As I sat across from the young founder in our Mumbai meeting room, I couldn’t help but feel a familiar pang of empathy. It wasn’t the first time I’d seen that combination of defiance and desperation in a pair of eyes. He had come to me for advice, but as the conversation unfolded, it became clear he was more interested in validation for his faltering startup than any genuine introspection or willingness to pivot. In that moment, I was struck by how closely this mirrored something I’d seen countless times in my IVF practice: the delicate, sometimes precarious, dance of trust between a patient and their doctor.
This founder was clinging to a vision, much like a patient who holds fast to the belief that the next IVF cycle will be the one. Both are understandable. Both are human. But both can be blind.
In my experience, whether in the clinic or the boardroom, trust is not just about believing in the other party’s competence or experience. It’s about being open to hearing what you might not want to hear. Patients come to me with stories of previous failed treatments, hoping for a miracle. Likewise, founders often present their startups as the next big thing, despite dwindling funds and mounting challenges. Both groups are often driven by hope—a potent but double-edged sword.
Patient trust, I’ve learned, is built on transparency and communication. It’s about setting realistic expectations and being candid about the uncertainties. When expectations aren’t managed well, disillusionment sets in. I’ve seen it in patients who felt misled by rosy success rates, and I’ve seen it in startups that were promised the world by investors who never delivered.
One of the most profound lessons from my medical practice that applies equally to investing is the importance of managing expectations. I’ve written about this intersection before in “What Investing Taught Me About Handling Patient Expectations”. The reality is, whether you’re undergoing IVF or launching a startup, success is never guaranteed. The numbers speak for themselves: the failure rate in startups is staggering, with only about 5% making it to significant success. IVF success rates, while improving, still hover around 30-40% per cycle for women under 35, and drop significantly with age.
In both fields, the key is not to inflate these odds but to prepare for them. This is where trust is truly tested. Patients and founders alike must be ready to hear the hard truths. And as someone in a position of guidance, it’s my responsibility to deliver those truths with empathy and clarity.
Let me share an incident from my practice. A couple came to me after years of unsuccessful fertility treatments elsewhere. They were exhausted, emotionally and financially. They wanted to know if I could assure them of success. I couldn’t. What I could do, however, was offer them a realistic assessment and a plan with clearly outlined probabilities. They appreciated the honesty, and while it was a difficult conversation, it laid the foundation for a trusting relationship.
Similarly, in the startup world, I’ve had to tell founders that their business model simply wasn’t sustainable. My role as an investor isn’t just to provide capital, but also to offer guidance, even when it’s difficult to hear. Trust in this context means being honest about the potential for failure and the need for change. A founder I backed once told me that the most valuable thing I gave him wasn’t money but perspective. He had been so focused on his product that he ignored the market signals screaming for a pivot. It was only after a candid conversation that he finally accepted the need for change, which ultimately saved his startup.
These experiences have taught me that trust is not just about honesty but about the courage to face reality, however uncomfortable it may be. It’s about acknowledging that failures are not just possible but probable—and that they are valuable learning experiences. This is a theme I delve deeper into in “When a Startup Pitch Reminded Me of a Fertility Consultation”.
The failed consultation with the young founder was a stark reminder of the delicacy of trust. As he left my office, I realized that he wasn’t quite ready to confront the harsh realities of his situation. But I hope that, like many patients I’ve seen, he’ll come to appreciate the candid advice given in good faith. Because ultimately, both in healthcare and in business, trust is less about certainty and more about navigating uncertainty together.
As I reflect on these intersections between my work as a doctor and an investor, I’m reminded that the underlying principles of trust, transparency, and managing expectations are universal. They are the glue that holds together the fragile hopes of patients and founders alike. And while trust might not guarantee success, it certainly lays the groundwork for it.