Stephen: 0:01

Welcome to season one of stethoscopes and car series for MedTech and sports innovators, which we gave him, founders, leaders, investors, and advisors been there, done it, and got the t-shirt learn from their stories, including their successes. And here I'm your host, Steven Carter. If you enjoyed this episode, make sure you follow us. Visit our website at the stethoscope. Hello and welcome. And I'm really pleased today to have with me here, Dr. Jillian Nesbitt, who's founder and CEO of Dr. Jillian. Welcome Jillian. Thank you for being here.

Julian: 0:51

Oh, thank you very much for having me. Yeah, no, very well, thank you. That's great.

Stephen: 0:56

Um, so you say on your, um, your LinkedIn that you're striving to improve access to mental health care, which I think is a great thing to be doing. Um, and hopefully what we're going to do over the next half hour or so is delve a bit into the journey of how you got there and how Dr. Julian has become what it is today. But maybe if you start just with a brief introduction for the listeners, as you know who you are, what your background is and what Dr. Julian is.

Julian: 1:22

Sure thing. Yeah. So, um, I'm a doctor by background. I've actually wasn't any doctors sort of in any training, uh, and in sports medicine. And now, uh, I then switched to bed GP. So, um, I'm actually still a practicing GP. I still try and cling onto my clinical hours. So a day or two, um, of GP work, uh, just because I really enjoy it. And I think it's, it's really, uh, it's important to just try and to carry on. So yeah, so background is, is, is a doctor. So I was sort of, I guess, was on the front line of medicine, uh, of health care, having done quite a lot of psychiatry placements as well. And I think for me, mental health care was the most fascinating thing because we it's the thing we at least understand. And in a sense, considering the brain is the thing that's most complicated. So I've always had this sort of passion for that. Um, and I guess the inspiration came from, uh, originally because I was working in Annie and, um, many patients were coming in having even tried to kill themselves and you ask them why, and they're on a waiting list for therapy. I mean, the problem is antidepressants only work for severe depression, which they are useful as sticking plasters potentially, but they don't treat the problem necessarily unless there's a chemical imbalance in severe depression, but a lot of the time it's actually therapy. That's the thing that actually treats the issue and gets to the core problem and actually makes people better. Um, and there's just an issue with complete lack of provision of that. Um, as we know that it's, it's a difficult resource, so I thought, is there a better way to find people therapists and can we match people better and actually hang on. If we do it on a platform and even online, then you could even utilize a global workforce therapist. And therefore if that person needs the specialist in this particular area, then they'll be able to get that because it's all done online. So that was the idea. So we built a platform up, um, now quite extensive technology, uh, where we can patients can actually get, get choice. So I wanted to really empower people so that they have choice. Um, they help get matched to the most appropriate ones for them. And then they choose based on their picture, their biography, and they can even message the therapist beforehand to say, are you, you know, are you right for me? Um, and they choose the time that's convenient for them. So rather than sort of being told on next Tuesday, sorry, Tuesday in six months, time at three o'clock, you've got an appointment and then they turn up to it because they're actually picking the appointment and finding the therapist that suits them. They've already started that therapeutic relationship, which actually gets, gets them engaged. So our DNA rate, which is I did not attend rate, I is very, very low and our engagement rate is much, much higher. So we were able to sort of, yeah.

Stephen: 3:54

Able to sort of give him more power back to the patient, I guess.

Julian: 3:57

Yeah, exactly. So finding that it's important to find the therapist that most suits that patient, um, and to give the power back so that they're, it's, they're, you know, they're the ones that are then gonna engage in that treatment because the worst thing is not engaging in a treatment. And I think in the NHS, it's a hugely difficult thing and there's tens, or even 20% did not attend rates and, and massive non-engagement rates. Um, and also not great recovery rates. Uh, we measure recovery based on questionnaires before and after. And, um, the NHS recovery rate is hovers around 50%. So only 50% of people will, will recover. Um, and the idea and what we've shown is that we can improve that and improve the engagement rate by fight, by getting people the right therapist at the right time. Um, and obviously there is a limited resource for therapists, but by utilizing a much wider network, you can, um, you can help to, to, to get that person better help more quickly as such. So that's the whole idea behind it.

