Why I Worry About Venture-Backed Mental Health & Addiction Startups
It’s frustrating if you’re a customer of an expense report SaaS startup and the company goes out of business, but it’s potentially devastating if your tele-therapist or addiction counselor suddenly disappears because the platform that employed them ran out of money. This is my most significant concern about the wave of mental wellness startups being funded with venture dollars — what happens to the clients of the ones which fail?
Traditional venture capital models lean into what’s called ‘power laws.’ Basically the idea that you are backing risky new ventures, many of which will stumble along the way, but one or two of the companies you back will be such outsized successes that the investment gains from those will more than offset the others.
Venture capital is a great instrument for high growth companies, or those who are very early in their development but intend to pursue a high growth strategy. If a normal small business must optimize for unit economics and profitability early in its lifecycle, a venture-backed business seeks product-market fit in a big industry and then trades nearterm profit-taking for long-term marketshare, with the idea that profits can be extracted later. I’ll pause for a moment now to emphasize that I don’t believe there’s anything fundamentally wrong with this tradeoff, which shouldn’t surprise you since I am a venture capitalist. If you’re reading this post because you think capitalism is a fundamentally broken system or that venture itself is evil, I’m sorry to share that I don’t agree. But I will absolutely acknowledge that companies which take any outside capital implicitly and explicitly incorporate the needs and expectations of that capital into their business planning. And for venture-backed startups this tends to be “get them customers.”
Which leads us to the fundamental difference between, say, a small self-funded online therapy practice and one that has taken millions of dollars in seed capital: the latter can acquire a larger number of patients much faster using investment dollars for both customer acquisition and to subsidize the economics of serving those clients. That’s what always gives me a little bit of pause in this…