What No One Tells Physicians Before They Start a Company
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You went into medicine to save lives. But somewhere between residency and the real world, you started wondering — is there more I could be doing?
That question is not a distraction. It might be your next diagnosis, and the biggest obstacle is knowing where to start.
In this episode, host Dr. Junaid Kalia sits down with Dr. Sara Rana, a physician-turned-venture capitalist and MD-MBA, who saw the gap between healthcare and finance firsthand and built her career bridging it. The conversation moves from her origin story into the practical frameworks, honest realities, and hard-earned wisdom any physician can act on today.
"Make your own terms. Chart your own path."
- Sara Rana, MD, MBA
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What You’ll Discover
[00:00] Intro: Dr. Sara’s Origin Story
[02:48] Why Physicians Must Speak Business
[04:52] Charting Her Own Path as Venture Capitalist
[08:46] Inflation, AI & the Forces Reshaping Financial Future
[10:45] Does Race & Gender Matter?
[12:58] 4 Entry Points to Entrepreneurship
[15:37] The Advice That Reframes the Struggle
[17:23] Does Geography Make or Break You?
The same disruption reshaping healthcare through AI is exactly why physicians can no longer afford to only speak medicine. This conversation is where that journey begins.
Transcript
Junaid Kalia, MD:
Good morning everyone. And I am so excited today. My good friend Sara Rana, who's a physician who turned into essentially a venture capitalist. And I'm so happy that she's helping me. Just full disclosure, she is an advisor to me.
She's helping me grow my company. But all in all, I just want to bring her journey to you. It's a fascinating journey because how she actually did a complete, MD degree and then moved her skills into a completely new field, which I know it's so hard to do, and then not only did that constantly consistently outperforms and breaks the glass ceiling.
And just to be honest, and fair, it is very hard for women. It's extremely hard for women. And that's why, I mean, you have seen me talk to my sister who's a psychiatrist who's broken some of the glass ceilings. She is actually my sister from another mother.
And I just wanted to highlight her that how, what her journey is, what has been, and how other physicians can follow her journey. Even full time or part time. She chose to be full time. I'm still part time technically. But more importantly, you can actually learn from her, her journey, her struggles and how she is coping still.
Again, the struggle never ends in the entrepreneurship world. And the idea is that we learn from our journey and how we can actually honestly help her as well. Because it is important that entrepreneurship is a community and especially in Dallas, Texas, we want to work as an ecosystem of, entrepreneurship. So Dr. Rana, extremely grateful that you took time. So introduce yourself. From the very beginning, like how were you actually first, started to be a physician.
Then what happened? What clicked in your mind and then said that okay, I need to do entrepreneurship and then go through your entrepreneurship journey.
Sara Rana, MD, MBA:
Thank you so much, Junaid, for having me here.
He is an incredible entrepreneur who wears many hats, does credible work, is working so hard, and I'm really proud to be a part of his journey and watch him as he grows and flourishes. I think the medical journey is something a lot of us, theses have been a part of.
I, think, you know, my family, everyone is a physician or somehow tangentially related to medicine. So growing up, that was kind of the only path I knew but what I found really exciting was my family all took, you know, medicine and made it entrepreneurial for them.
So I found that journey to be really fascinating because you get to, you know, make your own terms, chart your own path, but also use your skills along the way.
And while I went through medical school, this was during COVID it was quite isolating one too. I saw a huge shift and we still see it to this day where private equity systems, hospital systems take over small clinics or private practices or anything really independent nowadays.
And I found that to be really interesting because a lot of the people who are on the private equity side or hospital side have no idea what medicine is about. On the same end.
Physicians don't really know how to run a business financially. So it's a really big problem without people who know both sides. And so I graduated from medical school and realized, you know, why don't I join that private equity roll up side and see what that's about and see how finance people make decisions in health care.
So I joined Texas Health Resources on the And A side, rolling up clinics, imaging centers, surgery centers to PE firms. The first day I came in, there was a, a sheet, a kind of cheat sheet we were given. So we would rank physicians according to how many patients they would see a day, not the quality of outcomes,
It was solely based on how many they see a day, volume based. And that was crazy for me to see because as you know, in the medical journey you're always, you know, following the Hippocratic oath about always putting the patient first, very altruistic.
However, that is not the case in the finance, you know, lens. And so I would challenge these kinds of KPIs and objectives in these companies. I would give the perspective of the physician and even just my dad himself, you know, he's an oncologist and he spends minimum at least one to two hours per patient just telling about their diagnosis, what the process is like.
And he's had been able to retain patients for at least 15 plus years because of that and so I think, that's really where I found a lot of excitement in being able to change this status quo and advocate for physicians with my understanding.
And so it was a great journey. And I realized, you know, why don't I join the venture capital side where we're able to take money, invest in these founders, help them incubate and grow and scale and hopefully see returns from that. So I'm the head of all early stage investments. And we're pretty industry agnostic, sector agnostic. You know, we really like companies with some good traction, not a crazy valuation yet, and we can come in and grow them and get them to a great exit or liquidity situation.
