Dr. Julian Nesbitt, Founder @ Dr Julian Medical Group

Welcome back to another episode of The Graduate Guide. Today we're joined by Julian. Julian, welcome to the podcast.

Thank you for having me. Great.

So a good place to start, I think, is you started your career as a, as a medic, but you've gone into entrepreneurship with the Doc Julian platform. Can you just give us an insight into what that is and why you really started it?

Yeah, so I think, um, basically working as a doctor, I saw a real problem with, uh, access to mental health care. And also the sort of technologies that we're using in healthcare, I feel, you know, are really quite outdated. Um, and I wanted to sort of build a platform that could actually connect people way more easily in a more personalized way with the right sort clinicians for them. And, and I think in mental health was, was something that I was seeing all too often, people on 9-month waiting lists and things, and even then trying to, you know, commit suicide because of it. And I was like, there's got to be a better way of, of connecting people. Um, so why can't we do that online through a platform, utilize a much wider network of clinicians, um, and then actually get patients the right clinician for them? And then it's kind of evolved since then to sort of be giving them lots of different personal care, self-help tools, etc., on top of that. But the original thing is around sort of wanting to improve access to mental health care in a personalized way.

And for you, is there a personal motivation behind that? Because I think entrepreneurship, everyone sees it as this glamorous thing where they're not really trying to solve a problem close to home. But when it's something that you care about deeply, I think it's a whole other thing, entrepreneurship, right?

Yeah, I mean, anyone that wants to start a business has to have a passion for what they're doing, otherwise it just won't work, because it's the resilience you need is just crazy. So yeah, I think for me it was this drive from, um, I mean, it originally started— so there was this— I was doing a night shift in A&E, and I, I think I had 9 patients in a row or something that were all trying to commit suicide. And I was like, this is getting ridiculous, why, why? And they all said, I'm on this 9-month waiting list, uh, I can't actually get the right help that I need. Because actually in mental health, a lot of the time it's the therapy that gets you better or gives you those, those tools. Antidepressants, brilliant. They work really well when you've got that chemical imbalance. Sometimes they're used a lot as a sticking plaster and they don't get to the core root of the issue. Well, you know, if we can, if we can actually deal with, um, the core problem with therapy, then people can get a lot better. So I was like, what, you know, this is ridiculous. Why are people on these even worse waiting lists now? And obviously there has to be a better way of getting help. And I guess I kind of saw that problem firsthand, which is which is why I started the business, and I kind of— it's kind of grown from there.

I guess you couldn't have predicted your career to end up being in this world, but the world of medicine, that, that is something you chose to at university. Why, why did you pick medicine as a degree? Because I think a lot of people see it as that safe option, and then, you know, they realize, oh, it's 7 years, and they get deep into it, like, oh, that decision they made at 18 isn't the same, uh, that will keep them doing it. But for what, what for you about— yeah. The whole world, it makes you want to have a career in medicine.

Yeah, and it's tough, isn't it, with medicine? And you do sort of go on a hamster wheel a lot of the time. I think, um, I think medicine is an amazing career though, because actually, end of the day, you're sort of helping someone, the people, every single day. And I think for me, I was really into science, but then I wasn't necessarily a researcher in a lab, and I was like, I quite like being around people. Um, so it's kind of natural fit for me to to do that. And I think there's many— I think, you know, purpose in life, sometimes if you can help other people, that makes you happy, right, as well. So I think it is an amazing career in that sense. But it's— yeah, medicine is very tough as well, and you can feel like you're on this hamster wheel, um, of going through. But interestingly, now more and more it's accepted you can have more diverse portfolio careers in medicine. So, you know, it can actually, um, yeah, it can be a really good option.

Yeah. Well, actually, let's dig a bit deeper into that because I think You know, it's the friends that I know that are doing medicine degrees, I think they, they just see it as, you know, one route, and, and they kind of look to escape, maybe because they don't have awareness of what you can actually go on to do. So have you got some interesting examples, obviously aside from yourself and what you've built, of what you can do other than just being a traditional doctor?

