Founder Feature: Harsimarbir (Harsh) Singh | Pristyn Care
Changing the healthcare landscape across India.
At Hummingbird, we're fortunate to have been partners with Harsh and team since 2019, when we co-led their $12M raise. Since then, we've had the opportunity and conviction to continue investing into every financing round that has followed. It's been a pleasure to see the company scale from 250 hospitals and 14 cities in 2019, to over 1,000 hospitals and 50 cities at present. We remain grateful for the team's support and are excited to deepen our relationship further.
Ingredients for Success:
Hire for quality, not quantity. One of the regrettable mistakes from Harsh’s prior entrepreneurial endeavours was that he hired for larger teams that accepted lower salaries. This was, in hindsight, an expensive mistake. Harsh is laser-focused on not repeating the error; in fact, until Pristyn Care had crossed 1,100 employees, he would speak with each new hire directly.
Obsess over every user touchpoint. Customer experience is a moat. Before tech was incorporated into the workflow, Harsh would handle each patient interaction directly; he’d call users to make sure their admission was smooth, their pick up was on time, and that the hospitals were clean. It’s this kind of paranoia and dedication that leads to Pristyn’s standardised, high-quality patient experience.
Culture of merit and accountability. Culture is the life blood of any organisation; it drives how a person acts when the founder isn’t in the room. At Pristyn Care, Harsh and his team have inculcated a culture that sits at the intersection of radical transparency, accountability, and meritocracy. If there’s a blip in the patient experience, everyone hears about it and learns from it. If remarkable work is performed – for example, an employee donating blood or driving a patient to a hospital – it’s rewarded and communicated to everyone.
Survivorship bias, a phenomenon that’s always around us, but rarely do we stop to understand its consequences. From the songs we hear on the radio, to the movie stars on the screen - and, in context of this newsletter – the founders we celebrate when funding rounds are announced. What we don’t see, however, are the countless musicians, actors, and entrepreneurs that gave it their very best, but never saw their work product reach levels of critical mass.
Within this subset of those that try but don’t succeed, there lies a group that exemplifies perseverance, grit, and simply never taking ‘no’ for an answer. In today’s story, I share the journey of Harsimarbir (Harsh) Singh, a founder that failed three times over the course of 10 years – certainly a member of this gritty subset - before he struck gold with Pristyn Care.
The Entrepreneurial Itch
“I wanted to do anything but start up again”, was Harsh’s unsurprising response to my question about what it felt like post shutting down his third company. In 2010, it was an electricity theft detection business, followed by a ‘Groupon’-like app for restaurants, and finally, a quick commerce hyperlocal delivery service in 2015. Years of toil and company building, but no material scale. “I was exhausted. I decided to take my learnings and apply it to an exciting early-stage company. The startup – as luck may have it – was Urban Company. Having been there since their pre-revenue days, I had the chance to see a lot and experience what greatness looks like. There’s always noise in failure; it’s the success that gives you clarity. So, after the stint at UC, it was clear to me that I had to become an entrepreneur again – I had a feeling that the next time things would just work out.”
With the entrepreneurial itch alive and well, it was now up to Harsh to decide which direction to dedicate his efforts to. “As is the natural progression for any doctor, two of my friends, Vaibhav Kapoor and Garima Sawhney, were speaking about starting their own clinic. During our late-night chats, we realised that there was a natural chemistry and fit in our working style. The initial plan was vastly different from what Pristyn looks like today; I wasn’t an expert in healthcare by any means, but my role was to bring patients into the clinic, while Vaibhav and Garima would perform the surgeries. It’s humbling to see what we’ve built today compared to our early plans, but sometimes all you have to do as a founder is simply start.”
Very quickly, as the clinic built its audience, the magnitude of the founder’s vision ballooned too. Focus slowly shifted from running a streamlined clinic, to asking the question: how can we build a platform that standardised healthcare for all Indians?
As the team mapped out what Pristyn was going to be built around, it wasn’t the brainstorming sessions or chats with patients that gave them the extra clarity, it was feeling the pain point of the patient experience itself. “Around the time we were starting Pristyn Care, my mom was undergoing surgery. I felt the pain and ambiguity given with the quantum of decisions that had to be made: which hospital to choose, how does one undergo claim processing, how does a patient know that they are paying a fair price? I had goosebumps while driving to the surgery centre.” It's feeling the pain point that leads to a strong ‘why’ for founders. That extra push that keeps entrepreneurs going if things get tough; the fuel that keeps the fire burning.