Stephen: 4:55

Uh, w w one quick question around that and before we move on, but so, I mean, I can imagine as a mental health patient, I may not really have a good sense of what sort of therapist I want or whether some of the therapist is going to be a good match for me. So it's the, you know, it's great to have choice, of course, is the pivot is a platform also recommending particular therapists, or

Julian: 5:16

So it will give you a choice of, of, of those ones that are appropriate for you. Um, there are questionnaires that you can fill out. Um, however, we, I'm more for human contact, uh, the majority of people that come into it, so we have different ways of, of it working. So you can go in and pay privately. And in which case, your first session is an assessment anyway, and we can help match you based on questionnaires, and then they will help to guide you to the right to the right person. Uh, potentially we are, we have a customer service team that, uh, is free to call up and they, they will also help guide you to the right person as well, if you're struggling. Um, but we do find a lot of people, do you know what the issue that they most need help with is, um, and there's also loads of information about the different therapy types. Now, the majority of therapy in the NHS is, is CBT, but there's also some counseling modalities. And we will, we explain that in the platform, you can sort of get an understanding of that before you choose. We work in different ways. So, so you can pay privately. Um, but we also have, uh, NHS contract. So my passion was to get us into the NHS. So we work alongside the NHS where they refer into us and they, a lot of those patients have already been assessed so that they are appropriate for step two, step three is for instance CVT. So in those platforms, we give a choice of those therapists qualified in that domain. So therefore, you know, that the ones that you're getting are the ones that are appropriate for you in, in that, in that sense. But it's quite interesting that actually based on our sort of matching, uh, and, and, um, the way that people can, can choose a language, then the language of that therapist or the issue they most need help with, and then reading those biographies and messaging the therapist for free beforehand, they're actually able to sort of make sure that even they can find the person that most suits them as such. Um, but yeah, we help guide them. We don't give people overwhelming choice, so there's a sort of list of six. And then if you want more, you can press show more and then it will show you more. And again, it depends on the filters you've selected and also your availability, because it will only show up the therapist availability that you've picked when you're, when you're availability is. I mean, the, the idea as well is that we're trying to make life easy for the therapist as well. So by utilizing the platform, they upload availability when they want to work. So it's much more flexible for them. Uh, and then it's, you know, within matching the availability of the therapist to the patient as such.

Stephen: 7:26

Yeah. Yeah. I, it sounds like it's a completely different experience to the traditional NHS experience. Whereas you say you just get a letter through the post that says be here on this day to meet this doctor. Yeah, exactly. Doesn't that sound great. So, I mean, so, I mean, it sounds like an amazing platform where you've got, you know, is, is really quite incredible, but I guess there's been a, uh, an interesting journey to get you here. Um, and then for the listeners, I think hearing more about that journey and the, um, yeah, the challenges you've faced, um, I guess, you know, what what's gone? Well, the mistakes that you've learned from is going to be really informative for them. Um, so maybe sort of take us back to the beginning and I see one of the things you mentioned there, which I think would be interesting to hear about kind of along the way is, is getting your service into the NHS, because I know that's a big challenge for a lot of small tech businesses. Um, but anyway, yeah, take, take us back to the beginning and sort of talk us through that, the journey

