This Q&A session was conducted with undergraduate students at Brown University to answer questions about the development of pMD and building a successful bootstrapped startup.

‍It wasn't long ago that I was wondering what I was going to do when I graduated from school. Despite the fact that I had family background in the medical industry, I knew that I didn't want to get into it. That was the thing that I really didn't want to do. So I started my career at a consulting firm where I was able to be very analytical and problem-solve. I had the sense that I was really making a difference. But through the illness of my mother, I got thrown into the medical industry, and that was the area where I could help the most. I realized that of all of the great things I was doing in the general business area at the time, that wasn't going to solve the problems that were in play when my mother was in the hospital. That's how I got involved with pMD.

‍Student: What advice would you give to college students who want to start their own companies?

‍You should start it now. And I don't mean that in a “quit your university” way. I mean that you should keep your eyes and ears open about things that you could be doing. Engage your brain so it’s constantly thinking and looking at problems and how to resolve them. If you see something that looks interesting, start coding it. Code at night, code on the weekends. If you find the right thing, you'll find that it's not a job, it's a passion, a hobby. If you find a good idea, that idea is the seed of a company. Don't make the mistake of waiting for sometime in the future to start your life.

If you take that first step, the other steps will fall into place. And when you bootstrap it, when you're trying it on your own or with a friend, you don't have to worry about a lot of the things that people sometimes make the mistake of doing, like funding or waiting for everything to align. They end up waiting their whole life and never getting there.

‍Student: How do you know what feedback to listen to and what feedback to ignore from customers?

‍First, you have to know where you're going. I drill this into people I work with all the time. If you don't know very clearly where you're trying to go, you will never get there. You will walk around in circles and you'll walk the distance but it won't be where you want to go. You have to be very clear with yourself about the goals you want to accomplish. One of the things you’ll be forced to do as an entrepreneur is to limit what you're trying to do. You could do all 10 things or you could do one thing really well. And if you decide what that one thing is, then you have 10 times the resources to put toward it.

Secondly, we were very fortunate because we were a bootstrapped organization and I had majority control of the company. So we did a lot of pivoting early on. You try something and it doesn't work, you pivot, pivot, pivot. Have autonomy to make the right decisions so you know where you want to go and you have the ability to tweak it. You’ll have white noise from the customers. Some customers will ask for things that are great, and you know right away you'd love to do that if you had a staff of a thousand developers. And then other things just shine, little nuggets of goodness that are brilliant. And it's because you know where you're going that you know how to filter the noise down to the right things. It’s clear vision and control.

‍Student: Were there inflection points in starting pMD that have changed the way that you look at your life or change the way you run your company?

‍I came from a consulting firm where there was a lot of focus around balance, so I knew that it was important to be a balanced person. So I worked around the clock nonstop. And there was a point, and it was around my mother's death, and that my entire world was my company. And the death of a parent is going to shock anybody, but especially if you don't have balance. It's like balancing on a pole. Your life needs to be more like a stool, with three foundations that you can draw energy from. Recognizing the need for balance is a tough lesson that some people never learn.

The other thing was understanding the true value of people, of coworkers. What it all boils down to, what makes a company successful, is the people that you build into the company. You'll spend more time with your coworkers than you will with your family. And if you're building a team of intolerable people, you'll find that you'll have a pretty miserable work-life. Recruit people that are willing to take on some of the decision making, some of the responsibility, that want to be part of the outcome of the company. That was a big adjustment, realizing the type of people that a company needs to be successful.

‍Student: As someone who founded a startup as the tech bubble was crashing, what advice would you give founders in leaner times about how to make your startup stand out?

‍The tech industry goes in really big cycles. The smartest thing you can do at one point in time is also the dumbest thing you can do at another point in time. So the idea of bootstrapping a company and growing it yourself, maintaining control, is not in fashion right now. What's sexy is you get as much money as possible, fill a rocket with as much fuel as possible, and you point it and you shoot it. And if it happens to be right, then you're brilliant. But what the industry will shift to is the bootstrappers, the ones who have been able to create a company that has generated cash flow, because then you have complete freedom. You no longer need to raise money. The wise thing to do if you want to standout is to bootstrap. Start early, start often. The earlier you can prove that someone would pay for it, then the earlier you're setting your company on the right course.