The Obstacle is the Way

My ambition was always to do well in life. When you're the child of parents who moved to this country and had to build a life from scratch, and you're the eldest in that family, you build a real sense of determination to do something important and meaningful — because everything felt like a struggle. So growing up, my ambition was always to do something meaningful that let me and my family do what we wanted to do, in the way we wanted to do it, without the constraints we had growing up.

I went through school trying my best to embrace everything it threw at me — the exams, the tests, the assessments. I wouldn't say I was the smartest person. I'd guess I was the most observant. That was the only thing I did differently: I was super aware that school was a game. There were people who played it really well and people who didn't. So I tried to learn the rules — learn these things, don't bother with those — and by definition that meant you did well in exams, or better than most, and then you were classed as smart. But really I was just super observant.

I always knew I wanted to go to university, though I didn't even know how you applied. I just knew it was something you'd get to at some point. I ended up deciding to do medicine, mostly because I went to a summer school and it was a real eye-opener that normal people could become doctors. It sounds crazy, but growing up I always thought you had to be super special — smart, or connected, or that there was just something about you that let you reach that prestigious stage of qualifying. When really, I realised there were loads of people studying medicine who were very normal, from normal backgrounds, who just had the determination to do it.

I went in determined to become a surgeon. But once I started studying medicine and understanding what it actually meant to be a doctor — what the day-to-day was really like — the problems of the system became really apparent to me, I think more than to most people. And when I saw those problems, I got intrigued about who was trying to solve them, because it was so obvious to me that this couldn't continue. Some of these were systems so dated that no one had any desire to update them. Information just didn't flow — you had to copy and paste everywhere, paper records everywhere. Very simple things that just didn't make sense.

So I ended up hustling my way into internships at various companies, just to find a space where intelligent people were trying to solve these problems with good processes and technology. That made me want to do it more. I decided to take a year out of medical school to do a master's in data science, also at UCL. That led me to Google, because they sponsored my master's through a set of events I'm happy to explain — but really it was me looking for opportunities to apply what I was learning in a meaningful way.

After being at Google, working on the team and doing the master's, your brain becomes really aware that there's so much opportunity to build a new world where healthcare and technology coexist. So towards the end of my medical degree, I became determined to find a way to do something on my own steam. Eventually I grabbed my two co-founders, Will and Riz, and said: we should start something. I don't know what it'll be, I don't know how successful it'll be, but I think it's worth it. So we started Suvera, with the intention of bringing healthcare and technology together in a meaningful way that hopefully builds something valuable.

That's so interesting. I'd say I was definitely more motivated by overcoming the struggle we had growing up. I wanted to do it in a way I could feel proud of, but the real goal was to be in a career where I knew I could support my family — that was the most important thing to me. Doing good for the world was kind of an added benefit. That's the honest truth.

Oh, there's a whole chasm of ups and downs. You know those fairy tales where they go on a journey, meet something, and decide to take a certain path? All of those things happened in Suvera's story. We came from this place as a medical school project, doing it for fun — we needed a distraction from medicine that was exciting and interesting. We built this app and it kind of worked; people kind of liked it. It didn't have any formation of a business — we weren't thinking about commercialising anything. I did that before I went to Google for my internship. After leaving Google, I felt we should make this into something scalable, something with legs. So I started thinking about how it could become a business.

Okay, I'm not going to lie — it wasn't an app. It was a prototype. It was a series of screens linked together that you could just barely click between. It was as janky as it gets. You could click on a few medications — maybe five — and see the information clearly labelled and filtered. That's what it was.

So after I left Google I came back and said, I want to make this scalable, something big, because that's how Google think, right? We eventually did the ABC of where this could go and what we'd need to do, and realised we had to either grow it to millions of users by magic, or turn it into a pharmacy. Those were the two routes. Either you commercialise through advertising and sponsorship, or you become a pharmacy where the main goal is to dispense loads of medications. I knew nothing about running a pharmacy, and getting millions of users out of thin air felt too hard. So we pivoted.