Julian: 8:22

I'll take you through, and then I can give you a bit on, like, I kind of also feel I'm sort of still, even at the beginning, well, for that happen, we've got a lot of plans and things, but, um, yeah, so the, uh, okay. So I guess the, the main thing I, the main piece of advice is just believe in yourself. So I never believed that anyone could build something and no one thinks that they can build a business or do what yeah. But you've just got to go for it. And then it's about resilience because there's, it's a roller coaster. You get knocked down. I mean, the number of times that you wake up and you just say, why am I doing this? And then you just get through it and then it gets good again, and then it gets bad again. So it's just about resilience, I think. Um, you know, and, and it's about trying to find the right people. And a lot of the time, the people that you have at one point might not be the people that are right a bit further on. And then it's about actually having the bravery to say, sorry, that's not right. And I think some of the things that I mistakes I've made was, was just not having that bravery soon enough. And I think, you know, that's delayed things by making sure you find the right people. I mean, it's been hard for me because I've kind of done it on a shoestring. I kind of initially the idea was that, um, I sort of used a bit of my own money to start with a little bit like 10,000 pounds to build a very, very bad MVP app with Russian developers that friend had recommended. Um, but it was sort of at least proven that a little bit of a concept. And then I was able to sort of utilize, um, some of my network, um, and the, uh, it was interesting cause I was then on, on board with the kind of crew intrepreneur program, which is run by 10 young, but actually really, if you've heard of that and that kind of gave me confidence, uh, to keep to do it, I think, which was nice as well, because that's an NHS program, isn't it? Yeah. It's for, for sort of clinicians or, or people that work in that it's just, that wants to sort of innovate, I guess. And it gives you a bit of confidence to do it. Cause it was back in the day. And actually as a doctor, people do not want you doing anything else apart from being a doctor. So it's, uh, you know, you get quite a lot of backlash because it's about unusual. Um, so that program gives you confidence to do it. And I think so I, you know, built this little Russian app, which was kind of terrible. Um, but it sort of showed a bit of a concept and I was lucky. I, um, initially we, uh, so as long as the private market and then we, um, uh, I sort of used some of my networking and connections and trying to find out the need, right? So the, the key thing, if you build a business, don't build something that's not needed and make sure that, um, you know, and don't keep going. If it's not needed to make sure that you pivot and change to what is needed, if you're, if you're going down the wrong tracks, you don't spend ages and ages and ages building something that isn't needed because that's a waste of time and money, right. So

Stephen: 10:59

He's done it before where, you know, people, people think something's needed, but they're not actually tested it in the marketplace and

Julian: 11:06

Correct. Exactly. So don't spend loads of money on development before you've tested. And even actually I shouldn't have built an app. I should have done it on like just on a wire frame or gone into, you know, or something very simple, uh, to go and ask the, you know, patients and, um, the trustee, we worked alongside the IOP services, which was the main provision of NSS. So one app service gave me a break and said, okay, let's test it. We want to provide an online provision. This was, uh, quite a few years ago now. So it's sort of, I've been doing this since concept for like four, five years, but then kicked off really in the last two, three years. So, um, obviously I was a full-time doctor for a long time before that. So I was sort of bumbling along a bit, but the, um, the, uh, the service said let's do it. So that was nice. That was my sort of initial customer. And I think that's the hardest thing to do, but it was, it's about sort of going out there trying to present it, utilizing for the NHS there's there's other sorts of help. So there's edge send network that sometimes can be of help to help to introduce you to people. Um, and I think the thing is if it's needed, they come to you. That's, what's interesting. So, um, it's you, if I didn't have to do a huge amount of marketing is sort of, this is a provision of therapy. This is what we're trying to achieve. And actually then, um, people can come to us. So when it's not needed necessarily, it's quite hard. Otherwise they come to you. And I think the biggest, we didn't have to get proper full on NHS standalone contracts to start with. We were able to get subcontracts from providers. So we were sort of, and that is a much easier way to start. So if you want to do something first, then work alongside the current providers, helping them out, and then, then you can see what to see how that goes. But I think,

Stephen: 12:46

Yeah, I mean, so it sounds like the main message, there is one, if you, if you're providing something that the market wants, and so, you know, clearly you need to test and understand what the market wants to make sure you're providing it. Then you're going to have a much easier path into, into the service, into the NHS.

