How technology is redefining access to care

In this episode of the Decoding Innovation podcast series, Oliver Kharraz, CEO and founder of Zocdoc, talks to Mitali Sharma about telehealth and how technology is positively impacting health care.

Key takeaways:

Telehealth solves the supply and demand problem in health care, and helps patients to find providers when they actually want.
Telehealth will not be a full substitute but will be a supplement to in-person doctor visits.
Mental health is an area where telehealth was found to be effective, as providers can view the living conditions of the patient and assess accordingly.

For your convenience, full text transcript of this podcast is also available.

Announcer

Welcome to the Decoding Innovation podcast series, brought to you by the EY-Nottingham Spirk Innovation Hub, where we explore the innovative technologies, business models and ideas that are shaping the future of industries. During each episode, Mitali Sharma, a principal in the EY-Parthenon Strategy practice, meets with stakeholders at the cutting edge to discuss innovations in their space, challenges they need to overcome and their outlook on the future.

Mitali Sharma

Hello and welcome. I'm your host, Mitali Sharma and today's topic is telehealth. Our guest is Oliver Kharraz, the CEO and founder of online platform Zocdoc. Zocdoc allows patients to find providers and book an appointment without leaving the platform. Welcome to the show, Oliver.

Oliver Kharraz

Thank you. Good to be here.

Sharma

Oliver, before we get into telehealth and the role that Zocdoc is playing in that value chain, would you mind sharing your background and your journey so far?

Kharraz

So, as you can tell from my accent, I grew up in Germany and I had my very first company right out of high school. It was a pre-internet online company back in the day, when emails took five days to get from Munich to Los Angeles. And yeah, I bootstrapped it and at some point, I saw the internet coming, and I had a question to answer: Did I want to drop out of college to make the company internet-ready or did I want to sell it before everyone else sees the internet coming also?
I decided to sell my company in the early, early 90s, which was a great decision because it protected me from too much money, too early on in life. Instead, I went through medical school and residency with grueling hours, with very little pay, and at some point, I realized I'd rather be an entrepreneur again.
But I'd also realized that I sold my first company far too cheaply. And so, I wanted to learn something about business first. So, I became a consultant. I worked in health care technology for some years, and then as I became junior partner at my consulting firm, I realized that I had to find the right idea to start my company before the golden handcuffs were worn in too well.

Sharma

Fascinating background, Oliver. And since you've been on both sides as a provider and as a consultant, perhaps we can start with some basic definitions for our audience. How do you define telemedicine or telehealth?

Kharraz

Yeah, it's a great question. I think there are many different answers. My personal answer is whenever the doctor and the patient aren't in the same room together, that's telehealth. Many times, people think of this as happening through a video visit, but it can happen through phone. It can happen through other means.

Sharma

And if you were to think about the best use cases for telehealth, now or in the future, what would those be?

Kharraz

I think telehealth is something that's been struggling to take off, even though it's been possible for a long time. The telephone has been around for more than 100 years. Video visits or video calls were possible, at the latest, in Skype — that's 20 years ago. And we've really seen those blossom through the pandemic.
And why is that so? There's a couple of regulatory and administrative factors to this, but it got patients introduced to the ability to just talk to a doctor, do triage and find out if they actually have to come in in-person. So that's one big use case. It also juts out that telehealth is a great way to follow up with a doctor that you've already spoken to and who has already examined you on a prior visit.
And this is maybe the dominant use case for telehealth right now, mental health has emerged as one of the areas where telehealth is really a wonderful substitute for a less optimal solution than in-person visit.

Sharma

If you were to define the value chain of telehealth, what are providers or players in this space trying to solve for it?

Kharraz

Yeah, that's a great question. I think sometimes when people think telehealth, they think that it's a new modality that will do to in-person visit what the car did to the horse-drawn buggy. That turns out to be not the case, right? Think of telehealth more like the e-scooter. It's useful in some use cases, where you get some groceries from the convenience store around the corner.
But you would never take it to the airport. And so, what we see is that doctors, your neighborhood doctor, the one that you've been going to for a long time, will offer telehealth as a supplement to in-person visits and other ways to engage versus as a stand-alone solution.

