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“It’s important to know how to motivate your team” With Victor Bornstein

Training artificial intelligence to understand medical records, medical malpractice claims, and more specifically, identifying when a mistake has occurred. We’re currently using this to detect past mistakes, which is enabling us to bring much-needed transparency and efficiency to the medical malpractice space. And, long term, we will use this technology to detect likely future mistakes […]

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Training artificial intelligence to understand medical records, medical malpractice claims, and more specifically, identifying when a mistake has occurred. We’re currently using this to detect past mistakes, which is enabling us to bring much-needed transparency and efficiency to the medical malpractice space. And, long term, we will use this technology to detect likely future mistakes as we continue training the models. The reason this is so important for me is that by identifying moments of likely medical mistakes, we can also work to prevent them. Medical mistakes are the third leading cause of death in the U.S., and it’s also personal for me — my mother actually suffered a life-threatening medical mistake when I was 7 years old.

As a part of our series about cutting edge technological breakthroughs, I had the pleasure of interviewing Victor Bornstein, CEO and Co-founder of Justpoint, an artificial intelligence company making it possible for people to understand the merit of their medical malpractice claim and find the right experts for their case. Victor saw the opportunity to redesign this industry after experiencing it from both sides: as a child when his mother suffered a life-threatening medical mistake, and from the perspective of hospital systems. He has served as an Assistant Professor at Mount Sinai’s Icahn School of Medicine, an Entrepreneur-in-Residence at the Texas Medical Center Accelerator, and a Fellow at the healthcare venture capital firm Digitalis Ventures.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Of course. To be honest, entrepreneurship wasn’t a career path I was seriously considering for myself before 2014. Since I was a kid I loved to build and improve things, and because of an amazing Biology teacher in high school, I decided to focus this ‘building and improving’ mentality on molecular biology. But in 2014, during my PhD, I took a class about how to translate scientific findings into startup ideas with a venture capitalist and I realized that all the things I loved about scientific research were even more present when you build a startup: you are rewarded if you can see years ahead, the best teams are multidisciplinary, there’s a mix of strategy and execution, and you have the privilege of creating and testing hypotheses that can have a great impact if correct. The bonus was that unlike in molecular biology, in software you can very quickly test and iterate over ideas.

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

I moved to the U.S. in 2011 from Brazil and knew no one here. It’s not easy to launch a career in a new place when you don’t have a network. So to offset that, I quickly learned that if you write a very thoughtful cold email explaining why you want to meet that person, a lot of people reply to your message and are happy to connect, help, and give advice. Half of our Seed round investment came from investors I cold emailed, and that’s also how I met my co-founder and CTO (I reached out to more than 200 people until I found him. And — as a side note — some of those I reached out to who weren’t the right fit have now become good friends of mine!). Some of our first employees and advisors were also people I cold emailed. I’m now, unsurprisingly, a big advocate of the cold email. Some extra steps are required to ensure you get to know people thoroughly (when using for hiring or looking for advisors or other partners). But overall, it’s a tool that provides the significant advantage of expanding beyond your existing personal network and reaching the best people, not just the best people you know. In that regard, it can also be a catalyst for a more diverse team, by helping you expand beyond your known circles.

Can you tell us about the Cutting edge technological breakthroughs that you are working on? How do you think that will help people?

Training artificial intelligence to understand medical records, medical malpractice claims, and more specifically, identifying when a mistake has occurred. We’re currently using this to detect past mistakes, which is enabling us to bring much-needed transparency and efficiency to the medical malpractice space. And, long term, we will use this technology to detect likely future mistakes as we continue training the models. The reason this is so important for me is that by identifying moments of likely medical mistakes, we can also work to prevent them. Medical mistakes are the third leading cause of death in the U.S., and it’s also personal for me — my mother actually suffered a life-threatening medical mistake when I was 7 years old.

How do you think this might change the world?

Many countries have systems in place to take care of people who have had unfortunate events like medical mistakes happen to them. These events often lead to severe emotional and economic distress, so these support systems are critical. In the U.S., the medical malpractice system should fulfill this very important role, but the way it currently works, it isn’t fulfilling its promise to everyone. It might actually be one of the least respected industries in the U.S., as distrust exists on both sides: patients on one side, and doctors, hospitals, and insurers on the other. Our mission is to change this and make the system fulfill its promise by allowing the plaintiff side to bring valid claims to attorneys, even if perceived to be of low value, and for insurance companies (and the doctors they represent) to more effectively defend against claims without merit.

