7 lessons learned: from clinician to global entrepreneur
We live in an unprecedented time of change. Exponential technologies are revolutionising industries and democratising access to goods and services like never before, making them faster, cheaper and available 24/7. Healthcare is no exception but creating change in healthcare is not just a technological matter. It involves managing a complex web of organisations, professionals, patients, lobbies and vested financial interests. If you want to deliver a new model of health you need to be ready to lead the change strongly and boldly; you believe in a future where more people can access what once they couldn’t.
Our startup Straight Teeth Direct connects orthodontists with patients through an app allowing clinicians to work flexibly and oversee more patients through a virtual clinic and users to get straight teeth conveniently at home at a fraction of the cost. We have customers in 31+ countries across 4 continents and dentists in 5 countries in Europe. We have a vision of a complete model of preventive and interceptive dental care at home powered by technology, artificial intelligence and nanotechnology. Five years from now this will be commonplace and to do the contrary will seem backwards. However, in 2018, this is not yet obvious to those around us and herein lies the adventure.
“There is nothing more difficult and dangerous, or more doubtful of success, than an attempt to introduce a new order of things in any state. For the innovator has for enemies all those who derived advantages from the old order of things, whilst those who expect to be benefited by the new institutions will be but lukewarm defenders. This indifference arises in part from fear of their adversaries who were favoured by the existing laws, and partly from the incredulity of men who have no faith in anything new that is not the result of well-established experience. Hence it is that, whenever the opponents of the new order of things have the opportunity to attack it, they will do it with the zeal of partisans, whilst the others defend it but feebly,” – Niccolò Machiavelli in The Prince (1513), Chapter 6.
In 1998, I started studying medicine but quickly recognised I sought more autonomy and creativity, so I transferred to dentistry in my first year. I always thought dentistry was too focused on interventions; there was only drilling, not enough prevention or regenerative options. So, I pursued as much training and courses as I could, to then allow me to open a private practice in SW London focused on the type of treatment I believed in – minimally invasive dentistry and aesthetics.
Lesson 1: If you believe in a type of care or philosophy of treatment, find a way to deliver it.
The brand-new squat practice opened in 2009 with exactly zero patients. Through communication and marketing, we helped raise awareness locally about the new types of packages and treatment philosophy we had. Patients quickly became interested in a package we had created called Str8Smiler which included an accelerated brace, whitening and bonding. So, we delivered more and more of this. Eventually we created a desirable brand around cosmetic teeth straightening that is fast and discreet called I Love Straight Teeth which grew our clinic tremendously and generated enquiries nationally and internationally for our small London clinic.
Lesson 2: Find out what people want and make it available to them.
As interest grew, we were met with opposition from specialists who perceived that only they should be providing these treatments. The reality was all of these “new” patients were people who had for their entire adult life lived with crooked teeth not knowing there was a solution that was accessible or affordable. This was an entirely new market that was being unlocked.
We co-founded a national organisation with other leaders in this space focused on educating general dentists on how to safely deliver orthodontic care but continued to focus on how access to orthodontic treatment could be widened still.
Lesson 3: Create your own market space.
As we expanded, we started looking at technology to make the whole process as low cost and high quality as possible. I’ve always been interested in bleeding edge technology, so I was tracking mobile technologies, 3D printing and scanning developments. We identified a way to change the whole model from in-clinic to at-home. This had already happened in Dermatology and General Practice, so why not dentistry or orthodontics?
Lesson 4: The world is not a meritocracy. If your vision of the future is too transformative, you will face gruelling opposition.
We built the brand and concept, tested it, and then released a pre-launch video to gain consumer feedback. What happened next we could not predict. Demand skyrocketed, nationally and internationally. Then the profession backlash started. Rather than focusing attention on helping more people access a solution, we were met with outcries of scandal and outrage, claiming this is terrible for dentists who would otherwise be earning thousands per treatment. Articles and press releases were quickly written to disparage this new reality without questioning or consulting with us.
Lesson 5: Communicate your vision entirely. It is 100% your responsibility.
What we hadn’t publicised or communicated as well was the other part of our platform. We had created an entirely new way for dentists to treat patients, using a virtual clinic, without any investment on their part. A whole segment of the population was able to now access care that it could not before. We saw technology as a tool to democratise access to services and care; a tool to augment the dentist to be able to help even more people.
We redesigned our communication, completed the development of our platform and manufacturing facility. At the same time this was happening, we completed the sale of our clinic in London and, on the closing day of the sale, the UK voted to leave the EU. We took it as a sign to move on internationally to accelerate the process, and after researching different countries to base in, we established operations in Ireland and Portugal, and quickly sought out partners and other markets excited by our vision of the future.
Lesson 6: Find a way or make a way. If you want to be global, think global from day one.
We understood we needed to find other people and networks that are working on similar transformations globally across other industries too as the challenges are common, so we joined three accelerators, all focused on different verticals with different networks. We have had many international opportunities; coverage, awards and collaborations have enabled us to gain credibility and expand.
Lesson 7: All change occurs through massive action.
If you want to make something big happen, you need to put in the energy and time consistently and then step by step people will begin to believe in your vision too.
The summary I want to leave you with is creating change is not easy, but if you are creating a more equitable future and doing it for the right reasons with the right vision, you will find other leaders that believe in you and want to help co-create a new way. As healthcare professionals, we all know the limits of systems we work in and often we can also see the solution. All it takes is a concerted focus and effort and then you can help revolutionise health for more people.
Dr Aalok Y Shukla is a healthtech entrepreneur with a clinical background in dentistry. He has a particular focus on artificial intelligence and its clinical applications to deliver a more scalable, data driven approach to digital health services. After running his private practice in London for 7 years, he sold in 2016 and refocused on the unmet demand for accessible, affordable orthodontic care. He co-founded Straight Teeth Direct™ platform & mobile app that offers affordable convenient teleorthodontics to people who would not otherwise be seeking a solution and a new way to work for clinical dentists.