April Koh

Why Mental Health Scales So Poorly for Venture Capitalists. I’ve been watching a pattern repeat itself in mental health startups, and I think we need to talk about it. Private equity and VC-backed mental health companies promise clinicians the moon: ✔️ Better rates from insurers ✔️ Admin support for clinicians ✔️ Flexible hours ✔️ More access for clients ✔️ Scalable growth for investors ✔ More benefits But here’s what I’ve seen actually happens: 💸 Investors want passive income and high returns. 💵 The juice is not worth the squeeze, or at least not sufficient when negotiating with insurance companies 💼 Clinicians do all the actual work but are treated like widgets. 💥 The math doesn’t math. Negotiating better insurance rates may move the needle slightly, but it will never be enough to create the margins investors demand. (Look at investor response to United Health Care increasing payouts. They sued.) So when reality falls short of the pitch deck, leadership must go to the only place left to cut: the clinicians. Benefits shrink. Caseloads grow. Pay structures shift. Promises dissolve. Morale tanks. We have all seen it, repeatedly. It is a form of investor-class social loafing. Those contributing only capital yet expect the bulk of returns, while those delivering the service (therapists) get squeezed. In our mission-driven industry, this just doesn’t work. MH care isn’t infinitely scalable without drastically lowering quality. We're not McDonald's. (VC: "Maybe we can do it with bots or offshore clinicians?") I believe practices thrive when: — Local clinicians are valued as the CORE of the business — Leadership grows from within — Scaling is slow and intentional, not extractive — Profit is earned ethically, not wrung from burned-out providers That’s the model I’ve built my practice on, and I’m more convinced than ever it’s the best way to ethically scale. If you’ve seen this play out either as a clinician, practice owner, or client, I’d love to hear your take. #mentalhealth #privatepractice #healthcareleadership #psychologist #ethicalbusiness #practiceowner #burnout #mentalhealthstartups #investorrealism #integrity

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🎉 NYC's Citywide Doula Initiative is delivering incredible results! These numbers tell a powerful story about what happens when communities prioritize accessible doula support. 💜 NYC's strategic approach: Targeting 33 underserved neighborhoods and training residents to become doulas for their own communities, created exactly the kind of culturally connected care that transforms outcomes. 🧐 What makes this even more exciting?  Their geographic model proves what we see every day at Pacify: when families have access to matched doula support, incredible things happen. As we continue to expand our partnerships with Medicaid, WIC, and healthcare organizations across the country, Pacify is committed to matching expectant parents with doulas wherever they are, whether they need virtual lactation support or in-person birth guidance in their communities. Here's to communities making doula care more accessible in areas that need it most! 🙌 #MaternalHealth #DoulaCare

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The next frontier in Health Tech leadership isn’t resilience..... It’s regeneration. Most founders and execs I meet in Health Tech are brilliant at building systems that scale. But when it comes to their own system: Their body, mind, and relationships.... They’re often running on borrowed bandwidth. Investor calls. Product deadlines. Clinical partnerships. There’s always one more fire to put out. And yet… No matter how good your product or funding round is.... If the human system behind it is depleted, the whole machine eventually topples over. For years we’ve told ourselves the answer was resilience: Bounce back, push through, optimise harder. But resilience is STILL built on stress. And it keeps you surviving inside the same system that’s burning you out. What I see emerging with my clients.... (The ones building the future of healthcare and tech) Is a shift toward something deeper: Regeneration. Regeneration means designing leadership, culture, and growth in a way that restores energy instead of draining it. It looks like: -> Founders who build recovery rhythms into their week, not guilt. -> Teams structured around clarity and capacity, not chaos and heroics. -> Cultures that prize reflection and co-regulation as much as innovation. -> Leaders who model calm as a performance enhancer, not a weakness. Regenerative systems don’t just protect humans... They actually make better decisions, create better tech, and build companies that last. Because when your nervous system is regulated, your strategy, empathy, and creativity all come back online. That’s the kind of sustainability the industry rarely talks about.... But it’s the one that matters most. If you’re leading in Health Tech and wondering how to make you & your company more regenerative - not just resilient.... That’s the work I love. Helping leaders restore their system so their vision can thrive long term. 👉 DM me if you want to explore what that could look like in your world.

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As much as I love ChatGPT, it has real limitations in mental health contexts, especially when used as a therapeutic tool. It (and other LLMs) lack clinical grounding and safety constraints. Jimini Health just released a thoughtful framework for patient-facing AI: The New Hippocratic Code, a set of safety principles for LLM-native mental health tools. If you're building or investing in this space, it's worth a read: https://lnkd.in/d_AaQenK

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I often get asked by clinicians just what exactly are HealthTech startups looking for. So we did a review of this year's clinical engagement work and combed through over 100+ clinician placements we made. And here are the three most common profiles we get asked for. __________________________________ 1. Clinicians in leadership roles (by specialty) By far our most requested. These are the decision makers in their departments. Senior consultants in their specialty (oncology, GP partners, respiratory etc) who understands how care is delivered. The type of work ranges widely from: - Organizing clinical studies - Giving product feedback - Clinical pathway modelling. This cohort adds significant value upfront and often changes a companies trajectory drastically. __________________________________ 2. Clinicians with procurement and commissioning experience. These are often the ones that have managerial positions. So clinical head of ICBs or committee members that have experience actually setting up a new service and onboarding a new product. We find that these folks are rarer than the above, but highly sought after. Mainly because they: - Tell companies directly how products are integrated. - Identify barriers to set up and adoption. - Can help startups understand how budgets are formed. __________________________________ 3. Clinicians outside the UK (with market experience) The third category actually surprised us. We have been working with a quite a few startups and investors to find the right clinical profiles, mainly to help them get a better handle of how well their products will fit into a foreign market. We often find those who have an understanding of both the UK NHS system and a foreign healthcare system to be particularly valuable. And I guess that makes sense as companies do eventually have to grow outside the UK! ____________________________________ But really what this entire exercise have shown us is that the most attractive quality and experience you can gain (that startups want) can often only be built WITHIN healthcare. The work you do within your health system is something difficult to obtain outside of healthcare and has tremendous value when repackaged in a different light. If you are a clinician looking to make an impact in industry, don't underestimate the value of your clinical training and experience! I hope this piece helps you understand what startups are looking for! P.S. Does our experience reflect yours? Dr Avi Mehra | Dr. Abeyna Jones | Ruby Gadelrab Tudor | Dr. Azeem Alam BEM | Dr Jihad Malasi | Dr Faris Al-Ramadani | Dr Nikita Kanani MBE |

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i was recently asked by a reporter how you can tell whether a company is serious about whether their AI actually works or whether they are just doing it for marketing/PR. i think that is a great question that gets at the heart of a lot of skepticism in the field when it comes to healthcare & AI i think one important factor is how companies act rather than how they speak. recently, the FDA Digital Health Advisory Committee met to discuss AI in mental health with the goal of determining how this should be regulated and eventually used. i wanted to congratulate those individuals and organizations that engaged in that process and are truly invested in helping America succeed with AI in mental health, not just posting about it on linkedin or sales decks. check out the detailed commentary from American Psychological Association Spring Health Headspace Big Health Talkspace Otsuka Precision Health (OPH) and others here: https://lnkd.in/eJdFGPjA those groups may not all agree (that is the point!) but it is great to see that depth of thought and engagement behind the scenes from companies that are genuine in their commitment to AI and mental health

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