Sharma

So, it's solves for, like you said, triage. It solves for accessibility, and then, you know, maybe for some specialization, it makes sense, like mental health. Are there other things that you can see in the future?

Kharraz

Well, I mean, I think it will vastly depend on what kind of sensors become available, because one of the interesting things and why telehealth has escaped really a substitution effect so far is that we all have bodies. And it's like tele pizza in some ways, it doesn't exist, because to really get to the essential of what a pizza is, you need to be in the same room with it, so that you can take it and put it in your mouth in the same way the doctor needs to be in the same room to put their finger on your pulse to look in your mouth, to listen to your heart, to poke your abdomen. And as long as we have bodies, I think there will be a physical aspect to medicine as well. And so, telehealth will not be a full substitute for that.

Sharma

I understand and that's why you said it's a supplement. So, you've seen the doctor and maybe there's a follow-on discussion that would might make more sense remotely. But you have to see the physical aspect. You can’t get rid of that.

Kharraz

In most instances, that's going to be part of the full treatment.

Sharma

You mentioned mental health as an area that where telehealth has really taken off. Are there others?

Kharraz

You know, there really aren’t. Mental health is sort of unique in its ability to be conducted through telehealth in a very effective way. I've even heard from some mental health providers that they thought that telehealth was better, because they can now see into the living conditions of the patient. They can see whether an apartment that has always been orderly is starting to become messy, may be foreshadowing a psychotic episode or some other things.
So, it's one of the few areas that actually gets better through telehealth. In most other areas, it's really limited to sort of a triage, whether you actually have to come in to a follow up or in some instances, patients that are just very rural, don't have immediate access to a specialist to sort of bridge that distance through telehealth and maybe do this under the support of a local primary care physician.

Sharma

You also talked about the sensors, right? So post-op care with better sensors might be different.

Kharraz

What's interesting is that the single best sensor on our smartphone is the camera. And you'd think that specialties like dermatology, for example, would see a huge uptake on telehealth, which they don't. So, the consumer truly doesn't trust the sensors that we have today sufficiently to really substitute the doctor visit with a remote one.
But it's possible that doctors will actually trust this more, because they can research the issue and they can figure out what works and what doesn't. And so, we maybe will see a provider-led adoption of some of these sensors and then have the consumers follow.

Sharma

Makes sense. Let's shift gears and talk about Zocdoc. First of all, how did you come up with this idea?

Kharraz

Yeah. So my cofounder actually ruptured his eardrum and had a hard time finding a doctor, and that was a very personal experience, but it actually pointed to a very universal problem. As we looked at this, we realized that the average wait time to see a doctor is 26 days — from the time the patient picks up a phone and dials for doctors till they actually see one. That is an incredibly long time.
When we first launched, people said, “Well, of course there's a long wait time because there's a doctor shortage and whenever there's a shortage, people have to wait.” But we called nonsense on this answer, because doctors have last minute cancelations. They have no-shows. They've rescheduled. And they have hidden inventory in health care that is just impossible to find. And if you think about other markets where there's perishable hidden inventory, whether it's hotels or flights, there are marketplaces that solve this matching problem of supply and demand. In health care, Zocdoc is that marketplace.

Sharma

And how do you come up with the name?

Kharraz

Well, we actually wanted to name ourselves “doctors.com” and we tracked down the folks that owned the name, and they wanted millions of dollars for that. And we realized we wouldn't be able to pay for that, because we started Zocdoc with our lifesavings. So, we opted for Zocdoc, which was available for US$4.99, and we said, “Well, later when we raise money, we'll hire a creative naming agency to give us advice on how we should actually name ourselves.”
Well, it turns out we hired that agency roughly a year later, and they told us to stay with Zocdoc. That's a great name. It rhymes, starts with a “Z” and you can fill it with life. There was no predetermined meaning of Zocdoc and hopefully we've filled it with life in a meaning that our users enjoyed.

