Mar 26, 2021

Five Startup Ideas #027

A collaboration with Out of Pocket.

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I'm glad to share a special edition today: Part 2 of our collaboration with Out of Pocket (OOP). Below, you'll find five healthcare-focused ideas from some of the most impressive investors and leading thinkers in the space. Members receive an extra idea from OOP's founder, Nikhil Krishnan.

Nandu Anilal's "Mint for security" RFS was the most popular idea from last week. In his description of the concept, Nandu worried that consumers might not be ready for such a product — if readers of this email are any indication, it seems like there's latent demand. That concept pipped Mike Duboe's "B2B Commerce" play and Medha Agarwal's "next-gen financial tools."

Since this week saw Y Combinator's Winter 2021 graduate, I thought I'd share the three companies I thought looked particularly fascinating. (There were many others).

Which were your favorites from the recent cohort?

It was a great week of training. As you may remember, I'm currently working with my Future coach Eddie to conquer a 5K run in 30 minutes or less. This week, I've been working on speed. On Monday, Eddie had me vary between fast runs and slow jobs (800 meters / 400 meters). On Wednesday he turned it up a notch, pushing me into some Fartlek runs that involved intense sprinting! Definitely feeling pleasantly sore. I'm looking forward to a nice cruise on Saturday to round off the week.

As you probably know by now, I'm a big believer in Future, having used their service for almost two years. It's definitely helped improve my health, fitness, and as a result, mental wellbeing. Particularly now that I'm building The Generalist, I've found the accountability and flexibility invaluable. Readers of this email are able to get 45 days of personalized training for free, just by shooting a note to this email. If you have questions or want to try it out, hit reply.

Startup ideas...

Enabling the bioeconomy

Services and infrastructure to catalyze biopharma

With any technology or engineering breakthrough, the final product is always a result of outsourcing, and specialization of labor. Biopharma is no exception. While this has traditionally taken the form of CROs, the new biological stack requires more. 

We are still at the early stages of functionally engineering biology through reading, writing, and editing. Synthetic and data-driven approaches to biology have necessitated large-scale testing and experimentation at an unprecedented scale. Faster, less expensive, more accurate biomanufacturing would dramatically increase the rate at which researchers can design, build, test, and iterate biological systems. Thus accelerating the development of vaccines, gene and cell therapies, molecular engineering, and cloning, with practical applications translating to a wide variety of industries such as drug discovery, pharmaceuticals, food and agriculture, chemicals, and energy production. 

At Alix, we believe that the biological revolution is here. We’re keen to support the rapid expansion of research and development. One thesis we are particularly excited to invest in is what we call the Biological API Layer: service and infrastructure technology enabling the bio-economy.

Chas Pulido, General Partner at Alix Ventures

Modern doulas

Giving rural patients access to supportive care

Despite advances in medicine, maternity care has been characterized by rising costs and declining outcomes in the US. Maternal morbidity rose 26% from 2000 to 2014. Racial disparities remain prevalent, particularly across vulnerable or low-income populations. Additionally, modern hospital maternity care practices have reduced the availability of an attending nurse to remain with a mother during labor. 

Doulas are trained to provide physical, emotional, and informational support to women during labor, birth, and in the immediate postpartum period. While studies have shown doulas result in positive maternal outcomes, particularly in low-income populations, such services are primarily uncovered and rely on cash payments, leaving low-income and higher-risk individuals without support.

Why not leverage technology to emulate the experience of receiving bedside support to deliver physical, emotional, and informational support to these vulnerable populations and under-served markets during labor? The COVID-19 pandemic has incited the use of telemedicine across multiple birthing centers. Given the demonstrated efficacy of virtually-delivered bedside support, a tech-enabled service, paired with a digitized educational and emotional support platform could enable vulnerable hard-to-reach patients to access doulas and supportive care during birth.

Alyssa Jaffee, Partner at 7wire Ventures

Male birth control

Safe, effective, and reversible male contraceptive solutions

Whether it’s a daily pill, an IUD, an implant, or a shot, birth control is a regular part of most adult women's lives. Why isn’t it as big a part of men’s? Men today have just two viable options: condoms or vasectomies. Condoms have a very high dissatisfaction rate, and vasectomies are permanent. 