And so, you know, I think what was really great about this fund is how much we care about our LPs or investors.
And you know what's really sad is we may seem like the bad guys but we're not. We're just actually fighting for RLP is because they care about their money. I mean that we give back that could pay for their kids college tuition, that can pay for, you know, whatever savings are trying to figure out.
And so it takes a great responsibility when you manage people's money, you know.. And so yeah, you know, we're headquartered out in New York City. Most of the partners are there.
I cover the west coast to Texas, so I'm between San Francisco, Louisiana and Dallas.And something I Started too, is called the Technology Opportunity Fund.
I started this, micro fund into legendary ventures, which allows people to write, you know, like $100,000 plus checks and still get access to our great portfolio of companies and our fund and see some money plus more in a couple years.
And so that's something I start on the side. And that's been good to see grow.
And there's not a lot of people that look like me, both woman wise and culturally. I think in our culture especially. And what I'm really passionate about is educating our community on investing diversified portfolio risks and strategies and then just understanding venture investing, how that works, fundraising for a fund, what that looks like.
There's so many amazing, smart, talented people we know, but there is not education on this. And to be honest, I didn't even know what VC or PE stood for. Like, seven years ago, I thought it was just, you know, like pulmonary embolism.
You know, like, I didn't know, cardia. Like, I. I don't. What is that? And it wasn't until I went through my MBA and I got like, full exposure to the field and did some internships where I was like, wow, like, this is really exciting.
But I mean, you know, I think also just the immigrant mindset of finding stable jobs, you know, whether that's be a doctor or a lawyer, an engineer is still present to this day. But I think now that we have next generations coming along, we should be more diversified in what we go into and be leaders in different spaces and be united to help each other.
Junaid Kalia, MD, MBA:
By the way. Dr. Rana Asara, you are right. So what I'm saying is that we see that going through, we got these emails all the time and all of that. So long story short, a lot of physicians do come in and then her fund, exactly at that 100k mark, perfectionizes.
Sara Rana, MD, MBA:
I think our healthcare costs are going to go up. So I think with all these things, it's important to hone in on what skills you're really great at and make sure those go well.
I think in terms of investing, just have to be smart about how much risk you want to take.
You know, you don't want to just be, you know, misinformed or not understand what you're investing in. That's also a problem. And so, you know, I tell people you should do a little bit of ventures, you should do a little bit of S P500, you should do a little bit of, you know, direct companies really appreciate, but you know, make sure to have that diversified portfolio.
Totally agree. Just a little bit. I know the numbers that are shown on a public ledger that the inflation is going down. It is going to be really odd situation because oil prices are going to go high.
Junaid Kalia, MD:
Gold is high. So if you really look at the if you really look at the metric as gold, technically everything is going to go inflationary. So is oil right now. The other problem is that people like me with AI, which are breeding technology and saying that, you know, you can fire 30 virtual MAS, which is globally by the way, people, virtual mas are you need in person here in US and now you have what we call a deflationary cycle when technology is coming in because I decrease the cost of doing business when I'm using AI.
Strange. All these forces come together and just being honest, I mean, I can uptrend myself for neurology. I can up train myself with AI, but then I cannot up train myself with finance. And that's where Sara and her team comes in. They look at the whole gamut of things from seven years, how the world is going to look, how inflation is going to be, how other companies are going, what the competitive analysis is.
All of that comes into her play. And that's exactly what she asked me like when she was doing due diligence to me, hey, what about this company? What are you going to do about that? That's the quality of effort that she herself put in as a person.
Now, now I'm going to switch over to just, journey of yours as a person.
And so I'm going to tell a story, which is a very rare story by the way. Doesn't happen a lot. But I was a neurointensivist, neuro critical care fellow. We saw a patient and then, I went there and he said, I don't want you, I want another doctor.
Did I, did I offend him so much? So I walked out and I like got busy. So my nurse practitioner, who's actually from South India, amazing chap girl. I mean she was like, she's better than me. She went in there and she said, I don't want you, I want another person.
So I caught my chin, you know, Dr. Iagari. And then he came in and saw the patient. He's actually the chairman of Neuro Intensives. He said, I don't want you 100. So he, of course being the chairman, said, what do you mean by that? I'm the chairman, you don't want to see me.
He said, I want a white doctor. So I. Has it happened to you? Do you feel like sometimes race has been an issue?
You know, I don't.
I'm just out of all my years, 30 years of like training and everything here, 20 years never happened to me.
Very extremely rare case. I'm just going to be honest with you. Has this. But still it happened. But what I want to ask is that being a woman, that's hard. Then on top of that, woman of color, that's harder. Yeah. Has, has this been a challenge for you?
Sara Rana, MD, MBA:
You know, I think finance is really interesting. I think if you, it doesn't matter what you look like, if you can produce results and perform, then people will just do what you want to do, and accept you for who you are as long as you produce results.
