Second Opinion

Second Opinion, authored by a former journalist turned VC, offers in-depth analysis and commentary on health-tech trends and news for over 17,000 subscribers. It covers venture capital dynamics, digital health infrastructure, startup challenges, investment opportunities, and regulatory insights, while exploring specific sectors like women's health, diagnostics, and telemedicine.

Venture Capital in Health Tech Digital Health Technology Startup Challenges and Opportunities Health-Tech Investment Trends Regulatory and Policy Analysis Telemedicine and Remote Care Women's Health Mental Health Pharmacy and Drug Market Innovations Consumer Health Products Health Insurance Remote Patient Monitoring

The hottest Substack posts of Second Opinion

And their main takeaways

Is private equity going to come to digital health’s rescue?

412 implied HN points • 08 Feb 24
🏥 Health & Wellness Digital Health Private Equity Market Analysis Market Dynamics
  1. Private equity firms are hesitant to make deals in digital health due to post-pandemic fund performance and concerns about the current portfolio's growth potential.
  2. Many potential deals in digital health have complications, making private equity firms cautious and preferring to wait for better opportunities.
  3. Profitability is a key focus for private equity, leading to a scarcity of profitable companies in the health-tech sector and contributing to the hesitation in making investments.

Resetting expectations for VC investing in health tech

1729 implied HN points • 19 Oct 23
💼 Business Venture Capital Health tech Investing Entrepreneurship Funding
  1. Not every startup in health tech needs to be backed by venture capital.
  2. Health tech industry may not yield many billion-dollar exits, but there are numerous smaller exits ranging from $40 to $500 million.
  3. Venture capitalists should consider alternative sources of capital like private equity, government grants, family offices, and angel investors for health tech startups.

The inside story of why this once high-flying digital health startup failed

589 implied HN points • 18 Dec 23
💼 Business Startups Entrepreneurship Failure Venture Capital Policy
  1. Entrepreneurs should not avoid discussing failure, as it is part of the journey.
  2. Founders should be cautious of taking on too much at once, especially in terms of lobbying for policy changes while building a business model.
  3. When fundraising, founders should carefully consider investor relationships, future funding needs, and the value placed on patient experience.
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Why the fertility market is poised to explode

569 implied HN points • 07 Jun 23
🏥 Health Politics
  1. The fertility market is expected to grow due to increasing demand and advancements in technology and accessibility.
  2. Infertility affects a significant portion of the population and can stem from various factors, including lifestyle and health conditions.
  3. Fertility treatments, especially in the United States, can be expensive, leading to financial strain and limited access for many individuals.

This new class of weight loss drugs are costly - but is there a greater price to ignoring the problem?

511 implied HN points • 30 May 23
🏥 Health & Wellness Weight Loss Obesity Medication
  1. Obesity is a complex chronic disease that needs to be treated seriously.
  2. New weight loss drugs are effective and show promising results, but they are costly and come with side effects.
  3. It's important to consider a variety of evidence-based solutions, including lifestyle interventions, in tackling the obesity epidemic.

Who are the most active early-stage investors in digital health?

1022 implied HN points • 22 Aug 22
  1. Many active early-stage investors in digital health focus on specific areas within the industry.
  2. Investors look for mission-driven founders solving critical healthcare challenges and creating clear value for their customers.
  3. Thesis-driven investment approach helps in being true partners to entrepreneurs and providing valuable support.

Introducing the digital health tech stack

1592 implied HN points • 22 Mar 22
  1. Digital health companies make build or buy decisions based on their reimbursement model.
  2. Different types of health companies have distinct infrastructure needs and focus areas.
  3. Consideration of user experiences and key stakeholders like patients and clinicians is crucial when deciding on tech stack components.

Virtual care has its gaps - it’s time we talked about it

687 implied HN points • 16 Jun 22
  1. Virtual care has limitations and cannot replace all in-person visits.
  2. Approximately 30% of patient care services can be administered virtually.
  3. Health care providers should focus on integrating virtual and in-person care for optimal patient outcomes.

Telehealth: “Should I Stay or Should I Go…?”

452 implied HN points • 17 Aug 22
  1. Telehealth has seen significant growth, with a large percentage of US patients and physicians adopting virtual care.
  2. Telehealth lobbying activity has increased, with more for-profit entities getting involved in advocacy efforts.
  3. Healthcare startups should prioritize government affairs as a necessary investment for long-term success in the heavily regulated healthcare industry.

Is it a good or bad time for a health-tech company to raise?