And of course, in the long term as we work to build a system that can proactively identify likely mistakes and stop them before they happen, we will be saving lives.

Keeping “Black Mirror” in mind can you see any potential drawbacks about this technology that people should think more deeply about?

I could see a Black Mirror episode in which all medical decisions are made by algorithms. If there is bias in those algorithms, that’s pretty scary. However, a more immediate concern I think people would imagine, is the risk that in making the medical malpractice industry more efficient, we would increase the rate at which doctors are sued overall, which could lead to unjust claims against medical professionals, increase malpractice insurance premiums for doctors, impact healthcare costs, and make the profession so risky as to be unappealing. But I want to clarify that our approach to making the medical malpractice industry more efficient is actually contrary to that: our platform helps attorneys on both sides to understand the merits of a case quicker, and we have already seen how it can actually decrease the incidence of frivolous cases.

Was there a “tipping point” that led you to this breakthrough? Can you tell us that story?

Algorithms that help doctors’ decision making are widely understood to be extremely necessary to mitigate the medical mistakes that are estimated to kill more than COVID-19 every single year. Our breakthrough insight was when we realized that the medical malpractice industry provides us with the ideal insights to train AI models to understand and identify medical mistakes. That was quickly followed by a second insight that the medical malpractice industry also contained so much space for optimization; as we build our AI platform we can create immediate benefits for plaintiffs and attorneys today, while working towards the end goal.

What do you need to lead this technology to widespread adoption?

Put simply, we need to get the word out. More specifically, reaching patients or their loved ones who are impacted at the time that matters, in the window when a medical malpractice case can be filed (before the statute of limitations kicks in).

What have you been doing to publicize this idea? Have you been using any innovative marketing strategies?

I know that not everyone is naturally curious about this space — until they are affected by it, and then it’s tough to think about anything else. One of the pillars of our company culture is transparency and this is also reflected in how we interact with patients and how we publicize our platform. Our main approach is to share the insights about trends we’re seeing with the broader public so we can help all sides understand how it currently operates, and the reason we need the medical malpractice system to change. For instance, within the next few weeks, we will make available our artificial intelligence algorithms that allow people to understand how long claims like theirs have taken in the past and how much they have received. This information will be accessible to everyone, at no cost, on our website.

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?

It’s difficult to choose only one person since the help of so many people got me where I am today. My mother has always been an inspiration for me through her selfless work towards a better healthcare system and society in Latin America; my wife has been helping me with Justpoint from day zero and is the ideal thought partner; a venture capitalist, Geoff Smith of Digitalis Ventures, who helped me with all of my first career steps in the U.S. as I was finishing my PhD, and Vivek Garipalli, co-founder of Clover Health, who replied to my cold email, was the first investor to believe in us, and helped us build Justpoint. And there might be over 50 others I haven’t mentioned. That’s why it’s so important for me to pay it forward and help others tackling tough challenges.

How have you used your success to bring goodness to the world?

I’ve focused on helping individuals, especially those from disadvantaged backgrounds. I know my success has been dependent on help I’ve received along the way, and I try to pay it forward by mentoring, making connections, and whatever I can do to help increase others’ likelihood of success. I see this as a way I can do my part to help those individuals, but also to improve the world by facilitating the development of ideas I’m inspired by.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

1. The importance of not listening to every piece of advice I hear. People always have the best intentions when taking the time to share advice, but they are typically extrapolating their experiences to yours without understanding or being aware of the idiosyncrasies of your situation, and then applying a pattern that worked for them in the past into a situation that could be different. This is especially true for early-stage startups. For example: Talking to investors, they often have an idea of what they think will work. If you just talk to one investor, you might be tempted to follow that advice. But if you increase your sample size and talk to 200 investors, like we have, you realize you’ll end up with 200 opinions that go in different directions. What can be tricky is identifying which of those opinions will increase your likelihood of success.

2. In the very beginning, it’s important to know how to motivate your team, especially when people tell you things won’t work. When you’re creating something new, it’s inevitable you’ll come across a few naysayers and even though you know why they are wrong, they might have more weight in the rest of the team than you realized. For example: someone told us it’s impossible to start an insurance company from scratch. That person had considered building a health insurer and chose not to because “it isn’t possible” and shortly after that, we connected with someone who had done just that, Vivek Garipalli, and he ended up as our lead investor.