Yeah, I mean, there are loads of different roles people can take, uh, you know, chief medical officers in certain companies to help them, uh, you can go down consulting routes, uh, You've got a unique knowledge set that I think, especially if you're going to work in a, you know, healthcare businesses need that knowledge set. So, um, yeah, I mean, there are, there are a lot, there are sort of lots of different roles of using that, using that knowledge. And then just within medicine itself, there's a wide variety of, of things that you can do, um, rather than just sort of doing one job, you can do lots of different things. And I guess some career paths are more suited to that than others. Obviously, like if you're a GP, you can You could, you know, I work one day a week still as a GP. It allows me to do lots of other things, but actually you can just work one day a week, which is kind of, you know, really helpful that you can have that portfolio life with that. If you're a neurosurgeon, it might— it's slightly different. You can't work one day a week, but, um, there are different sort of roles in medicine, uh, that allow you to have that, that degree. I mean, I've got— I mean, yeah, there's GP friends that are non-exec directors in certain companies, uh, advisors, um down that, you know, that some of them travel agents, like you can do other things if you want as well. Yeah. So it's interesting.

And obviously you've demonstrated it is possible to grow a business from scratch alongside it. But what are some of the realities of entrepreneurship that you didn't know before that you think especially medics that might want to resemble what you're doing, they should know about?

Yeah, I mean, it's not an easy road, but then equally, if you are passionate about something and you see a real problem and you want to fix it, if you've got that drive and that passion, then you just keep going. I think if you haven't got that, then it's really, really hard and there's just no point. And I think you've got to— the biggest thing is you've got to see a problem that you think is a proper problem. I think what's lucky about working inside that system is that you are on the front line, so you can really understand what those problems are, which gives you a unique perspective actually when you're— some of the, you know, the best health tech type or healthcare companies out there are started by clinicians because they've really understood what the problem is. Um, when you start a business, I mean, it's, yeah, I mean, you'd have to learn everything on the go, right? You just, you don't know anything, do you? So you're just doing some accounting, working out how you do that. I mean, try— the biggest thing was getting people around you that knew what they were doing and getting advice. And it's, it's all about other people helping you, to be honest. Like, that's what you have to do.

And where did you find those people? Was that just through your, your network, or where did you look for them?

Yeah, yeah, well, it kind of, it does kind of fall into place sometimes. LinkedIn is obviously a really good medium now as well. And there are a whole range of accelerators out there that can support you. I, yeah, I mean, I had some people around me that knew a bit what they were doing. So that was great. They could help me, you know, from the very beginning bit. And then, yeah, it's just about networking and trying to find people. You've got to be careful though, because some people don't necessarily have your best intentions at heart as well. And in business, it's difficult. You've got to be, you know, careful not to be over-trusting as well. So, but make sure that you're, yeah, just getting advice everywhere, learning as fast as you can. And it's pretty much all about resilience, to be honest, because it's a rollercoaster.

I assume that's pretty similar to a career in medicine aside from entrepreneurship. Is there anything that you find, like, yeah, that you wouldn't have expected that is a, you know, big learnings from your time as a career in medicine, working as a doctor for football clubs, and, you know, things from entrepreneurship that actually help each other, right?

Yeah, um, well, so in medicine you're solving problems, you're diagnosing, you've got to have really good people skills, I think. Yeah, and different people are good at different things. So, you know, you've got to work out what your strengths are. I think a lot of business is about the sort of networking and making, trying to build a team around you and trying to inspire people and, you know, get that good people working with you. And I think the people skills that you develop in medicine are really helpful for that and the networking skills. You know, there's also sort of analytical element, etc. But it does depend on you as an individual of what you're, what you're good at. And it's really helpful to sort of know or work out what your strengths and weaknesses are. And then, you know, you don't— at the beginning you might have to do everything, but as you grow it and stuff, you don't have to do all the bits that you're not very good at. You can— you— the whole point is you try and find people around you that help you in that.