491 implied HN points • 05 Jul 22
  1. Growth stage companies are shifting focus to profitability, while early stage companies are still prioritizing revenue growth.
  2. Investors are generally more cautious due to uncertain market conditions, advising startups to tighten their belts and adjust their funding strategies.
  3. There is a shift in power dynamics favoring investors, leading to a flight of talent from growth stage companies and a focus on proven business models for investments.

Multi-Million Dollar Contract(s) Up For Grabs

196 implied HN points • 18 Apr 23
🏥 Health Politics Legislation Reform Health tech
  1. The US organ transplant system is in need of a significant overhaul to save lives and better serve patients.
  2. Recent government initiatives aim to introduce competition and reform to address long-standing failures in the system.
  3. Health tech builders have the opportunity to make a meaningful impact by engaging in the reform process and improving organ donation systems.

Some Personal News

1572 implied HN points • 02 Dec 20
  1. The health-tech industry is growing and evolving with the involvement of technology giants like Apple and Alphabet.
  2. Starting a new chapter in one's career can be bittersweet but also exciting.
  3. OMERS Ventures is focusing on investing in various sectors within health-tech, such as behavioral health and aging in place.

What it's like to be a full-time telemedicine doctor

471 implied HN points • 12 May 22
  1. Remote work as a telemedicine doctor has its perks, like being with family and pets while consulting patients.
  2. Building telehealth skills is in demand, with opportunities for clinicians to work full-time or part-time with various companies.
  3. Telemedicine requires doctors to adapt their approach, focusing on patient engagement, continuity of care, and the importance of trust in online consultations.

Hiring? These top recruiters have a lot of wisdom to share with health-tech founders

275 implied HN points • 19 Oct 22
  1. Recruiters from top agencies have valuable insights on hiring trends and challenges in the health-tech sector.
  2. Early-stage companies may have opportunities to attract talent amidst changes in hiring preferences and market conditions.
  3. Health-tech companies face unique challenges in hiring, but can overcome hurdles by emphasizing stability and addressing compensation concerns.

Every digital health startup is a clinic now

589 implied HN points • 29 Nov 21
  1. Digital health startups are transitioning into becoming virtual providers due to various challenges in selling solutions to healthcare providers.
  2. Setting up a virtual medical group involves complexities like hiring the right experts, mapping necessary processes, and ensuring compliance with regulations.
  3. Success for digital-first providers lies in evolving from digital apps to fully integrated health plans through strategic progression steps.

Why we're betting big on women's health

766 implied HN points • 01 Jun 21
  1. Women's health is a critical part of overall human health, not a niche market.
  2. Investment in women's health is essential as it remains underfunded despite being a promising area.
  3. Opportunities in women's health include addressing diverse health needs beyond reproductive health and periods, focusing on underserved populations, and innovating with a platform approach.

Why investors are leaning into direct-to-consumer health

550 implied HN points • 20 Oct 21
  1. Direct-to-consumer health companies can't hide behind bad products, forcing them to focus on creating valuable products for customers.
  2. Acquiring customers in D2C health can be costly, with importance placed on balancing the cost of acquisition with the value of customers over time.
  3. Some D2C health startups transition to serving payers after establishing consumer success, showcasing outcomes to attract partnerships.

Who are Europe's most active Health-tech investors?

176 implied HN points • 27 Sep 22
  1. There is a concentration of health specialists in Europe at pre-seed and seed stages, with a focus on B2B software.
  2. The list highlights specialist health funds in Europe, emphasizing the importance of the founding team's background in the industry.
  3. Several investors across Europe are actively funding digital health startups, with a focus on funding for a fairer future and disruptive, tech-enabled solutions.

Why navigation has become the next big thing in digital health

648 implied HN points • 17 Feb 21
  1. Healthcare is complex, and only a small percentage of people can navigate it well.
  2. Employers are investing in navigation tools to help employees find optimal care and save costs.
  3. Navigation tools in digital health are evolving, becoming more specialized, and may soon integrate with telemedicine.

Why didn't Haven work?

648 implied HN points • 05 Jan 21
  1. Haven, the Amazon, J.P. Morgan, Berkshire Hathaway initiative to change healthcare, disbanded after three years.
  2. Challenges like different company needs, varied markets, and lack of a centralized healthcare system contributed to Haven's failure.
  3. Future of healthcare innovation may lie in virtual, scalable solutions like virtual primary care models and engaging employees in better utilizing existing benefits.