I think, you know, I don't know if I felt it more as a woman. I mean, sometimes I've. I've seen where it's been a problem, you know, being a woman of color. But I think given that a lot of venture capital is really dense on the coast, there's not as much, you know, issues there as I think in Texas.
I think sometimes in Texas, people don't really know what to do. People look like us. I've had that experience in the medical side as well, but it's growing and I think, is it. There's barriers. There are barriers you have to break. But once you do, people realize we're all the same.
Junaid Kalia, MD:
So now I want to ask you, a friend of mine, just graduated from cardiology fellowship. Okay. Barely has money, actually has a little debt. That's how that's not abnormal when you physicians come out generally.
So if they want to start an entrepreneurship journey, what is, how would you do it in this day and age when you have very odd options like consultancies, investment plus advisors plus, you know, sales.
Go ahead. You know, I think there are a lot of different ways to do it. I started as an angel investor.
I think too, you know, if on the VC side, if people want to join, there are scouts programs. We also have one too. And they're basically like advisors. So if you bring an LP or you bring a startup and we end up closing it, you get a percent commission off that.
I think three, the consultant advisor route is great too. It's good to be able to join a startup because startups you have to wear every single hat, understand every single process, know what a board of advisors and governance looks like, know what a CEO does to the intern level.
And then I think for you know, doing your own journey and charting your own path is very scary. As you said, it should take planning. You should be at a point where you're financially stable or have some side to side income to be able to, you know, support yourself for a while. I think there's a lot of blessings that come with having to go on that journey of struggle because you, you understand how to put your time and resources into things that'll make you successful.
So I think it is important to plan that. Those are the kind of four, four ways I would think about it. I think that's my favorite song. I forget the lyrics perfectly. But prayers to the broken road that led me to the led me to you.
Junaid Kalia, MD:
So start startup journey is literally broken roads but eventually you get to the and then you understand how important those broken roads were because you become a from a coal to a diamond. You know how to do marketing, how to do fundraising, how to do sales cycle, how to do you know, product development and how to hire fire people, how to even deal with advisors, how to deal with a lot of nos.
I mean there are 100 no's, but one yes, one yes. So, so important that journey of broken roads is actually makes you so valuable that then VCs actually find you and then pay you because then you actually have the right again.
Anything other advice that you think we should actually give people, and then go from there.
Sara Rana, MD, MBA:
Okay. You know, I think one piece of advice I would give people is I think it's a very sexy, exciting journey like entrepreneurship, but people don't realize how hard it is.
So to actually do the due diligence and understand what that journey is before getting into it, I think that's really important. I think number two, people tend to forget around 95% of startups fail. Right. So being part of that 5% is really hard.
So, you know, making sure to understand what are the qualities and skills you need to be in that top 5%. And I think the number one skill I see in founders that I love are people who are quite coachable, who understand or willing to accept feedback, like Junaid.
I just want to make sure that you just don't need to be coachable. You have to be agile.
Because in medicine we learn see one, do one, teach one. That's exactly the start of my mindset. You cannot sit there and ask 15 people and then have a decision paralysis. You're done. Sorry, go ahead. No, he's right. And so I think that that's a really important piece and educating yourself and what you're getting into and realize that, you know, VCs are not bad people.
And honesty is so important. I think a lot of people try to make up and FOMO and don't want to tell us what's going on, but if you just told us, like, hey, this is where I'm at. This is where I'm struggling. This is where I need help, we are more than willing to understand and help that, you know. And I always say we're investing more in the people than the company because companies pivot, they change a lot along the way, but it's all about the relationship.
Junaid Kalia, MD:
You know, just like dating before marriage. Right? Like, we're going to get through the good, bad and ugly together. So true. Now, people have told me that, Junaid, if you were in San Francisco, Cisco rather than Dallas, you would kill it.
Now, I mean, how important is location for entrepreneurship?
Sara Rana, MD, MBA:
You know, I agree with that, Junaid. I, I mean, I think even, you know, my partners even pushed me out to San Francisco because they said, you are a number one draft pick and you are not growing and flourishing the way you would on San Francisco.
And that's true. I think here. Texas is an emerging market. It's also the volume, right?
So when you go to an event or people, you see different people each time. It's like water here. It's like the same people, the same people, the same people. Every event, every situation. Because the venture community is not big here. Startups have great ideas, but they are not able to get money because there are no funds here and no infrastructure for people to grow.
However, this place is great for finding enterprise deals, locking them down. Sales, great. But I think in terms of fundraising money and growing and scaling, yes, the coasts are better.
What I'm saying is that if fundraising is your primary concern I think you have to be either coast. If data is your primary concern then you have to be in Boston or Stanford because they can actually have access to data, medical data which is hard.
And then lastly, yes, if if you're too new you need advice, you need consultancies, you need just other founders around you. Yeah, you have to be in the Bay area. You know, kind of like entrepreneurship, the long term journey game. We'll win here. It's just going to take some time.
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Dr. Junaid Kalia, Neurocritical Care Specialist & Founder of Savelife.AI™