What Makes Healthcare Investors Trust a Founder?

Healthcare founders spend months, sometimes years, building products before discovering a painful truth. The technology works. The market does not care. Or worse, the people who love the solution are not the people who will pay for it.

In Part 2 of the conversation with Alex Fair, Founder of MedStartr and one of the most connected figures in healthcare innovation, a simple story revealed one of the most overlooked lessons in healthcare entrepreneurship. It was not about fundraising, artificial intelligence, or regulation. It was about proving demand before building.

Most founders validate the solution, few validate adoption

Healthcare is filled with intelligent people solving important problems. The challenge is rarely clinical insight. The challenge is adoption.

Many founders start with a strong belief: this problem is obvious, this solution makes sense, people will want this. Then they spend months building, and then they discover that hospitals do not buy the way they expected, clinicians are not the decision-makers, procurement has different priorities, the reimbursement pathway is unclear, and implementation takes longer than expected. The result is a product that solves a real problem but struggles to gain traction.

Alex learned this lesson early. Before building one of his companies he became obsessed with a single question: “My biggest fear was did anybody actually want this and so before we wrote a single line of code…” That question led him to do something most founders avoid. He went directly to potential customers.

Before you build, find proof

Many startup books talk about customer discovery. Very few healthcare founders do enough of it.

Alex spent 100 days walking into physician offices throughout New York. Not sending surveys. Not posting on LinkedIn. Not asking friends for feedback. Having real conversations — thousands of them. His pitch was simple: “Would you like to make your medical pricing fair for you and your patients?”

Those conversations generated 100 physician signups before significant development began. More importantly, they revealed something unexpected. The doctors were interested, but they were not necessarily the customer. That distinction changed everything.

The biggest adoption mistake healthcare founders make

Healthcare founders often confuse users with buyers. A physician may love your product. A patient may benefit from it. A nurse may become your biggest advocate. Yet none of them may control the budget.

Alex described discovering this firsthand. Even after talking extensively with physicians, he realized, “The doctor is not really the customer in that scenario because they’re not going to be paying for it.”

Healthcare buying decisions are rarely made by a single stakeholder. A founder might believe they understand their market because clinicians love the idea. Investors know that is only one piece of the puzzle. The real questions become: who experiences the pain, who influences the decision, who signs the contract, and who benefits financially? When those answers do not align, adoption becomes difficult.

Investors are evaluating the path to adoption

One reason investors pass on promising healthcare companies is uncertainty around market execution. The technology may be strong, the team talented, the clinical need obvious — but investors want confidence that founders understand how healthcare actually works.

Alex highlighted how difficult this can be for new founders entering the industry. Experience helps teams understand how products move through healthcare systems, how buyers think, and how adoption happens at scale. That does not mean first-time founders cannot succeed. Some of the most successful healthcare entrepreneurs entered with little experience. What separated them was their willingness to learn quickly, validate assumptions early, and surround themselves with people who understood the ecosystem.

Adoption is a team sport

One of the strongest points from the discussion was not about technology at all. It was about perspective. Healthcare innovation succeeds when multiple viewpoints come together: clinical, operational, financial, behavioral, strategic.

As Sabrina Runbeck shared during the conversation, “We have a five dimensional way to predict execution.” That matters because a company can look perfect on paper and still struggle to execute. The business plan might be impressive, the market size attractive, the technology differentiated — but if founders do not understand adoption dynamics, stakeholder alignment, or team execution, growth becomes much harder.

A better question for healthcare founders

Many founders ask whether people like their product. That is not enough. A stronger question is whether they can predict adoption before they build.

That means validating who experiences the problem, who benefits from solving it, who controls the budget, what implementation looks like, and what would cause someone to switch from their current workflow.

The founders who answer those questions early save themselves years of frustration. They raise capital more effectively, secure pilots faster, and create products that fit existing realities instead of fighting them.

Final thought

Healthcare innovation is accelerating and the opportunities have never been bigger, but opportunity alone does not create adoption. As Alex Fair put it, “Picking which companies are going to be successful is the hard part.”

Founders often assume success depends on building the best product. In healthcare, success often depends on understanding the market before the product is built. The founders who win are rarely guessing. They are listening, testing, learning, and proving demand long before they write their first line of code.