Live & Learn
The term ‘battle scars’ is used frequently in the world of entrepreneurship, and rightfully so. Repeat founders – especially ones that have stared in the face of failure – bring with them fundamental learnings from their past. Before we shifted the conversation to the core of Pristyn’s offering, I was keen to learn more about Harsh’s learnings from his prior ventures. “In general, there were three main lessons that I wanted to incorporate into building Pristyn Care. First, I knew that I had to hire an excellent early team with no compromises. In my previous roles, I optimised for more hires at lower salaries. I got this completely wrong; the result was a team that didn’t take the initiative we needed. Second, it was critical for us to have our revenue model in place from Day 1. Ever since we launched the business, we’ve had the patient pay for our services; we’ve always been honed in on unit economics. And third, we didn’t want to raise capital to launch the business. If Pristyn Care failed, so be it, I’d be bankrupt for the 4th time in my life. I learnt that by using our own money to scale, we’d have an unmatched drive to succeed; this motivated us beyond belief.”
One of the leading factors that I’ve seen drive company success is the founders’ focus on hiring. As ambitious and self-confident a person can be with their own abilities, a multi-billion-dollar business is built on the back of a team. It was clear to me that Harsh and his team not only had a hiring thesis, but they implemented this thesis ruthlessly.
“When it came to bringing people on board, aside from the obvious traits like intelligence and attitude, we looked for two things: a sharp learning rate and first-principled thinkers with no baggage on how to run a healthcare business. Case in point: one of our early hires came from a shared transportation startup. I simply asked him to take 3 hours to come back with a plan on how to build an orthopaedics business at Pristyn Care. He ended up calling over 5 orthopaedic professionals, spoke to his family members that had knee surgeries, and had meetings with doctors at a nearby hospital. His response wasn’t completely correct, but that wasn’t important – it was the quality of the thinking and ability to form a view in such a short time frame. These are the kinds of people we want – resourceful, quick to pick things up, and deliver with urgency.”
Scaling the Customer Experience
As technology investors, we celebrate the scale and impact of early-stage companies that positively change the lives of its users. But, especially in the context of a developing country like India, several of these success stories are not simply driven by technology altogether. There is often a large operational aspect to the businesses; processes and people that are required to be aligned with delivering a high-quality experience. This remains the case for Pristyn, too – and for them, the stakes are even higher, given it’s a patient’s life at stake.
After visiting Harsh at his office, what struck me was the sheer number of people that collaborated to make sure every process was executed to the tee. My curiosity was piqued. “It’s very hard to do what we do at scale. There are over 20 different touchpoints. The first step is to acknowledge that our patient experience is the only thing that makes or breaks the business. It goes back to our culture – we make sure that everything is known and transparent. If a patient is delayed by 30 minutes and I get an email, it’s likely that every employee at Pristyn will know about this delay; we want to promote accountability. Second, every touchpoint is tracked. If not by technology, then by a customer service rep. Before we built tech into our workflow, I used to call the patients several times to make sure that they are being taken care of; did the doctors examine them correctly? Did the patient struggle with admission? Were the rooms safe and clean? The questions I asked eventually became a song in my head, given how often I’d make these calls! And lastly, we conduct a 3-week training program for all doctors that work with us. Not on the surgeries – as they are veterans in this facet – but on ensuring a standardised patient experience. Every patient journey is consistent, from Bhopal to Bombay.”
What’s exciting about being able to share Harsh’s story is the fact that he’s done what so few founders in India have been able to do: not only raise capital from marquee investors, but also become a $1.4 billion dollar business in less than 4 years.
As with most of my features, I’m always curious to hear about how founders approach raising capital. There’s no doubt that fundraising is a skill, and that Harsh is a master of this domain. “First – going back to the learnings from my previous experiences – it was critical for us to showcase a positive unit economics business from Day 1. Second, I’ve been maniacal about always showing growth; you can ask my team! I am obsessed with presenting a table that highlights at least 30% monthly growth of Pristyn. And lastly, we never reached out directly to VCs; it was always via a founder introduction. That always leads to a much smoother conversation at the initial stages. Of course, today, every investor is an inbound, and that’s a product of how far we’ve come as a company.”
Harsh has a point – but “far” is an understatement. Since launching in 2018, Harsh and his team’s execution abilities have paid off. The ‘startup’ works with 1K+ hospitals and over 400 surgeons across 40 cities. Most impressively, the business conducts over 100K surgeries on an annual basis.
As we concluded the call, it dawned on me that Harsh’s passion and intensity resembled not just one of a driven entrepreneur. He strikes me as someone who has seen the dark side of the profession – where success slips from you quickly, as competitors gnaw at the market share of the leader.
“It’s always difficult for me to say that we’re successful and have ‘arrived’. The truth is, every one of our team members remains hungry to win and do more. We have a long way to go and are just getting started.”