Ten months ago, I joined an entrepreneurial venture with the mission of improving the French healthcare system. After months of hard work trying to turn around a challenged project, this promising startup ultimately closed its doors.
Nevertheless, this experience taught me a great deal, both in terms of business strategy and management during a period of crisis.
This article, based on my personal experience, highlights the challenges we faced, the strategic decisions we made, and the successes and failures we encountered in trying to compete in an ultra-competitive market dominated by France’s first unicorn.
Phase 1: The observation of a Strategic Duality At its inception, the company positioned itself as the creator of two distinct solutions, namely CityHealth and PublicHealth. The former is an online appointment booking and secure communication platform for private practice doctors. This product directly targeted a market dominated by industry leaders, such as Doctolib. The latter is a solution designed for public hospitals, aimed at improving post-hospital discharge processes and care coordination. Yet, despite these promising ambitions, both of these products presented a fundamental issue:
a “strategic gap”.
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While, CityHealth served private cabinets made up of just a few doctors, resembling a B2C model, PublicHealth targeted large public medical institutions, where decision-making cycles could take between 18 months and 2 years. Faced with this misalignment, we were forced to confront a pressing need: to rebuild the company’s overall strategy, reconcile the two products, and consolidate our vision. Our goal was to build a business model better suited to a startup, leveraging the strengths of a small company—such as the ability to pivot quickly and test iteratively—to compete effectively against larger competitors.
"In other words, fight with our weapons, not those of the giants." Phase 2: The Challenge of Strategic Consolidation The solution we pursued was to merge the two products into a single, cohesive, and synergistic offering, repositioning the company as an integrated platform primarily targeting hospitals. This new position not only permitted us to use hospitals as a channel to sell our product directly to the structure, but also to conquer the liberal market through patients leaving the hospital. Making it simple, using our platform, the hospital would be able to facilitate the exit of recovered patients and redirect them to the liberal system in the city as both were operating on the same system.
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Product Consolidation We integrated CityHealth as a low-cost extension of the core hospital-focused product. This cost-effective solution for private practitioners had also reduced hospital care coordination costs by streamlining transitions between outpatient care and hospitals.
Moreover, a key part of the process was building a clear and strong positioning for the company. To achieve this, we redefined the mission, vision, and values of the project with a simple guiding principle:
“ It is only by building a strong identity and a clear, differentiated position that we shall stand out.” This principle served as the foundation for our strategic decisions and inspired confidence among stakeholders. The strategic overhaul allowed us to present a clearer and more attractive proposition, with a single innovative product that addressed a growing need in the healthcare sector while offering potential savings of billions of euros to the public institutions.
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A New Product Strategy to Conquer the Liberal Market After consolidating the products and launching the hospital-focused projects, we turned our attention to the “post-hospital” market. The goal was to quickly penetrate this market, acquire users, and demonstrate the added value of our solution to hospitals.
Initial Problem: An Expensive and Inflexible Model
The original CityHealth offering consisted of two modules:
A free patient referral module. A paid medical agenda, priced in line with market standards, distributed via an on-the-ground sales team. This model, directly competing with giants like Doctolib and Cegedim, neither provided significant differenti