Julian: 13:03

So not so fragmented, but if they, if you know that the great thing is once you're, once you start doing it, it's needed, they all talk to each other. And it's a very, very small network. And the one piece of advice I'd say is never, ever sell to the NHS. So never, I think it was easier that I was sort of an insider. I knew how it works, but don't go as a sales person to the NHS. They will not buy it. They do not like salespeople. So

Stephen: 13:24

That's definitely useful. You say that, that, you know, you obviously you're, you're on the inside, you're a doctor, um, looking at kind of other people, you know, that have been successful in building these kinds of businesses. Is there a better hit rate for clinicians starting up businesses like this? Would you say? Or

Julian: 13:44

I think it's fair, but I think it depends on the company. Like, so it was interesting actually I was listening, uh, last night to a fellow entrepreneur. There's a term culture in our program, sort of put the thing that we did on zoom. And she was explaining about her eye care startup. And it was interesting. So she said that she was working as a, in ARCA and she understands the science. She understands the patients, she understands what the patient wants cause she's doing it. And then there was two sort of developers that were, um, uh, just a gang that developing games as elephants. So they tried to build it, but they built something very pretty, but it was completely wrong. Uh, so I think it obviously helps if you're understanding what if you're in the inside and if you're not in the inside trying to get someone that is to understand what the patient needs or wants, or actually what is the experience and then make sure you test it with the patients and then understand that you're building something that is the right thing rather than, and make sure the science is that I think

Stephen: 14:44

The main knowledge that you need

Julian: 14:47

And understanding you've got the right science behind it as well, I think is important. But so I guess, so we started with the NHS and, um, started building up and then we've got some angel investment. Um, but I kind of did this on a shoestring. So it wasn't a huge amount of, um, it was, it was, yeah, we haven't, I haven't raised properly and this is what I'm going into now, I think. Um, but yes, the, uh, it was sort of angel investment and, um, built. Although I was able to w I had a very good developer actually that we then found who, um, has built a fantastic platform and sort of now considered one of the market leading platforms actually. And interestingly, other therapy providers are now coming to us to buy our platform off us. So we're starting to diversify into a bit of a SAS model. Um, you've got to be a little bit careful with competition that, but it's a, we sort of, we don't want to just have this for ourselves. The whole point of this is that I want to give the patient the best experience. I'm not really in this greatly for the money as such, but I want to just, you know, but obviously we have investors and everything else, so I have to be careful, but the idea is that I want to, um, the platform and wants to build the best platform that other people can use. So we have got, we're starting out with, with, uh, selling the actual platform now as well. So that other therapy providers where their own therapists can, can use this platform. And I think what's going to be happening with the platform is that we're now as well as the, all the backend functional services sort of end to end system with a booking system, that then we have the appointment on the platform, on the academics that easy. Um, and then all the notes and everything are kept. All the assessments are done on it. And then there's different letters. You can download all your notes and each patient gets a personalized dashboard, so they can access that for life and go in at any time and any sort of information that was given to them by the therapist always accessible there. So if they needed to come back to something after the therapist finished, that they can, and, and now we're building a range of self-help tools in there that will be most suited to the patient and, and a very decent resource library, as well as all homework is going to be in that. So one of the biggest problems a therapists have is getting patients to do homework, because actually you only hit see your therapist one hour a week. Um, the rest of the time you need to be working on yourself. And, uh, we're going to build all of that into the system. So we were just, we're just about to launch that. So you're going to have, you're able to sort of have all of, uh, actually complete the homework. Cause otherwise they send a link, you have to download it, print it out, try and send it back. Nothing never happens. So this way, it's all in one place. And I think there are thousands of self-help tools out there. And you just have to be careful because if you say, download 15 different apps, no one ever does that. So we want to try and put everything into one place to make it look more, a lot easier for people. Yeah.

Stephen: 17:19

Yeah, it sounds, I mean, it's convenient for them, for the patient, but also presumably means that the therapist can have oversight of whether, whether the particular patient is keeping up with their homework, whether they need a little nudge or