And I think the, the future of medicine, of having a career in medicine, uh For students, I think a lot of them probably do question, um, you know, especially with the starting salaries maybe not being where they should be, um, they question, you know, what does the industry look like going forward. So I wonder from the position you're in if you've got any insights into, yeah, what do you think is going to be happening in the UK in the world of medicine?

And yeah, yeah, well, I've got my view is, um, the healthcare system needs to adapt and change to the modern world. Um, we are still in desperate need for clinicians, and I I personally don't think that that will ever change. You know, I'm a big believer in sort of augmentation and making life easier for clinicians rather than sort of replacement or, you know, personalization care. So obviously the AI boom, et cetera. I do feel like, again, as human beings, we need other human beings. And I feel like it actually will make life a lot easier for doctors because you can use your little AI assistant when you're there. So I think obviously AI is a thing that scares, you know, where's my job gonna be, et cetera. I think medicine's probably one of the safest careers that you can have in that. Um, and I do, you know, I think with digitization and, um, increasing personalization— I mean, for me it was all about the fact that this— I need— we need a new model of care. And I really want every patient to have their own, you know, personalized dashboard for their health, right? And with the right tools, resources, access to the right clinicians, tracking, etc., that's personalized to you. You know, we have it in banking now, we have it in others. Why haven't we got that in healthcare? And I think, you know, we've really got to push towards that, and then we can start to be more preventative, you know, in that sense as well, and just trying to, you know, give people the best life that they can. So, I mean, yeah, I think it— no, I do think it's an amazing career. It's hard, but if at the end of the day, if you're helping people all the time, that will make you inherently happy. That's one of your, you know, ways of trying to be happy. But it's, yeah, I mean, again, it's understanding the fact that you've got to go through some of the hard miles and the night shifts and everything, which is tough. But there are lots of different career paths in it that actually are manageable and are manageable with families. It's kind of hard if you're doing it as a postgrad, if you have a family and things. Sometimes it's crazy. It's like they send you to a different part of the country that your family might be in, which is absolutely ridiculous. But yeah, I think that, that I think is getting a bit better.

But what about med school itself then? Do you think it's preparing people well for the world of work? And I think there is one thing, and I know it's such an intensive course, but is there any way that people can start preparing themselves for really accelerating once they've got all their qualifications, starting as a doctor and getting to the top, that they could be doing while, you know, at university doing medicine school?

Yeah, I mean, well, medical school is brilliant in a way because you spend longer at university, and I feel like university is really good fun. It's like a lot of medics are renowned for working hard and playing, playing harder, right? So it's great fun to be at I think you've obviously got to do your basic learning, knowledge, training, etc. And, you know, potentially if you're interested in various other things, then why not research those as well? Why not understand accounting, business, you know, all sorts of business functions if you wanted to go into that? Likewise, whatever you're interested in, you can sort of do if you want. I have to say, when you start as a doctor, you sort of have to relearn a lot of new things, new skills. But the, the sort of baseline knowledge that you have is, is helpful for sure. Um, but a lot of the time you just, you do have to sort of learn on the job.

And then even before med school, looking at school and actually picking medicine as a course, like, what due diligence should they be doing to like check if this is the right thing to commit 7 years and then the rest of their life to?

Yeah. Um, and people do drop out of medical school, or they get the degree and then they go and do other things. I mean, The good news about that is you've actually got quite good qualifications to go and do lots of other things like, you know, healthcare, like consulting, people going to Bain, etc. But, and you've got to want to do it. I think, um, yeah, I think it's a case of, again, what you're passionate about, um, and understanding that it is going to be difficult. But I think the other thing to think about is it's quite hard for a lot of people that don't necessarily know what they want to do, and then they leave university and then they're kind of stuck. They're like, what do I want to do? Whereas at least with medicine, you're on a career trajectory. So it's quite, quite a stable, safe, you know, option in that sense. Understanding it's hard, understanding you've got to do night shifts, understanding you're going to work harder than your peers, probably at university, etc. But equally, you know, if you've— if you're interested in healthcare, diagnosing people, understanding how the body works, that scientific mind, then it's— I think it is, you know, it's fascinating.

