Where This is All Going

Okay, so this is episode 100 of the Big Picture Medicine podcast, and in a fit of celebration and self-indulgence, I want to talk about where this podcast is heading. If you find that interesting, then listen on. If not, just skip to the next episode and you'll get an interview with someone more interesting than me.

I started this podcast because I love the Tim Ferriss Show and I wished it existed for healthcare — and it didn't. So I just thought, why don't I create it? He's the OG, and I hope to one day be as great as him. I want to discuss some of the high-level philosophy and some of the micro stuff in terms of where this whole thing is heading.

One of the big problems in the healthcare content space is that a lot of the content is really boring, because it's essentially just a PR piece, a fluff piece — there's no real insight or analysis in it. So one thing I'm trying to get better at is asking good questions that result in interesting conversations and interesting insights. One way I think I can do that is by asking questions that are a bit more provocative and challenge the guest a little.

As an example: if you ask someone "what is a cat?", you're very likely to get an answer like "a cat is a four-legged mammal, it's furry, and humans keep them as pets." You might walk away believing you understand what a cat is — but that description also applies to a dog, so you don't really understand what a cat is at all. Whereas if you ask something more provocative and challenge them a bit — "isn't a cat just a shit version of a dog? Why would anyone own a cat?" — I think the answer you get is a lot more insightful. It starts pushing at the edges, and you learn a lot more.

There's a careful line to walk here. The question has to come from a place of curiosity, and not be set up as a gotcha or something that's going to make the guest look bad. I always tell my guests before recording: I want to make you look good here. If there's anything you're not happy with, or you want to skip a question, or you want me to delete a bit, that's totally fine — just let me know. I'm not a journalist, and I'm certainly not a hard-hitting journalist aiming to get the latest scoop. I just want to get better at asking better questions, still in a productive light and not in a gotcha kind of way.

The other thing I want to do is promote more cross-pollination. There's incredible learning to be had from different fields. If you speak to someone who owns a large retailer or large supermarkets, they'll have loads of insight on logistics. If you speak to someone in the fashion world, they'll have loads of insight on building a cult following, making something fashionable, creating a trend — which we can all take to healthcare and get great results from, I believe. So I want to speak to those outsiders and find out: what do you know that would be useful for us to know in the healthcare space?

My goal around growth is to get to a stage where the podcast gets 10,000 listens or plays per episode. I think that's a respectable size — you have a decent platform from which to get bigger and better guests, and to attract sponsors. Sponsorship is interesting to me because it would mean I could level up: I'd have the budget to send guests microphones before conversations, for example. I really try my best to get good audio quality, and I think that's the next level up for me.

The way I'm going to grow the podcast is that I've made it into a video-first podcast, so every episode is now available in video format on YouTube and on Spotify. That's great, because podcasting is great — but sometimes it feels like you're shouting into the void.

People don't really discover you through podcasting apps, whereas YouTube has a really good discovery method — their algorithm is really, really good at surfacing your content to the kinds of people who'll be interested in this niche stuff.

Apart from that, in terms of growth, I firmly believe in the basics of persistence and consistency, and just putting out what I hope is high-quality content. There's no real shortcut past that. I think there's an opening in the healthcare, entrepreneurship and big-picture space to become the hardest-working podcaster in the space. I'm certainly not there at the moment, but I think I could be, and that's what I really want to focus on.

A big inspiration for me is Harry Stebbings, who started the Twenty Minute VC podcast. If you don't know his story: he was a 16-year-old kid in London from a single-parent household with no real connections, but he wanted to get into VC, so he started interviewing VCs — just cold-emailing them. Over the past seven years or so, he's interviewed something like 2,000 people, he's now one of the biggest business podcasts in the world, and he's launched his own fund off the back of it. That's an incredibly inspiring story, and I think he just got the basics right. He put a lot of graft in, and that's what I'm going to do.

I've made it my mission to get to episode 500 of this podcast. We're at episode 100 right now, so 400 more to go. At episode 500 I'll have a think — am I going to take this in a different direction, do a different format, or stop doing it altogether? But I want to get to 500, and really that's just because I enjoy it. This is basically my hobby; it's what I do in my spare time. I love doing it.

But I'm also thinking hard about ways I can leverage this into something bigger — how I can create some synergy where one plus one equals three, how I can build off the back of it. So if you're a listener, you're probably a really smart person, and if you can think of ways I could build off the back of this, something I could pivot to, or you just have any ideas — send me an email: hi@musty.io. That's h-i at m-u-s-t-y dot i-o. I'd be really interested. One idea in the back of my mind is Big Picture Ventures — I think that could be quite interesting.

To finish off, I've got two asks. The first is around guests, and the second is around sponsorship. I've got a list of dream guests — these are loonshots, people who are very difficult to get, and believe me, I've tried. If anyone has a connection to these people, could recommend me, or has any advice on getting them, I'd love to hear it.

The 10 people are: Mustafa Suleyman of DeepMind; Baroness Joanna Shields of BenevolentAI; Jeremy Hunt, former UK Health Secretary; Anne Wojcicki of 23andMe; Dr Karen DeSalvo of Google Health; Lord Ara Darzi of Imperial; Dr Ali Parsa of Babylon; Dr Richard Horton of The Lancet; Vinod Khosla of Khosla Ventures; and Dr Anthony Fauci. If you know any of these people, please do send me a message — I'd be really grateful.

The last thing I want to discuss is sponsorship. Throughout this journey I've had a few offers, and they've just not made sense, for varying reasons. The main one tends to be conflict of interest. Imagine I accepted a telehealth startup as a sponsor, and then a few weeks later I interview one of their competitors — that creates this weird dynamic where you don't want to be too hard-hitting, because it looks bad, but you don't want to be too complimentary either, because then this other company is sponsoring you. It just creates a weird conflict that would really detract from the quality of the podcast.

The two sorts of companies that would make sense as a sponsor would be an investor, or maybe a consultancy-type firm or an agency. They'd tend to have less of a conflict with the type of content I'm making, and would probably get a decent amount of value from being sponsors as well. So if that's you and you want to reach out, please email me: hi@musty.io.

Okay, that's a wrap. Thank you so, so much for listening, and thank you for all the different degrees of support I've had — whether that's people who sent me a nice message, recommended it to their friends, made introductions to guests I've then interviewed, or offered me advice and mentorship. Just everything. Thank you so much. I'll probably see you again in this format on episode 200 — so that's probably going to be in about two years' time.