Sharma

Fascinating. If we can shift gears to the platform, what are the basic services that Zocdoc provides?

Kharraz

Zocdoc helps patients find a doctor, so they come to the website, they download the app, they put in what their problem is, what their insurance plan is, where they are, and they will immediately see doctors in their neighborhood, who accept their insurance. And importantly, they see the times that these doctors are available. They can just click on one of these times, the same way they would buy something on Amazon or book a flight, and they can check out within minutes and are done with that.
And so that takes down a process that used to take 26 days to typically an appointment that happens within 24 to 72 hours, so in order of magnitude better. For the doctor, this means that their valuable time that they want to work is actually utilized. And so, we are able to fill up their schedules more optimally and take advantage of their valuable time that is a scarce resource for us as a society.

Sharma

How do patients actually discover your platform?

Kharraz

So, patients come to us predominantly through word of mouth, which is probably the biggest compliment that any service can ever have. We hear they're very, very loyal. They come back for years and years. We still have some patients from the 2007 and 2008 course using us today, but they love telling their friends about it because it is a long and frustrating experience. Now, since we went through our business model transition, we have also began marketing our services through national campaigns and online services.

Sharma

Let's talk about the providers. How do they sign up?

Kharraz

Providers frequently also hear from their colleagues about us as a B-segment of the providers that have their own practice. It's nearly all inbound — 95% of our providers come to us, come to the website and simply raise their hand and say, “I want to be part of the service.”
We also serve enterprise-level customers in large health systems, where we have a salesforce that manages these clients and makes sure that the entire organization is familiar with Zocdoc. It's a decision that's broadly supported. It turns out to be a very easy financial decision for providers to join us, because there's a very, very high return on investment that is essentially guaranteed in a way that very few other marketing channels can meet.

Sharma

Let's get into the commercials in a little bit. Do you also work with insurance?

Kharraz

We don't directly work with insurance companies. We work with our provider clients and they tell us which insurances they accept. Interestingly, the fact that because millions of patients use the platform and rely on that insurance information, if ever anything was incorrect, we would immediately learn about it and be able to correct it. So, what we find is that Zocdoc is actually more accurate, when it comes to insurance information than the insurance directories themselves.

Sharma

Interesting. So, when you first came up with this idea, how did you bring about this platform and how did you think about what needed to be on this platform?

Kharraz

Yeah, it was a very, very difficult start. In our first month, we got only five appointments and three of those were from venture capitalists, who were trying out how the service actually works, because as it turns out, we had to learn how to manage micro-markets on a specialty, insurance and zip code level, because consumers don't travel farther than their zip code, and they want to certainly see a doctor that is in the specialty they want and accepts insurance. So, it was a long and hard running process to get that off the ground.

Sharma

So, when you said you launched it with your internal savings from family and friends, basically. You thought of the idea and you said, “Okay, let's put a website together, get the requisite software.” How did you go about it?

Kharraz

So, we were three founders in the beginning that each had some unique skills. I coded the doctor front-end, another cofounder of mine coded the patient end and a third one sold the initial doctors. And there was no software for this, we had to create all of this from scratch.
In fact, one of the things that makes it so hard is that unlike air travel, where there is Sabre as a backbone that keeps track of all the different flights and airlines there are, nothing like this exists in health care. So, we had to write the connections to hundreds of different practice management systems and really figure out how this works, which has been the sustainable mode for us in this business.

Sharma

How did you think about that minimum viable platform that you needed to have to connect to all the doctors out there?

