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Digital Health Black Sheep: Part 1

Written by Andrew Le, MD

UpdatedJune 21, 2023

Welcome to the CEO Corner, where Buoy CEO and Cofounder Andrew Le, MD sits down with industry leaders to chat about the provocative topics of healthcare today. Andrew recently spoke with Karan Singh, the cofounder and chief operating officer of Ginger, a provider of on-demand mental healthcare, including 24/7 behavioral health coaching, as well as video-based therapy and psychiatry support and self-guided content. They talk about being founders in digital health, mental health changes and challenges and what the next generation of founders should look out for.

This interview has been edited and condensed for clarity.

Andrew Le, MD: Karan, do you mind just kind of walking us through your background and role at Ginger and tell us how it came to be?

Karan Singh: Yeah, absolutely Andrew. I’m cofounder and chief operating officer at Ginger. We are an on-demand mental health system that began a little over a decade ago. Think of it as a virtual clinic for your mental health with a team of coaches, therapists and psychiatrists. Additionally, self-care content is available 24 hours a day, seven days a week. You can typically access care in under two minutes, which is a far cry from the standard times of weeks or months in this country. I had been in the biotech and pharmaceutical world for quite some time and then had a personal brush with mental health when a family member tried to take their own life.

I always thought of myself as being able to read people and judge character, but this event shook me to my core. I went back to school to see if I could do something about it. I was in the Health Science and Technology program at MIT Sloan and Harvard Medical School. I really wanted to understand this intersection of healthcare and data and technology—particularly in mental health, where there aren't many objective measures. There isn't a blood test for your depression or an easy way to measure stress. We originally planned to build a technology platform, selling into provider groups. And then about six or so years ago now we became an actual licensed medical provider, delivering care in all 50 states and about 50 countries internationally.

Andrew: Wow. I didn't realize you had such an extensive international reach. That's amazing. I wish I had known about you when I left school—two years after you. It was frowned upon at Harvard Medical School, right? And it's so lonely.

Karan: I know, I felt like I was a black sheep. There was no digital health. You were either in the biotech world or maybe you did electronic medical records, but there wasn't anything in between.

Andrew: Then from a medical student perspective, if you didn’t do clinical or wet lab research, you did nothing. That was pretty much it.

Karan: How much has changed, right?

Andrew: That's so true. What part of your job doesn’t feel like work? When are you in a flow state?

Karan: That's my favorite question. I ask that of everybody I interview, too. Much of work is just finding your superpower—that thing you love to do. And when you're doing it, you feel like you're in flow state; it doesn't feel like work. A big part of it for me is finding purpose, being on a mission or having a vision that matters. Our vision is a world in which mental health is never an obstacle, and that feels especially important right now. It was true pre-COVID, but it's especially true now. People are recognizing that. As I've been saying, mental health is coming out of the backroom and into the boardroom. There's a conversation that's happening fundamentally in many different forums but certainly in the workplace.

The magic combo for me is working on something I'm really passionate about—a problem that impacts a lot of people. That's important, but it definitely doesn't sustain you for 10 plus years. The second part of that equation is just working with the incredible people in this space. It had been a pretty small community, but now we're starting to see people who were doing their second or even their third act. We're going to continue to see that.

Our vision is a world in which mental health is never an obstacle, and that feels especially important right now.

Karan Singh, cofounder and chief operating officer of Ginger

Andrew: I totally agree. In some ways—I know you didn't say it explicitly— I feel like when I go to work, if me taking out the trash moves us forward, then let's do it.

Karan: Yeah. That's right. And especially as the founder, you're going to wear so many hats. But the best part is working on work that matters with great people.

Andrew: I love that. And you talked about second acts. This is your first act—mine too. It's always fun to hear it from a founder's mouth. What were some of the biggest challenges along the way? That sets up my favorite question: What are you proudest of?

Early in his business journey, an angel investor shared "The Martian" with Karan as an example of the need to "survive until you thrive", sound advice for the difficulties of new business growth. Image courtesy 20th Century Fox Film Corporation)

Karan: That is a good question. I wrote about this recently in a series of articles on LinkedIn. I called it “Pivots: a three-part series,” which is about our business model pivot that goes from selling to providers to becoming a licensed medical provider. Our team pivot was about the team evolving and changing over the years and recruiting great talent, from a new CEO to the executive teams. My own pivot was really about learning to evolve my mindset, change, grow and really build resilience. If there's one thing that I'm particularly proud of, it's maintaining a growth mindset and developing that bounce-back muscle. I didn't learn about that in school—or at least didn't really talk about it much in school—but the reality is you need a whole lot of resilience—as an entrepreneur and founder, and certainly in digital health. And you've got to figure out ways to keep evolving and growing and learning and changing. That is the game.

Today, I'm really excited about having changed my orientation of what success might look like and what the win is here. At the end of the day, it's making an impact and helping a lot of people. With people increasingly becoming more open, the stigma is starting to reduce. It's still clearly there, but we're able to help many people across this country and the globe. I'm proud of that at a company level.

Andrew: Karan, I want to touch on a couple of the things you said that are super powerful. First, on the growth mindset and resilience sides, I could not agree with you more. But I also think you're alluding to the idea that we weren't trained for it. However, I would argue we were selected against it. You go to medical school, and it's all about getting the perfect grade and not used to failure. Here’s a comparison. High-performing athletes lose all the time, even though they pour in so much effort. They pick themselves back up and are ready to train the next day. Picking yourself back up is the win.

Karan: I couldn't agree more. Being real, being authentic, being honest with yourself when you're going through this journey is so critical for success. One of our company values is to seek truth, speak truth. That's a big part of the equation here because it can be hard—especially in digital health—to know when you're "losing" or when you're not being effective because the feedback loops can be slow. I've learned to know whom to trust for what and when and whom to ask for advice about this journey. You get so much advice from many different people, and sometimes it's tricky to know what's most relevant. It’s the same way an athlete needs a great coach who can help with performance and milestone issues and suggest changes for improvement. How can you learn? How can you grow?

In Part 2 of the conversation, Karan talks about light bulb moments—or lack thereof, the supply/demand imbalance that plagues all of healthcare, and diversity, equity, inclusion (DEI) strategies within companies and how to address DEI in underserved populations.