We said: actually, medication is a part of what doctors and nurses and the clinical system have to manage as part of care — and all of that happens in medication reviews. So how can we use our technology to make medication reviews easy? Then we realised medication reviews could be automated. When we asked doctors how they did them, they'd say, we fill out this form. That's it. The form changes a bit, but it's more or less the same form. So we built that form inside the app and said, we could send this to patients, they could fill it out, and you'd get all these reviews without speaking to anyone. Doctors said, that could be interesting.

We did it with one practice. And they got so many forms that they told us to stop. That taught us two things. One, patients actually like a more accessible way to reach their clinician — they're willing to try something that makes their lives easier and saves them from booking an appointment and spending half a day on a medication review. But two, you're giving practices more information without the ability to handle it. We gave them so much, whereas before it came in drips and drabs — when they saw the patient, not when the patient decided to send it in at midnight. So we realised the two things we could design around were creating a more accessible route to a clinician, but doing it in a way that managed that demand. So Suvera pivoted again to where we are today: a virtual clinic where we do all the reviews with our own clinicians. The practice basically does nothing, and they get a list of patients who've been reviewed — not just for their medication, but for the condition they're managing.

We realised their biggest problem was that they didn't have enough people, and they had this almost untethered demand coming their way. What they needed was a team to support them with that demand — not a tech solution, because the tech solution only generated more work for them.

This is the big thing I see between companies that do really well and companies that just about get there or struggle. They think their solution will reduce the work and make things efficient. Most times they actually make things less efficient, because you put more process in the way of the outcome and you generate more work. We're seeing a lot of that with the triage platforms that came about during the pandemic — you go online, type in your symptoms, and someone gets back to you. If you let a patient do that, of course they'll do it three or four times more than they would if they had to book, call, wait, and see somebody before telling them how they're feeling. So we had to recognise that the biggest problem in the system was simply that there wasn't enough staff for the demand. We had to support them to meet it.

Our first review was with about 200 patients — a very small pilot. We sent a text message saying, you can now review your blood pressure. We started with high blood pressure, using an app we shipped to both Android and Apple. We got the approvals, ready to go — and then you had this flood of patients just submitting information. Eventually we had to stop it, because a practice told us to.

So we decided, this isn't going to scale if every time a patient's engaged we have to stop it. I reached out to our now medical director, Anthony, and said, I feel like we're going to need a care team, and I have no idea how to do that, but I think you do. He said, okay, let's have a chat. Anthony became the pseudo care team in a pilot. He was a registered GP with all the approvals to look after patients, so he became an extension of the practice we worked with. The reviews were done in the app and then went to him — he'd check them and say, you're all good to go, or, actually, we need to see you, your blood pressure's quite high. And the practice loved it. They had a GP working with them — granted, for free, so of course they loved it — who did the reviews, and someone checked them, and they had to do nothing.

So we said, we need to scale this. We registered with the Care Quality Commission, because we were providing care. We did the work to make sure we had the proper checks and balances, we improved our technology to make it safer, and we started to sell the service to GP practices — groups of them — saying, we can manage your whole patient list. All you have to do is give us the people you want us to see, and we'll do the rest.

What I didn't say is that there were some patients — about half — who had a good time using the app. They reviewed their condition and sent it off to their practice. The other half absolutely despised everything to do with it. They were like, what are you doing? Why are you here? Sometimes I was on those customer calls. We had one lovely lady who said, I've just got a text message to view something in the app — what's an app? And she was so upset. We realised this wasn't going to work for a lot of people, and we needed to build something that addressed that difference in people's tech literacy. So some patients loved it, some absolutely despised it.

There were also a lot of practices that just didn't believe we could be helpful, or felt there was a lot of risk in having their patients managed for blood pressure by a company outside the system. Not everyone we spoke to welcomed us with open arms. But I think it's about recognising that the narrative for every new service or technology has always been fraught with a lot of scepticism. I don't believe this could work. I don't believe we even need it. Things aren't great, but they work. And then you realise everything is a slow progression of realisation that it can actually be better — and that these guys, although their early version wasn't that good, are improving over time.