Kharraz

We got accepted to a very prominent startup competition, with a stipulation that the service had to launch by mid-September. And mind you, we got started this in July of 2007, so we only had two-and-a-half months to get ready. So, we slept on desks and really very little. And we had the ambition to have the site up and working and running, and have enough doctors on the site to have a scrollbar in your browser, so that it looks like there's plenty of choice. Obviously, that was a good start and a good forcing mechanism. It ended up not being nearly enough and it took us several months before we even had 20 bookings in a month, which is totally subscale.
And turned out that we had a choice to make whether we would hang in there and continue going or whether we would stop because it was too hard. And my in-going thesis was that when patients find a doctor in the area that they were looking, they would book that doctor. It just turned out it was very, very hard to make that match happen, because patients were searching everywhere, where we didn't have doctors, and doctors were signing up, where we didn't have patients looking.
And then with no patients booking these doctors, the doctor ended up leaving the platform. So, in the beginning, we had leaky buckets on both ends and it was very difficult to make this work. This is why we doubled down on the few patients, where we could make it work to really give them a great experience.
And there were technical challenges as well. Sometimes, we would allow a patient to book in a time slot that was no longer available. And I remember one patient specifically, where I raced the patient to the doctor's office, because they were already on their way. And I picked up a bouquet of flowers on the way and was there in person to apologize to this patient and ask them to give us another chance with their next booking.
So, it is very much a blocking and tackling exercise to get a marketplace off the ground. And you need to do whatever is necessary to satisfy your initial set of customers on both ends of the marketplace.

Sharma

So, if I were to distill what you just told me, you had the great idea and you knew there was a need in the market. Did you test your idea before actually launching the solution?

Kharraz

We tested it in the sense that we created mock-ups of what we thought the website would look like. And we went to Starbucks, and we chatted up people and said, “Hey, would you look at this? And there is a US$5 Starbucks gift card for you, if you tell us what you think.” What does this do? How would you use it? Would you use it at all? Would you trust it? And we got a lot of feedback qualitatively before we even launched. And we started with a pretty rigorous testing culture from day one, so that it could only get better and better every day.

Sharma

That's fascinating. So, there was almost immediately direct feedback from the ultimate customer.

Kharraz

Yes, we tried to get that wherever we could. And for sure, it was slow in the beginning, because nearly by definition, you've very, very few users and so you can learn only slowly. Today, we can answer a question that would have taken us a month or two to answer when we started out, in a matter of minutes or hours.

Sharma

For sure. You don't know what you don't know. So, when did you know that you were going to get the network effect?

Kharraz

We realized the network effect on the patient side would work probably six to 12 months into operating the website, because we saw patients coming back. They were very loyal. In fact, they started booking more and more doctors on the service, as we introduced more and more specialties. So, it felt like patients really loved us and our thesis was that they would utilize this, as we actually have the inventory, that became very clear. On the doctor side, it was a slightly different experience, because initially we launched with a fixed price subscription business — think software as a service (SaaS) business — and it turns out that was the wrong business model for us.

Sharma

Can you describe more?

Kharraz

Sure. So, it turns out that some doctors would get thousands of patients through Zocdoc. Some of them would get dozens or less. And if you charge everyone the same price, it's always the wrong price. It's either too much or too little. And it ended up putting our economics on the doctor's side under water. So, we actually had to pivot our business model many years into the business in 2017, sort of a decade in, when we were already at scale. And most importantly, we had to go back to all of our doctor clients and explain to them that the model was changing. Now, for the ones that were going to pay less under the new model, that was not too difficult. But some of them were going to pay dramatically more and those were more difficult conversations. It took us overall nearly three years to make that happen.
But everything that we hoped would happen as a result of that has actually been the case. It's a much easier threshold for a doctor to join us. It's working in suburban and rural areas now. And there's an incredible growth that is now happening pretty autonomously, where doctors recommend that to their peers, because it's a great value and a risk-free service to stand up for.

Sharma

Oliver, the network effect is great when it gets going, but it's hard to get it going. How did you do it?

Kharraz

I would love to tell you there are some smart solution to that. We just brute-forced it. I have several pairs of shoes that I'll walk through going door to door, from doctor to doctor, trying to convince them to join the service. And in a similar way, we have many patients who visited the site and were looking for a doctor in an area where we just didn't have one yet.
And we locked this as future demand to be satisfied and we just kept going on the doctor side. And it is hard, as you say. I don't think there's an easy solution to break through that. If there is, we certainly weren't smart enough to find it.

Sharma

This is perfect segue into the discussion around the business model. As I understand, it's free for patients and doctors pay, is that right?

