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    (ED NOTE:   Move over, .  This website heartily endorses .    As any doctor will tell you, some of the best doctors in America are foreign, and/or foreign-trained.  This blog  also serves to start the documentation of a rising Healthcare superstar, Gautam Sivakuma MD, and  to state that he may be one of the first residents in a new speciality, called, “Internet Medicine”!)

    Posted by Gautam Sivakumar on October 23 2013

    I can’t remember when I first read about Silicon Valley; it must have been in my late teens. Living a world away in Northern England, I read tales of entrepreneurs and engineers, innovators and creators, all of whom were trying to make their mark on the world, trying to make some meaningful change, always ambitious. It was like reading about a fantasy world, like something from Lord of the Rings.

    At that time, I was in the process of thinking about applying to medical school and pursuing a career as a doctor. Ever since my mother was diagnosed with cancer and my family experienced truly great medical care, I knew that my calling would be in medicine. But I was also enamored with technology; it was just plain cool. I loved tinkering with hardware and checking out the latest software online. At the time, I had no idea that I could ever combine my passion for medicine with my technology obsession.

    As the years went by, I taught myself to code and design, working on interesting projects that allowed me to build things. I was lucky enough to get into one of the best medical schools in the country, and subsequently got my dream job in medicine. However, I became frustrated with some of what I was seeing.

    Medicine has many modern day innovations: amazing CT scanners, da Vinci robot surgery and cutting-edge drugs, but the software I used in hospitals to find essential information about my patients was useless at best and nonexistent at worst. Why was it that the same patient who had undergone surgery with a da Vinci robot had their information stored in software that looks like Windows 95 or on scraps of paper with scribbles on it? That was crazy to me.

    One day I just had enough. There was a limit to how much I could say, “Hmm, I know I could design better software than this,” and I had to start saying, “I’m going to design better software than this.” If as a doctor and programmer I didn’t try to fix this, who was going to? At one point I went as far as to convince myself that the Hippocratic oath may even suggest an obligation to do this! So I quit, sold my apartment and moved back into my family house to found a startup that would go out and tackle the biggest pain points in medicine. And we would do it using great technology.

    I spent a few months prototyping and testing something that I felt would solve a critical clinical need. I took it to my old hospital to show them what I had built and they loved it. They wanted it. It was then that I knew I had something that was more than just a good idea. I called my burgeoning company Medisas.

    Medisas makes software that allows doctors and nurses to transfer really important patient information between shifts. This ‘handoff’ process is responsible for 66 percent of all serious medical errors – according to studies done on the process – resulting in the deaths of thousands of people every year. Our software helps medical professionals conduct a safer handoff, giving them easier access to the most important information about their patients and enabling better care. It lets your doctor spend more time at your bedside and less time trying to find information.


    I applied and was accepted into the Y Combinator program as a single founder, the most prestigious accelerator and seed fund in the world. Medisas was one of only 46 companies that was funded that cycle, from the thousands that applied. I knew that if things went well over the course of YC then I would be able to base the company in the heart of Silicon Valley.

    I came out to California to meet with mentors, mingle with other great founders and find my feet as an entrepreneur. It was fantastic, I had been transported to the fantasy land I’d read about as a teen. A place where my ambitions to change the world were welcomed. A start-up is like a seed, that can be planted anywhere you want. Why would you not choose to plant that seed in the most nutritious soil? At the time I didn’t even think about the visa issue. My job was to build the business, right?

    Medisas is a labour of love focused around better patient care through the use of technology – that’s why the team works long hours and has sleepless nights. But we’re also a company, a company that has raised money from the top U.S. investors and employs U.S. citizens. We’re a company trying to create economic value for our shareholders and team whilst saving the lives of many people. In order for the company to reach its full potential, I have to be able to spend time with the team here in San Francisco. I’d also love the freedom to hire the brightest talent, regardless of where they are in the world and bring them here to help us build out this vision.

    Applying for an O1 visa is a long, time-consuming and expensive process. You need to chase busy people for letters of recommendation, get press clippings, proof of funding and more. It requires a ton of preparation. I have a really great lawyer, but most entrepreneurs do not have my resources and would not be able to afford this. Despite having the resources and support, even for me it has been a long and arduous process. It’s certainly not a process that one could navigate by oneself, and definitely not while trying to run a startup.

    This process has taken up so much time that I’ve missed out on key hires, had to refuse client meetings and essentially put important work on ice. This is not what a founder should be doing. We’ve had to delay launching our software with U.S. hospitals, which is harmful from more than just a business standpoint. Every day that our software isn’t deployed in a hospital is another day that unnecessarily risks the life of a patient.

    There is great potential sitting untapped in the United States to create jobs, to further the economy, to create value – sometimes you just need an outside catalyst. I have a feeling that the best, hardworking, smartest people from around the world could be the catalyst that unleashes all of that – and more deeply than simple economics. Perhaps when you’re next in a hospital, it will be the software written by an immigrant physician who was lucky enough to make it here that will save your life.


    Author’s Note: Thanks to Jake Klamka, Lance White, Tim Young, Paul Graham, Gayatri Sivakumar, Balaji Srinivasan, Indu Nedumpara, Linda Nguyen, Dave Hersh, George Huo, Geoff Ralston and Alexi Robichaux for helping me with this.


    1 Comment

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