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“Know what you are trying to achieve and why you are doing so”, With Douglas Brown and Dr. Nadine Hachach-Haram

I think success with a tech company all boils down to one thing: Know what you are trying to achieve and why you are doing so. This anchors you. In health technology it’s important to ensure you know who your customers are and what is important to them. At Proximie, our end users are surgeons. […]

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I think success with a tech company all boils down to one thing: Know what you are trying to achieve and why you are doing so. This anchors you. In health technology it’s important to ensure you know who your customers are and what is important to them. At Proximie, our end users are surgeons. Being one myself, I know how high their expectations are, how unforgiving they can be on anything less than perfect in terms of both quality and the authenticity and consistency of your brand. We work hard to get this right. When you achieve this, you can remain authentic and consistent in how you communicate across all channels. Finally, be responsive, provide a way to address issues quickly as well as continually understanding and learning what customers want from your platform or solution.


As a part of my series about “Lessons From Inspirational Women Leaders in Tech”, I had the pleasure of interviewing Dr. Nadine Hachach-Haram, a clinical entrepreneur, lecturer and surgeon who regularly supports global medical charity missions. She founded Proximie — a web-based dashboard that provides augmented-reality surgical assistance via a live video feed — in 2016.


Thank you so much for joining us in this interview series! Before we dive in, our readers would love to learn a bit more about you. Can you tell us a story about what brought you to this specific career path?

I’ve always been passionate about plastic and reconstructive surgery. I grew up in war-torn Lebanon where I witnessed a great need for that kind of medical care. So early on, I decided that I wanted to give people an opportunity at a better quality of life by restoring their form and function. In my journey to where I am today, I started to become involved in global health initiatives. I worked in many countries around the world, helping to build and scale sustainable health models, including Peru, Vietnam and throughout the Middle East. But I also worked with big, international medtech companies, advising them on how to scale their new techniques and devices.

What I recognized after 10 years of doing this kind of work is that there is a fundamental challenge of access, variation and care in the quality of healthcare. At the moment, where you live in the world very much determines the quality of your care, and it shouldn’t be that way. They often say necessity is the mother of invention. I saw there was this huge problem getting expertise to where it’s needed, and that’s when I began looking to technology to solve it.

Can you share the most interesting story that happened to you since you began at your company?

Yes, sure. I call this my litmus story. For years my mother had a series of gastro-intestinal issues that frequently landed her in intensive care. Essentially, she required complicated reconstructive surgery to repair her abdomen wall, a very complicated and specialized procedure. A couple of years ago her condition reached the point where her quality of life was seriously deteriorating. The daughter in me said we should immediately fly her from Beirut, where she lives, to London where I live, so that I could use my many contacts as a practicing clinical surgeon to get her the very best specialists. When I told her this, she said something that took my breath away: “No, I want to have the surgery done in Beirut where I’m familiar with my doctors and can be close to friends and family. But I want to use Proximie to have the best surgeons in the world assist with the procedure.” It was the ultimate benchmark, using Proximie for my own mother’s survival. Fortunately, the surgery was a complete success. She’s now once again taking walks, going to the beach and playing with her grandchildren.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

The fact is, being an entrepreneur doesn’t get easier as your start-up grows; it just gets difficult in new ways! So many people seem to want to help, yet then you discover most will only do so in exchange for shares in your company. As a surgeon, the world revolved around me in the operating room, everyone catering to my requirements; not so much as an entrepreneur. When I began the company, I thought to myself, how hard can it be to sell to hospitals? After all, I am a surgeon! Getting periodic reality checks from strong, passionate and trusted team members was how I got through it all.

Can you tell us a story about the hard times that you faced when you first started your journey? Did you ever consider giving up? Where did you get the drive to continue even though things were so hard?

It wasn’t my intention to build a business; I wanted to fix a problem. I had seen first-hand how all too often a lack of access to quality healthcare in the developing world had resulted in needless pain, suffering and even death. I knew there had to be a way to connect surgeons to share knowledge and expertise to save patient lives in an accessible and affordable way. The challenge was building a platform that worked in developing countries and rural areas. It had to work seamlessly — after all, we’re talking about a surgical procedure — but with low bandwidth and on an everyday device like a laptop, tablet or computer. At times, it seemed to be an insurmountable problem, but I never thought about giving up. Seeing patients every day and knowing the difference I could make with the device that I imagined was more than enough motivation to never give up.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I know it’s very cliche, but I would really have to say it’s my family. I have three young children, a loving husband and also my husband’s and my extended families, all of whom have been really supportive. They’ve provided the infrastructure to help me do what I want to do. It takes a lot of emotional and physical push to grow a business that’s disruptive. It has a lot of ups and downs. However, my family has been with me on the roller coaster ride of being a techpreneur. I couldn’t have done it without them.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

My life-lesson quote comes from Arsène Wenger, the champion soccer-football player and coach: “The biggest things in life have been achieved by people who, at the start, we would have judged crazy. And yet if they had not had these crazy ideas the world would never make progress or worse for it.” This certainly applies to me and even my predecessors in surgery, who wanted to forge a portfolio career beyond surgery itself. A decade or more ago, those who wanted to combine an MBA and surgery were looked at as crazy, let alone also wanting to be an entrepreneur in digital health technology and having a family!

