As a co-founder of InsightMedi, a small healthcare startup from Europe with business operations in the United States, I frequently get asked about the differences between working in one market or the other. Most commonly, I am asked about differences between the perception of a company and the value they create, the aversion to risk, the available talent, the size of fundraising operations, and the culture of innovation.
It goes without saying that every experience is unique, but I would like to think that after spending three-plus years running the business in both ecosystems, there are greater similarities than there are differences. Perhaps the variations between one experience or another may not lie in the time zone, but on the nature of your own business, team, and product.
That being said, there are enough articles and posts out there describing the differences in the magnitude of both startup ecosystems. We all know that the United States will generally be the place where bigger checks are going to be written, bigger risks are going to be taken, and unicorns with potential blockbuster IPOs are more likely to be developed. In Europe, things are getting better and the gap is closing (although it’s still significant). It is however known that the patience for generating revenue tends to be shorter, e-commerce and shared economy investors overshadow niche investors, and regulations are not only less accommodating for startups, but they change and adjust constantly all over the continent.
The appetite to be bold
One key aspect that seems to come up in every comparative analysis I make is the entrepreneur’s ambition. That drive to create a leading corporation that changes the world in a significant way, no matter how risky it might seem at the very beginning.
I believe this difference in attitude is directly related to the education system. Even though education in major European universities can be considered equivalent in terms of quality, the US system seems to do a better job at fostering that hunger for world domination in some of their students. They seem intoxicated with bravery, presented with a plethora of industry-related opportunities, and determined to succeed regardless of the price to pay.
In Europe, you’ll easily find great talent, ambition, and desire but with a slightly different tone. Even young entrepreneurs dreaming big will talk about work-life balance, creating wealth to enjoy it, and working to live instead of the opposite.
Innovation in healthcare
When it comes to healthcare and the need to improve its processes through innovation, either in the technological or structural side of things, I believe both ecosystems have a very similar mindset. Despite that healthcare systems in the US and Europe are extremely different, the entrepreneurs I meet on both sides have analogous missions. Similarly, investors and healthcare institutions alike are joining forces to create programs that foster innovative solutions to similar problems, even though the amount of money, the size of potential partners, and availability of mentors destined to do so continues to be radically different.
The biggest disparity may come from the motivation behind the innovations we see in healthcare. In the United States, healthcare is first seen as a business, then a service. That is true today more than ever before and it really shapes the mindset of people looking to unlock business opportunities. Throughout Europe, healthcare is considered more of an essential right of its citizens, and the rules by which you innovate must comply with regulations in a very particular way.
A great example of this would be the new MedTech Europe Code of Ethical Business Practice that is going to be put in place starting January 1st, 2018, where the EDMA Executive Committee and the Eucomed Board are strongly recommending to their respective members the elimination of the sponsorship of passive attendance of healthcare professionals to third-party organized conferences, a.k.a direct sponsorship.
This type of regulation doesn’t come free of controversy and many raise concerns about the implications this new code of ethics will have over the opportunities of continued education in the world of medicine. Regardless of the effects that these types of measures may have, new opportunities open for healthcare entrepreneurs who want to bring alternatives to the table as other opportunities close for those hoping to profit from practices based on the direct sponsorship of healthcare professionals.
Time is better spent focusing in what really matters
During the course of three and half years, we’ve incorporated our company in Europe and the United States and talked to many entrepreneurs, VCs and Angels from the US, Spain, Belgium, and the UK. We’ve also gone through a couple of accelerator programs in Baltimore and Madrid, met with mentors and industry experts from the healthcare world in both ecosystems, and signed a major US institution as our first paying customer.
In every case, no matter what language was spoken or the continent in which meetings were being held, the concerns were the same, the goals were extremely similar, and the likelihood of us getting away with what we wanted had more to do with the strength of our business than with the location in which we were operating.
Biography: Juan Gonzalez is the CEO of InsightMedi, a photo-sharing platform created to foster the healthcare community by providing innovative ways to share, update, and expand their knowledge. Before joining InsightMedi he worked as a software developer with talented people in places like the Institute of Astronomy (University of Cambridge, UK), l’Observatoire de Paris, and Goddard Space Flight Center, NASA.