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NYC Pioneers: Cyrus Massoumi and ZocDoc

Cyrus Massoumi is the CEO & founder of ZocDoc. ZocDoc is a New York-based company that helps you book doctor appointments online. After getting an ear infection on a long flight and not being able to get into a doctor quickly, Cyrus came up with a new solution, ZocDoc. Cyrus was kind enough to take time out of his busy schedule to talk about startup hurdles, hiring, cultural changes, and many other topics. For more from Cyrus and ZocDoc, please visit their blog and find them on Twitter at @Zocdoc.

In a recent TechCrunch article, you talked about how things didn’t go so smoothly when ZocDoc launched. What were the biggest hurdles you faced and what’d you do to overcome them?

There were a few things – first, we launched shortly before the worst economic recession many of us had ever seen, and people thought that companies wouldn’t be able to raise venture capital financing again. The harsh environment forced us to be extremely focused with the few resources that we had at our disposal, which was a blessing in hindsight because it forced us to stay focused. For our first two years, ZocDoc only offered appointments in New York in order to hone our business model and make improvements to our service, ensuring scalability and a great patient experience.

Secondly, this was a completely new concept at the time to doctors. Initially, it was an uphill battle in selling this service to them. Doctors are constantly bombarded by reps seeking their endorsement or use of a product or service, so we had to break through that noise. There was a time when I was going door to door with a PowerPoint presentation, and I’d be in a doctor’s waiting room for hours before I was able to get in to give my pitch. It took a lot of hustle to get our first doctors to sign on.

Lastly, people thought we were overly ambitious to think we could change the way people access healthcare in this country. In launching ZocDoc, we weren’t David going up against Goliath. Rather, we were looking to change patients’ existing behavior. When we launched, we thought that we’d have this incredible amount of patient demand on our hands. In reality, it took time for us to get our first few appointments. But after we got a few dozen of them, word of mouth kicked in and the growth increased dramatically – and it has been compounding ever since.

ZocDoc spent its first few years conquering New York. Now, you’re going nationwide, seemingly rolling out to a new city every few weeks. What are your plans after that?

We’ve only been able to succeed at ZocDoc through focus, and right now we’re laser focused on offering our service to patients and doctors nationwide as soon as possible. We’re currently live in 19 markets and expanding at a rapid pace, but we still have a lot of work to do on that front. We like to say that it took a thousand 0.01% improvements for ZocDoc to work, and we’re still making those changes every day. So, our plan right now is to continue to make these incremental improvements as we serve more and more patients. Once we’ve made more progress, we can start to explore solving other patient problems within the healthcare system.

What’s it like going from a startup to more established company from a culture perspective? What has changed?

It’s funny, around the office we often ask ourselves – when are we not a startup anymore? Even though we’re now over 300 people, I think we still consider ourselves a startup and we approach our work in that spirit. We try to stay nimble, to be open to new ideas, to be scrappy and agile and able change direction quickly, just as we did back when we were five people. I will say, I am just now reaching the point where it’s getting harder and harder for me to know everyone’s names. I came back to the office after travelling for a few days and there were 50 news faces. But we make it a priority to ensure that everyone is connected, that it’s a fun place to come to work, and that there’s a sense of teamwork and camaraderie. For instance, we cater in lunch every day so we all eat together, and I also make sure to have lunch with our new hires each week. It’s a great way to get to know them and for them to have a chance to ask me anything. Also, something that’s been helpful in maintaining our culture as we grow are these seven core values. They have served as a guidepost to help us preserve all of the things we love about working here.

You constantly talk about how important hiring is. What do you look for in people?

One of our investors, Vinod Khosla, gave us the good advice that the first 20 people we hired would set the tone for the company’s culture, because they’d help attract and hire the next bunch, and so on. We’ve always been really particular about who we hire and we challenge everyone here to hire people who are better than themselves. We tend to attract very curious and intelligent people who like to solve big problems and who are incredibly mission driven. Even more specifically, we want to work with people who speak up, who own it and who make work fun.

With dedicated accelerators like Blueprint Health, Rock Health, and Healthbox, healthcare is a growing field for startups. You’ve transformed how patients get into their doctors. What coming changes should we be excited for?

As a company that felt like we were swimming upstream back in 2007, it’s been exciting to watch health tech become such a hot space. In the first quarter of 2012 alone, health IT companies raised $102 million in 2012 (up 75% over the same period in 2011). That’s amazing growth on the investor side and with recent legislation changes it’s an area that’s increasingly ripe for disruption. At ZocDoc, we solve one patient problem around access to medical care via online scheduling, but I think that’s only one of many interesting pain points that needs to be addressed. I think we can see expect to see improvements in cost transparency, in mobile diagnostics, in products and services for the quantified self movement and it goes on and on.

ZocDoc was started in New York before it was trendy to be here. Why didn’t you go out west?

You know, it didn’t even occur to us to go out West. My co-founders and I had all been in NYC for a while, and it didn’t feel as though geography would be a barrier. Also, in looking at our core business, New York has an incredible volume of doctors so it was an exciting place to start. We also knew that if we could prove this concept in New York, one of the most dynamic and competitive medical markets, we could be successful anywhere. Now, when we see New York dubbed “Silicon Alley,” we’re proud and humbled to have been among the first wave of companies putting down roots here.

What does the future hold for startups in New York?

Possibilities for startups in NYC are as endless as they are for startups anywhere. With the democratization of the web, great ideas and great companies can grow from anywhere. I think it certainly helps to be in places like San Francisco or New York where there are rich pockets of talent, investors, etc. but I think it’s an exciting time for startups in general.

During your CNBC interview in April, you mentioned about 20% of MBA grads are going into startups. After a few years at McKinsey, you did too. If you knew you were going to create a startup, would you still have made the decision to go to Columbia? What would you advise other potential founders to do?

I think there are lots of different paths to success, and what may work well for one person may not be effective for the next, but for me, business school was a great experience. I think it can bring tremendous value in expanding your network, opening doors and learning historically from others’ successes and failures. If I had it to do over again, I wouldn’t change a thing.

Who’s been your biggest influence and why?

My father. He was a physician and I saw firsthand how the changes in our healthcare system over the years have made it increasingly difficult for physicians to run a successful business. Given reduced reimbursement rates, physicians have to play a volume game and see more patients than even in order to maintain the same quality of life for their families. Without this insight gained through my father, I don’t think I would have fully understood the need that ZocDoc fills for physicians.

Besides ZocDoc, what’s your favorite startup?

I’m a big fan of Warby Parker (in fact, such a big fan that we gave everyone at ZocDoc a pair for the holidays last year). They’re delivering a quality product in an innovative way, and they’re managing to do a lot of good while they’re at it.

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