Kharraz

That's right. It's free for patient, always has been free for patients. It's free for doctors to sign up and be on the marketplace. Doctors only pay when we introduce a new patient to them for the first time. So, unlike any other marketing channel, where you pay no matter whether you get a new patient or not, and where you have to potentially pay multiple times to acquire the same patient, on Zocdoc, you pay for that only once. So, it turns out to be the deepest and most predictable, most cost-efficient channel for doctors to grow their practice.

Sharma

Do you also get paid through the insurance companies?

Kharraz

We do not get paid by the insurance companies, even though we're creating a lot of value for them. If you think about Zocdoc, it's one of these rare companies that are really a “win-win-win-win.” It's better for the patient, because they get to see the doctor within a day instead of a month. It's better for the doctors, because their perishable time gets utilized more effectively.
And it's a benefit for the insurance company, because patients actually go to see a doctor in their office instead of going to urgent care or emergency rooms that typically have worse outcomes at much higher costs.

Sharma

Is there a difference between the size of a practice and how that benefits you?

Kharraz

We work with practices of all sizes. The cost of doctor varies by specialty and somewhat by practices. But we make sure that every practice has a very strong ROI from working with us.

Sharma

Shifting gears a little bit, often Death Valley is described by entrepreneurs as the time before they become profitable. They're operational, but not profitable. Did you face that? And if yes, how did you get out?

Kharraz

Fair question. We didn't charge any money for the first six, seven, eight months of our existence. So, by definition, we had expenses and no revenue, but we weren't really fazed by that. We wanted to prove that the concept worked, that we knew that there was value creation happening, but we didn't want to burden ourselves with also having to charge doctors, from the get-go, because, as we discussed earlier, it's enormously complex to get a two-sided marketplace off the ground as it is.
So, we have been going after a revenue-lite model for a long, long time to get the marketplace going. And in only as we sort of hit to critical mass have we started charging. But mind you, even today, we make sure that providers and doctors who join the marketplace have a fantastic ROI, so they have never any reason to leave.

Sharma

So, your expectation was realistic based on the take rate?

Kharraz

We initially started with a subscription model, so it had a very different take rate, depending on how many patients a provider would get. But it's always clear that this was a matter of scale on the supply and demand side to cover our fixed cost. And I'd say, the one piece of that under an entrepreneur is complete control is what are your fixed costs.
And we have learned to be very, very rigorous and economical in how we run the company, always trying to replace spending money with some ingenuity and hard work.

Sharma

Any stories you want to share?

Kharraz

I think one of the most marquee stories here is maybe us reducing our marketing spend to zero, which was obviously very, very hard, when part of the problem over two-side marketplaces demand generation and we found ways to incentivize our users to recommend us to all their friends through extraordinary customer service. “Wow experiences” that just made people talk about us, which ended up being much more cost effective than trying to acquire them on Google or any other marketing channel that was open to us at the time.

Sharma

So, describe one of those “Wow experiences.”

Kharraz

So, for example, we would send them T-shirts that made them a “Zoc star,” that had special unboxing experiences that people ended up posting on Twitter at the time. When things didn't go well, we would sometimes meet them at the doctor's office with flowers. We would send them gift cards, personal apologies, postcards with the pictures of team members inside, so they knew who was looking after them. And a call center that they could call 24/7 that would pick up after the first ring.

Sharma

What you described is fascinating, you knew your stakeholders and you figured out what would appeal and what would make it a win for each of those stakeholders, and then you stuck by those.

Kharraz

I think that's a great way of summarizing what we tried to do. We just wanted to set high expectations and then beat them, so that everyone had a reason to tell their friends about this unique thing that actually works in health care, because sadly, many times our expectations in health care are quite low.

Sharma

You came up with this model of charging different for different practices — which is very nuanced, by the way — a little bit later in your journey or was that right off the bat? You knew you were going to do that?