Our prescription for mental health

353 implied HN points • 19 Aug 21
  1. There is a significant need for mental health resources due to high prevalence of mental health conditions and lack of access to treatment.
  2. Issues in quality of care include provider shortages, difficulty in matching patients with providers, and need for better matching.
  3. Opportunities for improvement include addressing gaps in care for geriatrics, severe mental illness, children and teens, and exploring group therapy options.

How do you build your brand in digital health?

432 implied HN points • 09 Apr 21
  1. PR experts recommend building in-house comms capabilities and augmenting with outside support as needed.
  2. Consider having a presence on platforms like Substack and Clubhouse to stand out in digital health marketing.
  3. Personal relationships with the media are essential for founders, but respect the expertise of a PR pro to determine newsworthiness.

Is it finally Remote Patient Monitoring’s moment?

314 implied HN points • 01 Sep 21
  1. Remote Patient Monitoring (RPM) is gaining traction due to Covid-19 and changing healthcare incentives.
  2. RPM helps monitor patients outside of clinical settings to prevent serious health issues.
  3. CMS and commercial payors are supporting RPM with reimbursement codes, making it financially viable for providers and beneficial for patients.

Your ultimate guide to hiring doctors into digital health

452 implied HN points • 25 Jan 21
  1. Chief Medical Officers (CMOs) play a crucial role in digital health companies and can have diverse responsibilities such as product development, clinical operations, or sales.
  2. Integrating tech and clinical teams in digital health organizations can be challenging, but open communication and mutual respect between engineers and physicians are essential.
  3. Recruitment strategies for CMOs in digital health vary, with options to hire tech-savvy doctors, clinicians with experience in specific fields, or individuals with entrepreneurial backgrounds.

What it's like to have a baby during a pandemic

393 implied HN points • 21 Mar 21
  1. Having a baby during a pandemic can be lonely and challenging due to restrictions on visitors and social interactions.
  2. Remote work can be a significant benefit for pregnant women, offering more flexibility and support during pregnancy.
  3. There is a need for improved access to healthcare, support for new parents, and reform in the maternity care system to prioritize the well-being of women and families.

What's next for pharmacy in 2021?

452 implied HN points • 15 Dec 20
  1. Regulatory changes in pharmacy might see more legislation recognizing pharmacists as part of patient care teams.
  2. Investors continue to find pharmacy appealing, especially with the growing specialty drug market and increasing focus on medication adherence.
  3. There's a shift towards prioritizing consumer experience in pharmacy, with tech founders leading innovations to improve services and patient choices.

Our health-tech predictions for 2021

393 implied HN points • 21 Dec 20
  1. There will be a new class of investors in health-tech with a focus on diversity.
  2. Expect to see more approvals for 'care at home' services and an increase in medical school admissions.
  3. Potential challenges include poor health outcomes due to delayed care, record levels of burnout among healthcare workers, and some health-tech start-ups facing closure.

Why is it so hard to disrupt health insurance?

334 implied HN points • 04 Feb 21
  1. Start-ups struggle to disrupt health insurance despite raising significant funding.
  2. Investors poured money into tech-backed health plans due to large market opportunities, but the industry has major challenges like low margins and high barriers to entry.
  3. Attracting new members to newer health plans is difficult due to standardized products and the need for scale to negotiate prices and fund administrative costs.

Why did One Medical buy Iora for $2.1 billion?

196 implied HN points • 08 Jun 21
  1. One Medical's acquisition of Iora for $2.1 billion was not surprising, as it strategically expands their primary care services.
  2. One Medical chose to buy Iora instead of building as a way to quickly enter the Medicare Direct Contracting space.
  3. One Medical may not expand beyond primary care and is focusing on improving its virtual care services.

Are we overhyping telemedicine?

216 implied HN points • 08 Feb 21
  1. Telemedicine saw a surge in usage during the pandemic, but in-person care is still important.
  2. The future of healthcare may involve a hybrid model of telemedicine and in-person visits.
  3. There are emerging trends in healthcare real estate, such as pop-ups and more home-based care options.

Livongo's former CFO gets real on today's digital health market

58 implied HN points • 22 Feb 22
  1. Livongo's former CFO emphasizes the importance of having a strong team in achieving financial success.
  2. Digital health CFOs should focus on managing cash effectively and communicating growth strategies clearly to investors.
  3. Investors in the digital health market should consider companies with potential for long-term growth and explore opportunities for M&A activity.

In defense of tech-enabled services

2 HN points • 08 Dec 22
  1. Investing in health care can focus on software or services made efficient by software.
  2. Tech-enabled services in healthcare have potential for success and represent large markets.
  3. Companies often start as SaaS but pivot to services to impact care models at scale.