the hype from our previous success in Shanghai was gone. We went home immediately after and wasted the rest of the week, almost giving up on the business right there.

We didn't agree with the feedback, but weren't confident enough to believe in ourselves. When multiple senior executives with years of experience tell you that your business sucks, it's hard to believe you're right, but that's exactly what we should have done. We knew our business better than them. Collectively there was probably 100s of years of startup / consulting / healthcare / investing / operating experience, but nobody had more experience in the inexpensive-paper-based-diabetes-diagnostics-in-urban-slums-in-India industry. Our business model has since been proven economically and commercially successful.

Understand the incentives

Over the past months, we've had a lot of advisors and mentors telling us to do different things, and at times it became extremely confusing. When a 2B VC firm is advising you to take path A and the CIO at a major pharmaceutical company is advising path B, it's hard to know what to do. I realized the importance of understanding everyone's incentives when we were deciding whether or not to pivot away from a distributed-production model to a centralized-production model.

Note: Our business was in distributing paper diabetes diagnostics directly to end users. We had the choice of centralizing production in China, or using a local ecosystem of printers and distributors.

As we heard many rounds of conflicting advice on which model was better, we were accidentally forwarded an email discussing the PR potential of the local distribution model - something to the effect of "imagine how great it'd sound in the papers to add jobs and empower the local community”, and that was when the choice became obvious. The people advocating for the distributed-production model didn't care about the feasibility or viability of the model - their incentive wasn't to see REACH succeed or maximize our impact. It was to get us (and by relation, them) into the media spotlight with a “fresh” and “innovative” new business. Centralized production wasn't sexy or newsworthy. But it meant we could bring the cost down for our customers by more than 70%, making our solution more affordable for some of the most price-sensitive customers in the world. It was obviously the right decision, and it was only when we realized the underlying incentives behind the advice that we could properly discount it's worth.

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Note: I left this post unfinished back in 2015, and I won't try to retrofit a neat conclusion now. But rereading it in 2025, I'm glad to see that lessons that felt worth remembering back then still hold true for me today.