So understanding how innovation comes to fruition is really important to overcome those hurdles, where people are saying no and it's so easy to give up. There are always more people saying it won't work than people saying it will. But if you understand how innovation comes about, you realise that's a necessary part of it. If anything, if everyone's welcoming you with open arms, you should be a bit worried — either you're too late and there are loads of people already doing it, or people don't understand the risks, or you're not doing something innovative enough for them to see any risk in it at all.

Two main things. One was having worked at other companies that were very well funded, winning contracts, growing. You become aware of the things they do well, but also the things they don't, and what it takes to get to that stage. I was very aware of those journeys — how they had false starts, and that if they hadn't persevered they wouldn't have got to where they are. Knowing the real narrative of these companies — that today wasn't smooth sailing, and if anything the struggle was a necessary part of the success later on — I always kept that in mind. Whenever we faced something, I'd think: this is good.

Struggle is good, because on the other side of it is more success. It's about framing your mindset to see that difficulty as the way. Ryan Holiday talks about The Obstacle Is the Way, and that was very much my mentality — every time we met friction, I'd think, follow it, keep pushing, see how far we can go.

The second point is that, having worked at Google with the best of the best — the best minds, building some of the best products, things you wouldn't see in real life for years — I also understood the things that just weren't going to be done at that level. The things Google wouldn't commit to, the things left on the table. So I could see that if big tech, from Google's perspective, wasn't going to do it, someone had to. That felt like an opportunity. If I hadn't been in those rooms, I'd have believed they would do it — but I knew they wouldn't.

And the third thing was just having a really great team. When I was demoralised, Will was like, we can do it. And when he was demoralised, I was like, we can do it. Having the right people, with a sense that something must be possible — and that if we don't figure it out, someone else will.

Being a black man in healthcare and health technology, you definitely feel like a unicorn. I walk around feeling like there's only one of me here. And that's not necessarily a good thing or a bad thing — more just a sense that I'm bringing something different to the table. I try not to look at it and say, this is horrible, everyone in the industry who enabled this is terrible. I look at it and say, this is an opportunity to prove things that haven't been proven by someone like me. That's a great chance.

It is difficult, because to build a company this risky you need really strong backers — people in your corner even when things aren't going well. And people build connections with people they know, understand, and have an affinity to. A lot of that is to do with race. A lot of it is to do with class. A lot of it is to do with upbringing. So I've always had to work harder to get to where I am, and I think people never quite understand that. There are more barriers I have to come across, more moments of self-doubt, more people who'd put obstacles in the way, to get to the same place. It's like running a race with weights attached — you have to put in that extra effort just to keep up. That's always been part of my story, for unfortunate circumstances that are society-driven, which I can't change. So all I can do is use it to make me stronger and more able to do things other people can't.

I've used my background — my difference as a black man in this space — as an advantage. If I didn't have those personality traits, I wouldn't have ended up at Google, wouldn't have done the internships I did, wouldn't have had this determination to do something risky. The odds were already stacked against me in any direction, so you might as well do it where the upside is huge. I turn all of that on its head and say, being one of a kind in any market is a good thing, and if it means you can lead from the front, even better.

Don't get me wrong — it's lonely. And I'd like more people like me to be involved in this space, to be given the opportunity to take these risks. I don't think people don't want to take the risk; it's that they don't see a route to opportunity. Because of some fortunate events, I've been given the space and the networks to have people backing me to do the thing I want to do.

After we pivoted to the virtual clinic, it was a process of getting our regulations in place and making sure we had the foundation — because there was a big risk that if we didn't, we'd get in trouble. We stayed focused and managed to get that in place. All the while we were in communication with practices, understanding what they needed from us and how we needed to operate. So we ran small pilots, again replicating that first pilot, and grew the team to support them.