Kharraz

And so, we did it 10 years into Zocdoc journey. I was in the CEO seat for two years at that point. We had tried a couple of other models before that turned out not to change unit economics sufficiently for this to be truly scalable. And so, we went all the way, and we went through the effort of actually going to DC and asking the regulator for permission to operate this model, which wasn't a given that we would get this. But thankfully they've seen the value in a utility like Zocdoc existing and allowed us to operate this, and we're very grateful for that.

Sharma

When I think of your business model, it sort of rests on the concept of the network effect. So, you're bringing together the right provider, with the right patient and they're able to find each other. Is this something that is easy to replicate?

Kharraz

You know, there is the network effect, and I think it's very, very strong. And clearly there are some businesses like Airbnb that defend themselves solely through the network effect. One interesting thing about Zocdoc is that there's also a very high hurdle that I would say is in the technology and anthropology layer. And I'll give you just one anecdote to illustrate that.
So early on, we had our calendar integrations working, so we were reading the practice's calendar to find the gaps in this calendar. And we were uploading those to the Zocdoc cloud, so that we knew when to allow patients to book. But we would still get sometimes cancelations from the office manager, saying the doctor wasn't available and we couldn't figure out why.
So, we did a screen share. We looked at their calendar, we looked at our copy in the cloud. They were identical. The smartest people at Zocdoc were working on this problem. I brought them pizza, I walked their dogs, they couldn't figure it out. So eventually I just decided, well, I'm just going to sit in this practice and see what's going on.
And so, I sat next to the office manager. I saw photos of their dog or of their kids. I fixed their printer. I taught them better strategies to play Minesweeper. I still couldn't figure out why these cancelations were happening, until one day the doctor came in and said, “Hey, I'm out next Friday.” And what does the office manager do? Do they open the calendar and block out next Friday or do they take a Post-it note, write on it “Doctor out next Friday” and then stick that to their monitor?
And so, in the real world, of course, the Post-it notes happen. When you're naive to that, you create a lot of unhappiness on the side of the patient, the doctor, the office manager, then ultimately Zocdoc. You know It's happening. Math is your friend and you can sort this out. And this is just one example. There were literally 1,000.1% solutions that we had to figure out before we took the show on the road, before we even left New York as our initial market.
And I think that learning and the depth of knowing how to do this in a way that actually satisfies the patient and satisfies the doctor is an enormous mode that the waves of competitors have not been able to cross. And these waves have come and gone as a result.

Sharma

If we can go to your expansion strategy, did you launch in more than one city when you initially launched?

Kharraz

We actually only launched in one very small neighborhood in Manhattan, because we realized that matching the demand and supply is a micro-market problem. It's a zip code, specialty, insurance type problem. We had a huge map of Manhattan on the wall, with flags dotted, the doctors and which insurances they accepted. And we were trying to manually, by eyeballing it, create the right density and the right supply network that would make patients happy with what they found on Zocdoc.
And obviously, over time, we learned how to do this in a more scalable fashion. But we have always gone market by market to create local density and only move on to the next one when you've created a good solution in your prior market. And I think that's one of the things that really differentiates from some of our early competitors that have since vanished to one dentist in New York and one in Las Vegas that really helped no one. And I think that kind of focus has been a differentiator in our early strategy.

Sharma

How did you figure this micro-market issue? Was that because of your background as a doctor?

Kharraz

I think we just put ourselves in the shoes of the patients and we listened very carefully to what they had to say. And one of the early feedback we got through our Starbucks certificates was that people wanted to see critical mass. They wanted to see at least a certain number of doctors to feel like they have true choice. And that was very difficult to realize when you had them distributed in completely different cities, because clearly, no one gets on a plane to fly from New York to Las Vegas to see a dentist.

Sharma

Interesting. And when you were thinking about funding, at what point did you say, “You know what, we need outside investment”?

Kharraz

We got it pretty far to launch without outside investment. And we then actually did sort of a friend's round, and one of the most flattering things happened, some of my friends invested without even looking at the business plan, just based on me being willing to give up my career in consulting over this idea.
They said, “Well, then it must be good.” And they wrote checks, it is still one of the best compliments I've received in my life. And then we ended up raising our first institutional round from Khosla Ventures. We got Marc Benioff, we got Jeff Bezos to be involved. And in subsequent rounds, Founders Fund, Goldman Sachs, DST and others. I feel very, very, very blessed with the support that we've been getting from big name investors that really saw our vision and agreed with it.

