Free money.
Fake valuations.
Fantasy startups.
Bill Gurley just rang the bell:
The party’s over.
Welcome back to capitalism.
Here’s the macro reset every founder, LP, and partner needs to hear.
And for those of you who run an independent medical practice this is essential knowledge.
A thread… 🧵
Fake valuations.
Fantasy startups.
Bill Gurley just rang the bell:
The party’s over.
Welcome back to capitalism.
Here’s the macro reset every founder, LP, and partner needs to hear.
And for those of you who run an independent medical practice this is essential knowledge.
A thread… 🧵
Between 2008 and 2021,
capital lost its mind.
Cheap money was everywhere.
The Fed flooded the system,
rates plummeted,
and venture firms raised faster than they could Google “due diligence.”
What followed?
Delusion.
Valuations broke from gravity.
Growth eclipsed margins.
Narratives outpaced actual numbers.
1/
capital lost its mind.
Cheap money was everywhere.
The Fed flooded the system,
rates plummeted,
and venture firms raised faster than they could Google “due diligence.”
What followed?
Delusion.
Valuations broke from gravity.
Growth eclipsed margins.
Narratives outpaced actual numbers.
1/
Startups stayed private too long.
Late-stage VCs stopped assessing risk and started crafting mythology.
Founders built oversized teams and called it “strategy.”
Burn wasn’t a problem, it was the pitch.
But public markets didn’t buy the story.
Then the music cut mid-song.
2/
Late-stage VCs stopped assessing risk and started crafting mythology.
Founders built oversized teams and called it “strategy.”
Burn wasn’t a problem, it was the pitch.
But public markets didn’t buy the story.
Then the music cut mid-song.
2/
Now?
We’re back to the old rules.
Rates are up.
Liquidity’s locked.
LPs are sidelined.
Exits? Scarce.
IPOs? Forget it.
3/
We’re back to the old rules.
Rates are up.
Liquidity’s locked.
LPs are sidelined.
Exits? Scarce.
IPOs? Forget it.
3/
Gurley said it plain:
“The private markets lost all discipline.”
We forgot the core equation:
More money in than out.
Margins are no longer optional.
Neither are real unit economics.
—-> independent medical practices must transition from lemonade stand partnerships to real companies.
STOP TAKING ALL THE MONEY OUT!
4/
“The private markets lost all discipline.”
We forgot the core equation:
More money in than out.
Margins are no longer optional.
Neither are real unit economics.
—-> independent medical practices must transition from lemonade stand partnerships to real companies.
STOP TAKING ALL THE MONEY OUT!
4/
Public markets don’t care about startup vibes.
They don’t care how many people you hired, or how clever your onboarding funnel is.
They care about outcomes.
Margins.
Retention.
Real cash.
You’re either priced like a business or not at all.
5/
They don’t care how many people you hired, or how clever your onboarding funnel is.
They care about outcomes.
Margins.
Retention.
Real cash.
You’re either priced like a business or not at all.
5/
Gurley sees echoes of the dot-com bust.
But don’t mistake him for a pessimist.
He’s not bearish.
He’s clear-eyed.
The best companies?
They’re forged in the wreckage.
Not at the party, after it.
6/
But don’t mistake him for a pessimist.
He’s not bearish.
He’s clear-eyed.
The best companies?
They’re forged in the wreckage.
Not at the party, after it.
6/
Today’s best founders?
Heads down.
No noise.
No hype.
Hiring lean.
Running tight.
Focused on metrics that matter.
Their investors, including YOUNG PHYSICIANS that you want to hire, aren’t asking about vision,
they’re grilling them on CAC, burn, payback, margin….
7/
Heads down.
No noise.
No hype.
Hiring lean.
Running tight.
Focused on metrics that matter.
Their investors, including YOUNG PHYSICIANS that you want to hire, aren’t asking about vision,
they’re grilling them on CAC, burn, payback, margin….
7/
Gurley’s warning is simple:
If you’re still clinging to 2021-era thinking, you’re already behind.
This is a new cycle.
Discipline is back in vogue.
Being cheap?
That’s leadership now.
8/
If you’re still clinging to 2021-era thinking, you’re already behind.
This is a new cycle.
Discipline is back in vogue.
Being cheap?
That’s leadership now.
8/
So yeah, welcome back.
This is capitalism.
No more tourists.
Only builders left.
9/
This is capitalism.
No more tourists.
Only builders left.
9/
🎧 Want the full breakdown?
Listen to all of Bill Gurley’s @bgurley
commentary:
For more sharp takes on healthcare startups and independent practice insights. Follow @dutchrojas.
-Rojas out
Stay sharp.
Stay building.podcasts.apple.com/us/podcast/inv…
Listen to all of Bill Gurley’s @bgurley
commentary:
For more sharp takes on healthcare startups and independent practice insights. Follow @dutchrojas.
-Rojas out
Stay sharp.
Stay building.podcasts.apple.com/us/podcast/inv…
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