The next inflection point came when we signed relationships — once we had our regulation — with large groups of practices who said, we're not just going to give you one practice's patients, but three, four, five, six. That became a validation: someone was going to trust us with not a few hundred patients, but a few thousand. It said this is a model where there's a real need to support patients at a population level, rather than practice by practice.

After that, the validation came from funding and raising investment. Not every business needs to raise, but if you're doing something as risky as this in healthcare, you'll really struggle without it. We had some initial money in the bank, all raised on that first idea — the medication review we wanted to automate. So people really took a bet on us, not the idea, because we ended up changing it. Once we had more validation from the virtual clinic, we could justify raising more. That was another inflection, because it gave us validation from seasoned investors — people who do this for a living — saying, I believe you could use our capital to build something meaningful. That's business-building validation that there's something here worth investing in.

If somebody was going to go down the path of creating something in this space with a similar mentality, the thing I'd recommend to help them get there faster is to spend more time really understanding what you can put in front of people that requires very little capital, that you can learn from. I say that because we saw this opportunity with the virtual clinic, but had a very strong desire to grow it as soon as we saw it. We could have spent more time diving into that space and understanding the nuances — the challenges people would have, where customers are really coming from. It was only later, when we realised there was more for us to do, that we took a step back and had those conversations again.

So when you see something working, try not to get too far ahead of yourself. See how you can make it work a little bit better, and understand the levers that would add more value to customers, before you decide to push on the gas. Try to lean off the gas even when things are working a bit, so you can build a series of learnings. That's the first thing — not diving too far in, even when you recognise there are signals.

The second thing is focusing a lot more on your team, and making sure you don't make decisions about co-founders or who's going to lead your technology too early. What you want are people willing to grind to figure something out early. Don't make too many commitments, because then you have to hold yourself to them without really knowing what's going to happen next. Be clear: we don't know what's happening, but we can offer you this — it's going to be a role to help our technology; it's not going to be head of engineering or VP of engineering, you're going to be an engineer working with us, and I'm going to be the product guy. Keeping things ill-defined early and working collaboratively without hierarchy or titles helps move the ego out of the way. Team dynamics — who does what, who's in charge of what — can cause a lot of delay. We could have done better to strip away those titles early and just say, I need someone to work on design and branding, someone to work on this, and we're going to work as a team to get this done. When we feel like there's a business here, we'll define those things better. When you're bringing people together, try not to set expectations too high, because you don't know what the future's going to be.

I'm a big fan of Stoic philosophy — which has become a bit of a Silicon Valley ritual, I know. For those who don't know, it stems from the likes of Marcus Aurelius, Roman emperors and leaders who managed and maintained huge empires, but had a way of reflecting on their day that recognised their weaknesses, recognised they were human, and recognised that one day it would all end. For me it's about adopting the sense that whatever we do, fundamentally we're all flawed. As amazing as everything can be around you, there'll be times when things are not amazing. Trying not to ride the waves of life helps you deal with things as and when they come, really well. I've definitely adopted that as part of my thinking.

And, as I've said already, to do anything meaningful there's going to be a lot of risk, and you're going to have to face a lot of obstacles — but that's a necessary part of getting to the other end of success. There's no company story that doesn't have some part that's fraught with, this could have been the end. That's a necessary part of getting to a place where there's success, because on the other end of it you've done something most people would have thrown their hands up at.

I remember reading Tony Hsieh, the founder of Zappos — he has a book I listened to regularly when I was travelling from Stevenage back home in my final year. At points he'd say, this is it, this is the end of the company, this has to be it. Obviously we know this thing sold to Amazon, but in my head I thought, there's no way you can overcome this continuously. And he just said, we're going to do it, we're going to try, we're going to keep going. That built this sense in me that the only way is through.

You have to build that resilience. It's not for everyone, to be honest — and there are times you have to know when to call it quits. But most times, on the other end of something that's really hard, or feels impossible, is the thing that's going to make this last. That mentality of not riding the waves, but also realising that to get through to anything really substantial and valuable in the world, you're going to have to do the things other people probably wouldn't.