Sharma

What is your advice for somebody else trying to go on this journey of trying to raise money for their bright idea?

Kharraz

Actually, one interesting anecdote here that tells you just how idiosyncratic that process can be. My cofounder and I went to a number of venture funds, and we heard time and time again, “Yeah, you know, we like the idea, you guys seem smart enough,” but they wouldn't give us money until at some point, one of these venture capitalists, I think somehow felt sorry for us, and he took us aside and said, “Hey guys, you can never raise money because you look like consultants. You have khakis, your button-downs.” And we heard that and said, “Oh my God.” You know, the thought process is that consultants can get anything done.
We went to the Gap, we bought jeans and T-shirts. We showed up to our next pitch with that. And we pointed out that we both were entrepreneurs that had prior companies and we got funding from there.

Sharma

Fantastic story. And what an indictment. Interesting. As you were approaching for funding through the investors, did you already have the stage gates in your mind or was that something that evolved with the discussions?

Kharraz

We were actually sort of shifting the stage gates, if you want to, as we went along, because we started in 2007, when the economy seemed fine and then in 2008, the Great Recession started. And so, even though we had not thought about making money, charging or profitability before, very quickly that became a reality for us. And we wanted to demonstrate that this through providing a service that providers are willing to pay for.
That is not something that we really thought about. And I think it just goes to making sure that you are going to decide, guys, whenever you raise money. I think as we all know, the current focus is very much on profitability, and curtailing the burden and the financial needs of the company. I think we were always reactive to these needs as well.
We started out marketing and then we realized that we can substitute a lot of these marketing dollars with creativity and ingenuity. And so, we very quickly adopted a very frugal DNA at Zocdoc. And I think that's probably the right DNA for a lot of entrepreneurs that get started right now to adopt as well.

Sharma

Interesting. So, if you had to do it all over again, what would you change?

Kharraz

I think one of the key components is always luck. I don't want to pretend that we could repeat this, if we just started over. I will say that the courage to go through the business model transition after we had already achieved the immaterial scale is something that I had to build up over time, and I probably should have acted on this much sooner, when I first realized that the old business model was unsustainable.
It is, I think, one of these formative things that we all go through, where we were trying to avoid the very, very painful and risky decisions. And sometimes, it just have to be made and you need to go with what you rationally understand versus what you would rather avoid doing.

Sharma

What's next for you?

Kharraz

Look, we won't rest until health care is ordinary in the sense that it's a marketplace like any others, where patients know exactly what they owe for consuming services, where they don't have to be in a room that's just designated to waiting, that doesn't exist in any other industry, where quality is understood and information travels freely. We don't want to be all of these things.
This is a big sector; it requires many people to contribute to that. But I think Zocdoc can be the connective tissue between all of these services that makes providers and health insurers and practice management systems and other technologies work together more seamlessly.

Sharma

Fascinating. Well, Oliver, thank you so much for your time. It's been fascinating. I sincerely enjoyed your journey and how you stuck to your guns. It's an inspirational tale.

Kharraz

Thanks for having me.

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The Decoding Innovation podcast series is a limited production of the EY-Nottingham Spirk Innovation Hub, based in Cleveland, Ohio. For more information, visit our website at ey.com/decodinginnovation. If you enjoyed this podcast, please subscribe, leave a review wherever you get your podcasts and be sure to spread the word!

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Presenters

Mitali Sharma
Former host, Decoding Innovation podcast

Oliver Kharraz
CEO and Founder, Zocdoc

Podcast

Episode 4

Duration

39m 37s

In this series

Series overview

EY refers to the global organization, and may refer to one or more, of the member firms of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst & Young Global Limited, a UK company limited by guarantee, does not provide services to clients.

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How technology is redefining access to care

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