What does Out-Of-Pocket look like if it succeeds beyond your reasonable expectations?
Nikhil Krishnan: Out-of-pocket has two goals:
- Make it easy to understand how healthcare works. That's the newsletter, courses, etc.
- Make it easy for people to start healthcare companies. That's using events, community, syndicates, etc., to make it easier for people to find cofounders, capital, and validate ideas.
The craziest version that combines both is a new university/campus or creating a program on an existing campus. Can we make a track that teaches people all the practical things they need to know about building healthcare? Can we use the program to help people find cofounders/create prototypes?
You had a bunch of data-focused healthcare jobs before betting on yourself. What gave you the courage to make that leap? What has surprised you?
Nikhil Krishnan: I've been writing publicly about healthcare for about 8 years now, so I've been getting feedback for a while that the things I write resonate with people and they're generally interested. By the time I left CB Insights, the healthcare newsletter I wrote had 90K+ subscribers. When I left and I got DMs on Twitter asking what I was doing next, I had a sense that I could potentially do it as a full-time job.
Most surprising thing? Well, a core part of many Out-Of-Pocket projects is that we ask people to apply to get into things (our conferences, hackathon, Slack group, etc.). I've been shocked that not only have people been willing to fill it out at all—especially since it's a sketchy-looking Google form—but that the quality of people has been so high. My takeaway is that excellent people have been craving some layer of curation to find other excellent people.
What are the best and worst things about your job?
Nikhil Krishnan (Out-Of-Pocket):
The best thing is the response to my newsletter. It has become a beacon for curious healthcare people who love sharing ideas and explanations. I get to learn so much, people trust me with information, and the new ideas keep me optimistic about healthcare.
The worst thing? Running a one-person business means celebrating wins or handling losses alone. There’s no one to share the joy or frustrations, and I miss the camaraderie of coworkers sometimes.
Would you rather be funny or happily married?
Nikhil Krishnan (Out-Of-Pocket):
If I weren’t funny, I wouldn’t be happily married, lol. But I’d choose being happily married—especially since my wife is staring at me while I write this!
Who else in healthcare inspires you, and why?
Nikhil Krishnan: I feel like the more I read about Katalin Karikó, the more inspiring her story is. Her work on mRNA basically underpinned the vaccines and mRNA as a therapeutic modality. She came from true poverty, emigrated here with her family and very little else, and is now a shining success story.
The university she worked at initially shunned her work in mRNA because it never received grants, and she was demoted. Prestigious journals did not see the work as worth publishing. But she deeply believed in her work enough to keep pursuing it, and eventually, one person (Dr. Drew Weissman) took a bet on her, and the rest is history. Now they both have a Nobel Prize and recognition for their work.
But damn... that path is not for the faint-hearted. How many other people have wild ideas shunned by everyone else? Who’s someone you could take a bet on today that might change the trajectory of their life? Her story makes me think about that a lot.
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