Julian: 17:30

Correct, and it will put, do push notifications and then you've got, and then in the actual appointment itself, you can have the dashboard for the therapists showing what the patient's done. So it saves a lot of time makes everything a lot more efficient. Um, and then, you know, even just having the assessments in the system means that the therapist doesn't have to do the assessments during the session so they can be done pre prior in the, and the patient can see their recovery chart graph to see how they're getting on making sure that that they're recovering on things. And yeah, and so NHS is where we start and then they talked to each other. So that was my main bulk, but then started working with them, occupational health companies and charities. So we're now trying to scale up that market. So, I mean, there are comp capacitors now in this sort of private space working with them corporates. Uh, but I think that's where we want, we want to go into now in, in maintenance. And I think our platform is sort of a little bit more advanced than a lot of those other competitors in that sense that want to just provide therapy services. So the idea now is that we want to with working with those and, um, forming different partnerships, uh, at, at the moment as well. Um, and again, going to the sort of university space and our platform allows us to create white labeled portals for any organization we work with. So we can customize each one and then we can add different admins with different permissions. So yeah, it's very flexible in that sense.

Stephen: 18:48

[inaudible] you started off to be the kind of the service provider and the platform you developed was the, was the tool that you developed in order to be that service provider. So at what point was that a kind of a light bulb moment where you thought actually we've got something bigger here, but that the platform itself becomes the business.

Julian: 19:07

It's a very interesting question. And it's, it's difficult because you don't want to confuse it too much. I think by doing, by building the platform, but because we knew what was working, what wasn't, and we spent four years, five years building it sort of with a lot of different. And again, there's a lot of governance you have to go through and everything else, of course. Um, and by all that patient feedback that we've had, I think, uh, it was then sort of hang on, is there anyone else doing this out there? And people have built platforms, but, but no one was sort of actually selling that platform. And, and I've had approaches of once we actually, most of the therapy providers are all in dark ages. And again, before the pandemic, everyone was like, oh, no, online is terrible. Don't use online therapy. Um, so now suddenly they're like, oh yeah, okay. Yeah, we should all do everything online. Okay. So, um, so suddenly it's like a bit of a switch and I think, um, a lot of these companies now are trying to scramble to either build something or not. So I thought there was a gap, let's say, whoa, hang on. We've built something. Why don't you just license it off us?

Stephen: 20:07

So say, would you say then, I mean, Dr. Julian sounds like it's an example of one of these businesses is actually as horrible as the last couple of years of being probably it's actually benefited you in some ways. I

Julian: 20:19

Think, I mean, I guess, I mean, I guess so. Yeah. It's created an

Stephen: 20:22

Opportunity that might not otherwise it'd be,

Julian: 20:24

You don't want to, I mean, I think obviously the pandemic has massively benefited digital health in all aspects because suddenly it's like everyone has to use digital. Um, and it sort of, especially, you know, with the NHS, they've even been pushed to say, you know, they've sped up their digital processes hugely. So I think any digital health business has benefited in that sense, but I think it's obviously, um, yeah. And, and it's, I think it's going to be a tough time. I think a lot of people are, have struggled and wouldn't, do you need some help? You know? Yeah. There's times when, um, yeah, I mean, it's, it's obviously been very, very tough and, uh, I do think we need to provide the support for those, for patients that need it. I think the other thing that we want to do, um, as compared to like calm and Headspace and all those, I want to build a lot of what they have, but actually the evidence-based versions of that, because what they've got isn't evidence-based and provide it for free. So I don't think people should be paying to use a breathing tool that has a blob that goes in and out, like, you know, you should be able to do that whenever you want. So, um, I know they have nice stories and things, but yeah. So the idea is that a lot of materials that we were going to build can be free so people can download the app and just use it whenever they want. And then if they need the therapy, it's that, uh, when they need to assign,

Stephen: 21:35

Yeah. That was a great ambition. I mean, and, and anything that makes that kind of help, the more people need more freely or more accessible, um, is, has got to be a good thing. And so taking you back to one of the comments, so you talked about your kind of fundraising journey, how you basically, you know, choose big, big, strapped it to start with, and then you've had some angel investment thinking about the kind of angel investment side of things. What, what was your experience, um, when you went out to kind of seek angel investment where they, you know, what, what, what was it, they, what was it that drew them to you or, or what, what were you looking for in terms of matching yourself with an investor?