Research efforts on novel male birth control solutions have started and stopped repeatedly over the years, and there have been reports of a male birth control pill becoming available, since the early 1970s (yes, 50 years ago). When one trial was halted in 2016 due to a concerning rate of negative side effects, many women were puzzled because the side effects were the same as those that women have dealt with for decades (as it turns out, it was not that simple, but still fascinating!).

Contraline is one example of a company that has sprung up to commercialize a new form of male contraception, but given the scale and importance of the problem, I would love to see many more companies taking this on with a broad range of approaches. Men deserve choice, just as women do.

In the US today, 45% of all pregnancies are unintended. Safe, effective, and reversible male contraceptive options would help reduce unintended pregnancies, shift some of the burdens of birth control off women, and provide men with more control over their reproductive health. A triple win!

Annie Case, Principal at Kleiner Perkins

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A better search tool for

The majority of useful information on the US Food and Drug Administration (FDA) website is buried in a lengthy PDF. For example, Summary Basis of Approvals (SBA), communications between the Agency and Pharmaceutical companies, and FDA Guidance Documents are all deeply buried.

The search bar on the website lumps all its results together and does not allow a user to search by product, date, or result type. Most importantly, the search bar on or any other search engine does not allow users to quickly find specific content hidden in any of the large regulatory documents. A better search tool for would use text recognition to convert the thousands of PDF documents into a readable format. That would generate a more useful search output for drug developers, clinicians, and researchers.

Cidnee Vaykovich, COO at Starton Therapeutics

Nike for those with chronic diseases

Products designed to create a more comfortable life

More than 40% of Americans are living with a chronic illness, which often leads to significant changes in access to normal activities such as travel. A diabetic may be hesitant knowing he or she will have to deal with the complexity of traveling with insulin, syringes, meters, and backup supplies that must be kept cold. An individual with Parkinson's disease may rely on complex, expensive equipment to stabilize tremors; the idea of packing it all up, being stopped at TSA, keeping everything safe, and getting on a plane can be daunting.

I think there’s room for a company to focus on building for the chronic illness community, centering its value proposition around performance, much like Nike. This company would create product lines for specific chronic diseases, facilitating access to travel, exercise, and other normal activities. Some examples include:

  • Suitcases. For a diabetic, it is crucial to have cold compartments for medication and protected space for delicate and expensive supplies.
  • Exercise belts and backpacks. Standard running belts, for example, are not built to carry a glucometer or insulin pump.

With 140+ million people suffering from chronic illnesses and 75+ million with multiple, the market is large and the desire is there for products that fit each individual's lifestyle.

Jack Clancy, Population Health Solutions at Optum

Our exclusive community officially has more than 200 members as of this week. It features some of the most impressive investors, operators, and founders in the tech and investing world, united by an interest in exploring what comes next. Every day, members share startup ideas, discuss different markets and investments, and receive support in their work. I personally play matchmaker, connecting members with complimentary interests and experience to one another.

We're also hosting regular discussion panels, just for members. This week, Justin Mares, founder of Kettle & Fire discussed his micro private equity investing strategy.

If you'd like to be a part of a tribe that aspires to be the most thoughtful community in tech and investing, join as a Member, here, and fill out an application.


As always, clues are available to those that would like them. Just respond to this email.

Over the past week, I've been getting into Drive to Survive, the Netflix docuseries about Formula One. Perhaps that's why I can only think of Sid J as the Lewis Hamilton of the Coda; insanely rapid, a relentless winner. Once again, he snagged the top spot of the podium, sharing champagne with Ashton W, Krishna N, Jake K, Sam P, Neal K, Avery K, Robert H, Shreenath R, Prasanna D, Khaled J, Jake G, and Michael F.

The answer? Legendary investor, Mary Meeker.

The Generalist’s work is provided for informational purposes only and should not be construed as legal, business, investment, or tax advice. You should always do your own research and consult advisors on these subjects. Our work may feature entities in which Generalist Capital, LLC or the author has invested.