Ok super. Thank you for all that. Let’s now shift to the main focus of our interview. We’d love to learn a bit about your company. What is the pain point that your company is helping to address?

Proximie is a technology platform that uses a combination of machine learning, artificial intelligence and augmented reality to empower surgeons and clinicians to virtually scrub into an operating room anywhere in the world.

As I mentioned before, as a surgeon, I grew increasingly frustrated with the widening variation in care that I not only witnessed in the developing world where I had dedicated my time to global surgical initiatives, but also across established health systems in the most technologically advanced countries. Our mission is simple. We believe that where you live should not determine your level of healthcare. When you walk through a hospital’s door, be it in New York or Nairobi, everyone should have confidence that they will receive the best quality care in the world.

What do you think makes your company stand out? Can you share a story?

I’ve been talking about healthcare in developing countries. But in reality, Proximie was made for the kind of pandemic that has swept Europe and the U.S. We have seen how COVID-19 has forced innovation at a pace that was previously unthinkable. The urgency that was needed to try and combat COVID-19 has been a catalyst for incredible collaboration.

Take, for example, the recent case of Mo Tajer, a 31-year-old salesman, seriously ill with a rare cancer. Because of the position of his tumor, attached to two major blood vessels in his abdomen, it required the precision that only robotic surgery can provide. The problem was that the patient and his surgeon were in London but the specialist, Dr. Jim Porter — one of the world’s leading practitioners of the required laparoscopy known as common keyhole abdominal surgery — was in Seattle.

By using Proximie, Dr. Porter not only could watch the surgical proceedings from his living room 4,700 miles away, but could actually guide the London surgeon as to the intricate series of incisions that the procedure required via a tablet touchscreen. The surgery was such a success that the patient awoke feeling no pain and a week later was already on his feet.

Are you working on any exciting new projects now? How do you think that will help people?

For sure! As you know, technology continues to evolve at a rapid clip, and we have a founding principle to harness the best available technology solution to achieve our mission of saving lives. One core component of our platform is the ultra-low latency, which means that surgeons can summon up data and images relevant to the procedure, to see what is going on with extremely high clarity. Adding to this, we have been able to apply artificial intelligence to Proximie. Surgeons can discuss a patient’s procedure in real time with a colleague using our augmented reality tools. This means patients are more likely to get the best care the first time, and every time.

I have been very lucky in that my career has been supported by amazing people, which has meant that I am able to continue to be a surgeon and run a business. As such, I really enjoy sharing my story with students across the world, so I can help them imagine what is possible. Part of this is ensuring that everyone who wants to be a surgeon has the equal access to knowledge. We are now beginning to offer Proximie as a teaching tool. With the touch of a button, medical school students can access experts from anywhere around the globe to interact, discuss and learn.

Let’s zoom out a bit and talk in more broad terms. Are you currently satisfied with the status quo regarding women in Tech? What specific changes do you think are needed to change the status quo?

When I think about women in tech, I’m reminded of the quote-meme by U.S. Supreme Court Justice Ruth Bader Ginsburg, “I ask no favor for my gender. All I ask of our brethren is that they take their feet off our necks.” Look, there are definitely obstacles to being a female techprenuer that their male counterparts do not encounter. Ditto, for women surgeons. But there are always means for getting around obstacles, which I’ve learned during my journey over the last 20 years. In fact, it’s a bit of a misconception that there are few women in technology and heatlhtech in particular. That’s really not true — there are literally thousands of us! However, admittedly we oftentimes are not very visible. I think those of us women who have succeeded in what, no doubt, is still a white-male-dominated industry, must make a conscious and sustained effort to make ourselves noticed through speaking engagements and news media opportunities like this one.

In your opinion, what are the biggest challenges faced by women in Tech that aren’t typically faced by their male counterparts? What would you suggest to address this?

The biggest challenge facing women in tech is a lack of capital. Finding investors, of course, is difficult for everyone, but women face another level of skepticism. That brings me to the next challenge facing women in tech — unconscious bias. To overcome this challenge, we must educate men on how their behaviors contribute to women being stigmatized in the tech industry. Another way of framing this is not being taken seriously due to gender perceptions. In fact, women are just as passionate about technology as men.

What would you advise to another tech leader who initially went through years of successive growth, but has now reached a standstill. From your experience do you have any general advice about how to boost growth or sales and “restart their engines”?

Fundamentally, I believe it’s about the “why.” Why are you getting out of bed to do the things you do? We all spend an extraordinary amount of effort, blood, sweat, tears and occasionally the odd swear word, to reach our goals. If you do this and remember to have fun along the way, I believe you will be successful.

Do you have any advice about how companies can create very high performing sales teams?