Julian: 22:12

Yeah, sure. I mean, so you've just got a decent pitching practice and it's very, it's quite daunting when you start and it's just, yeah, it's just about, you know, you've done endless pitching to various events when you do them, but it's get, get used to the part of the journey you have to go through and do your pitching and do you, and I think, um, again, investors interested, if the, if you've, if you're passionate, you've identified a clear market need and you've got traction. And I think, you know, then it's, it's, it's sort of a, more of a no brainer for that. I think, um, if you've identified in a massive problem and you've got a solution that is an interesting one that you think will work and who's getting traction, then I think it's, you should be able to raise to raise money from that perspective is it's, uh, making sure that you've identified a clear story and it's yeah. I, I think that that's the key really,

Stephen: 23:05

Um, having a good story in being able to present it and get it across in the right way, I guess. And I guess be prepared to accept a lot of nos along the way.

Julian: 23:12

Yeah, of course. I mean, yeah. And, and not to get beaten down by that because most of them will be those. So you just have to sort of pick yourself up and just yep. Okay. Never mind, but yes, it's, it's, it's, uh, it's just the learning curve of the journey from that perspective.

Stephen: 23:29

Did you, I mean, and when, when you're out there looking for money, did you get a sense, what, what was, what was more important to them? Was it the, was it the market need? Was it the team that you'd pulled together? Was it, um, the, the kind of innovative aspects of what you were doing?

Julian: 23:44

What's interesting. I think, um, well, when I re I, again, my team has been taking time to build and, uh, I, I probably didn't have the best team to start with, but I've sort of been evolving and there's been, uh, yeah, it's, it's, uh, I guess so when I raised, initially I didn't have the greatest team, but it was sort of, you know, you kind of, obviously team is really important. I've got a much better team now. I think the, uh, from a perspective of like raising big money, I think obviously that's very important from the team perspective. I think when you're sort of starting out, it's more about your vision, uh, what traction you've got so far, is it working what, and then identifying what you need the money for and making sure you've got a plan for that, um, I think is important and then knowing your competition and why you're different is quite important. So, um, making sure that, you know, you've got some envy, you know, um, you've got some USP's in that. Um, but yeah, mainly I think they were, it was it's about the sort of vision I think, of the star is what the Keenan

Stephen: 24:46

Interesting. Interesting. Listen, I'm kind of conscious of time picking on, I know you've got a busy day ahead of you. Um, so I've got two questions just to, just to finish off with. Um, and so the first one is you kind of look back at these events you've had, um, if you're talking to, um, a med tech startup, let, let, let's say it's a clinician and a doctor or someone who's got an idea and that, that they want to bring to the world. Um, so they're just, just starting out on this startup journey. Um, what, what would be the one kind of biggest piece of advice that you would give to them

Julian: 25:25

Believe in yourself and have resilience. It's keep going to be honest for me, certainly times that I nearly just said, why am I bothering? But you just have to keep going because there'll be so many downs and you just got to keep going through the downs.

Stephen: 25:39

Yeah. That's a great that you did, right. You did. Um, and then one final question, which is, would you rather fly on a magic carpet or own an invisibility cloak

Julian: 25:52

Flying a magic carpet visible?

Stephen: 26:01

Yeah, me too. I'd love, love these bands are flying on the carpet. Well, listen, and yeah, a bit of a silly finish there, but, um, yeah. Great, great to have had your own hair Julianne and, um, yeah, really appreciate you taking the time and, uh, wish you every success with the ongoing growth of Dr. Julian

Julian: 26:16

And a pleasure to be here. Thank you. If I was just say, if anyone wants to get in contact. Yeah, I'm on LinkedIn[inaudible] but just, um, just message me on there if anyone's interested. So thank you. Great.

Stephen: 26:28

Thanks. And we'll share your details when we publish this as well. So people can get in touch with you.

Julian: 26:33

Thanks.

Stephen: 26:35

Thank you for listening to this episode to get to follow us. So you don't miss the season two coming early in 2020. I've been your host, Stephen Carter of the intellectual property. If you want to connect with me or our guests, you'll find contact details in the notes and on our website, stethoscopes and rugby balls, Newcastle. And remember as a way to do it better, go find it until next time. Take care.