3. The intensity of the rollercoaster. Going into this endeavor, I was very aware that creating a company from scratch is an emotional rollercoaster. I thought I was ready for it. But especially in the beginning, when you have nothing to show and most people don’t believe in you yet, you feel the highs and lows to an extreme I didn’t anticipate. I realized that knowing you’ll be on the rollercoaster versus actually going through it are very different things. An example: we didn’t have much time to bootstrap before exhausting our personal finances, so we gave ourselves a firm deadline of one year to get funding. We got our first check in the bank just a few weeks before that deadline — so you can imagine the lows, and then highs, surrounding that moment.

4. At what stage to focus on different types of investors. I spent a lot of time reaching out to venture capitalists in the earliest stages of our idea, when it was still being shaped. Now, I know that I should have spent more time talking to founders of companies I admire instead. Especially in the earliest stages, founders are not only more likely to write early-stage checks than other investors, but they also see the potential of your idea that might have to pivot very easily. If they worked on a company that is comparable in some way, they can also help you get there.

5. How to double down on the benefits of remote work and how to mitigate its challenges. From the inception of the company, we were a remote first company. We actually had never met our CTO in person before we signed all the agreements making him a co-founder. As everyone is saying now, remote work has amazing advantages but also some challenges. On the advantages: you can hire people regardless of their location, which broadens the talent pool and can lead to true diversity on the team, and remote work facilitates efficient execution of straightforward tasks. Nevertheless, creative output and communication have to be fostered in a much more intentional manner otherwise they will suffer. Now, we’ve developed a wide array of strategies and systems to solve these challenges. One example of these is forming trouble-shooting teams whose members are from different areas of the company — the perspectives of people with seemingly unrelated skills multiplies ideation and the number of high impact ideas on all sides of the company. The results have been so successful, we decided to become a Work From Anywhere company and I moved to Boulder, Colorado, which means doubling down on the benefits for me. 🙂

You are a person of great 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. 🙂

There are a couple of causes that are dear to me. One of them is fostering access to job opportunities and education in places with less access. I was born in Nicaragua and grew up in Brazil, and was exposed to very different environments: while I had the latest video games growing up, I also played in favelas and junkyards with kids whose parents were struggling financially. From my upbringing, it’s very clear to me that skills and creativity are evenly distributed, even if opportunity is not. With the increasing prevalence of remote work, particularly within the tech sector, there is no reason why more of these opportunities cannot extend beyond hubs like New York and San Francisco, and into communities within and outside of the U.S. that have traditionally had less access.

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

Agua mole, pedra dura, tanto bate, até que fura. It sounds better in Portuguese but translates to: water dripping day by day wears the hardest rock away. A lot of what you achieve in life is about grit. If you spend a tremendous amount of time thinking about a very specific issue and working on it, you’ll be ahead of most people; you’ll see possibilities that others don’t. I believe that philosophy has helped me in finding opportunities, and bringing non-obvious ideas to reality. There are, of course, challenges to this approach as well — by focusing on something so intently, you see things that others don’t, and so others might need more proof before they realize what you envisioned is possible. That makes it even more important to quickly translate theory into practice.

Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say? He or she might just see this if we tag them 🙂

Successful companies often get to make existing industries more efficient, but it’s not often that a company gets to redesign an entire system. Because of the complexity of analyzing medical malpractice claims, this became a system where both plaintiffs and doctors end up unhappy and most sides agree it needs to be redesigned. Currently, it might be easier for an insurer to settle a frivolous claim than to litigate it, but on the other hand, valid claims that are seen as ‘low value’ might never be given a chance because they might not cover the litigation costs of the plaintiff’s attorney. On top of that, when a patient selects an attorney, it’s often done based on which attorney is the best one at marketing in your town, not by the one that is necessarily the best lawyer. The first use case of our AI platform allows patients who suffered medical mistakes to understand the value of their claim in seconds instead of weeks and connects them with the best attorney based on the attorney’s legal, not marketing, skills. The more our AI platform learns, the more we will improve other processes in medical malpractice and beyond. Medical malpractice alone is a $30B dollar/year industry, so there’s a lot of opportunities for the startup that becomes the market-defining company in this space.

How can our readers follow you on social media?

You can follow me on LinkedIn, where I’m most active: Victor Bornstein, PhD. We also share our most meaningful updates on our website, justpoint.com.

Thank you so much for joining us. This was very inspirational.

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