We look to build our team across all disciplines, including sales, based on three principles. First, there’s the principle of alignment and clarity of the mission and vision. Talented people join Proximie because of our mission of saving lives every day. This is what we do, and we are proud to be joined by so many people who share our vision of changing healthcare for the better. Next, comes the principle of empowerment and accountability. Every individual should be able to feel like they are contributing to this mission each and every day with each and every task. This precept is very reminiscent of the NASA janitor who was asked by the visiting U.S. President what he did there, to which he replied “I’m helping put a man on the moon.” The final principle is reward, recognition and harnessing a positive team culture. This comes in a multitude of forms, from beginning our weekly company call with a vision story from the previous week of how we helped an individual patient. It comes in the alignment of recognition of team members who stand apart and rewarding them in innovative ways beyond finance alone. It also comes in fun and silly ways of building a team. For example, last week our staff had a blast at a virtual cocktail party.

In your specific industry what methods have you found to be most effective in order to find and attract the right customers? Can you share any stories or examples?

As with so many things, COVID-19 really has made us all look at how we position, message and reach our customer base. Having a robust segmentation and targeting methodology is critical now more than ever. And you must review it regularly to ensure you’re attracting your targeted customer. During this disruptive time, we listen more than ever to understand our customers’ needs. We strive to be authentic and consistent with our messaging, and then utilize the right channel so they hear about us. An example would be understanding that, for our surgeon user base, Twitter is a key channel; so short, sharp impactful messaging with premium imagery has been particularly effective for us.

Based on your experience, can you share 3 or 4 strategies to give your customers the best possible user experience and customer service?

Due to the virus there has been an urgent need to incorporate integrated technologies into routine or complex practices. Everyone is looking for ways to seamlessly maximize healthcare resources, scale the delivery of expertise and reduce the transmission of the virus.

As I mentioned previously, in many ways, Proximie was built for a pandemic of this nature, although I have to confess that I never imagined that it would be used in this way. From enabling self-isolating clinicians to remotely support colleagues on the front line, to virtually connecting MDTs for hand trauma and cancer management, every clinician can connect and collaborate off site during COVID-19 by using Proximie. We are finding new ways to apply our technology to amplify the skills of frontline clinicians. It is secure, easily integrated and works at low bandwidth with existing or easy to resource hardware, which has meant we can — and have had to — be agile to meet the demands of this global imperative.

Over the last few weeks, Proximie has been used to ensure clinicians have access to remote expertise, in order to help address the overwhelming needs of patients suffering from COVID-19, and also those patients suffering from treatable non-COVID-19-related conditions. Our technology allows clinicians to demonstrate — in real time — the actions needed to be taken to ensure the best patient outcomes, and to do so without compromising the current effort to manage the pandemic. Using just a laptop or tablet with an in-built webcam, which can support video feeds from any medical device, Proximie can provide real-time redistribution of remote expertise.

As you likely know, this HBR article demonstrates that studies have shown that retaining customers can be far more lucrative than finding new ones. Do you use any specific initiatives to limit customer attrition or customer churn? Can you share some of your advice from your experience about how to limit customer churn?

Customer churn is the biggest thing we focus on in sales and marketing. We spend a lot of time addressing it with data updates daily and team data calls weekly. To be completely transparent, I’d rather spend the time in retaining the customers I have, rather than pursuing new customers. We do digital as well as more traditional ways of keeping in touch with our clients. And we try to make them part of the journey. As a result of all that time and effort, not to mention a great product, we have a low churn rate.

Here is the main question of our discussion. Based on your experience and success, what are the five most important things one should know in order to create a very successful tech company? Please share a story or an example for each.

I think success with a tech company all boils down to one thing: Know what you are trying to achieve and why you are doing so. This anchors you. In health technology it’s important to ensure you know who your customers are and what is important to them. At Proximie, our end users are surgeons. Being one myself, I know how high their expectations are, how unforgiving they can be on anything less than perfect in terms of both quality and the authenticity and consistency of your brand. We work hard to get this right. When you achieve this, you can remain authentic and consistent in how you communicate across all channels. Finally, be responsive, provide a way to address issues quickly as well as continually understanding and learning what customers want from your platform or solution.

Wonderful. We are nearly done. Here are the final “meaty” questions of our discussion. You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

My movement is to equalize health around the globe. If the pandemic has shown us anything, it’s that we’re all on this planet together, and what impacts one part of the world has a very good chance of impacting every other part. It’s the foundational philosophy of public health but taken to a global scale. As John F. Kennedy said, “A rising tide lifts all the boats.” That is, all of us benefit when global healthcare is improved.

We are very blessed that very prominent leaders read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂

I’d love to break bread with Dr. Atul Gawande, the bestselling author, MacArthur Fellow and surgeon. He’s also chairman of Lifebox, a nonprofit that works on reducing deaths in surgery globally. I admire how he looked at quality and standards of surgery from an entirely fresh perspective. A lot of his work inspired me, especially when he talked about surgical coaching and surgical mentoring. I think sitting down to eat with Dr. Gawande would be a pretty awesome meal!

Thank you so much for this. This was very inspirational, and we wish you only continued success!

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