And then talk more about mental health, which obviously your, your business specializes in. Maybe we apply it more generally to careers. I think it's very hard to do, um, to just build your career or work really hard without all your personal life ducks in order and your mental health sorted. Yeah, obviously you're, you're working with like genuine specialists in this space. So what, what is it someone can expect from um, the training that you're— the specialists give, and, and maybe some of the, the main insights you've gained on what can get people like their mental health rights for the workplace.

Yeah, um, it's interesting coming into this on mental health thing because it's— we're going through a crisis and there's more and more people with a mental health problem. I think— well, I've got theories of why, um, the modern world that we live in is far too stressful in that sense, although we are also in a world that kind of we can just get whatever we want whenever we want it, you know, going to the supermarket buying it. So the challenge isn't there, but then we've got this constant fight or flight response from this constant sympathetic nervous system, which is, which is your flight and flight, flight or flight response from the modern world. Your phone going off all the time, you— there's no break, there's no, you know, there's no way of doing that. So it's understanding the way that your body is and works. I mean, for me it's like learning. Um, I manage my mental health through high-intensity exercise because that gives me that sort of way of, uh, switching off with that, with that sympathetic nervous system to make the rest of the, the rest of the day less stressful and you feel better about yourself. Um, there's lots of techniques to that. Um, I think you've got to be— try and be happy in yourself. It's really, it's really hard because lots of people will have different concerns, worries, and it's working out ways of, of managing those in the best in the best way possible. I mean, obviously in the NHS and what we do a lot is CBT techniques, sort of understanding why you're thinking or feeling that way and what are— what ways are there to mitigate that. Happiness is a really interesting topic though, because the reality is your brain, you know, you— we should be happy in, in life, right? So our default as a baby is we're normally happy unless we need food or whatever. But it's the way our brain tells us that we're not. So if you can take charge of the way that your brain is talking about you and actually say, no, I'm not like that, I'm happy, and then think about the things that make you happy, you can sort of start to change that a bit.

Yeah, I feel like that it's all very good advice, but I think, um, maybe the, the tough part is even realizing that you're— you need the help, right?

Um, yeah, yeah, yeah, yeah, of course. Yeah.

And I mean, I guess from what you're experiencing, you're— when you start the business, you were seeing all these people that had hit that, that threshold that was like, okay, they can't do it anymore. Um, and I wonder what signs people should be looking for, um, and how people can be more proactive with their mental health.

Yeah. Um, yeah, and it's, it's tricky, isn't it? And it's the ones that don't necessarily want to talk about it. And men, it's always been that sort way of doing it where people have been hiding it. I think, well, there's different signs. So depression is diagnosed as you are feeling down every day for like more than, you know, more than 3 months, essentially. That's where you have clinical depression, where you sort of have an issue with the brain, plus you've lost interest in activities that you would normally do. So you might notice someone being more withdrawn, quiet, not sleeping very well. They might Sometimes if they can go the other way and they can be over, overexuberant, or if someone is sort of angry, that there's probably a reason why they're angry. And it's, it's trying to de-escalate and find that, come to the root of the problem, you know, in that sense. But I think it's— but what's good is the stigma is going now. I think people are way more accepting of mental health as a condition where we're much more aware of it now, which I think is really important. And again, it's about understanding it and saying, well, what can I do to try and make that that better.

And we've touched on careers in the world of medicine, but what careers in the world of mental health and that whole space? Uh, I mean, it's a— it's really booming, this whole industry, and companies like yourself. So I wonder what a student and graduate can expect, what kind of roles they can expect, and what, you know, as a business owner and someone who employs people, what you're looking for from these, these graduates.

Yeah, so if you take sort of mental health roles, there's, I mean, there's lots of different mental health roles. From the doctor perspective, obviously you've got psychiatry. I mean, for me, the, the brain, I feel like, is the most fascinating thing. How we think, why we think, how we feel, to me is the most fascinating thing around that. So, um, we obviously, uh, employ a lot of clinicians and therapists. So there's different types of therapists. You've got the sort of counseling, which is a, a different way of working to CBT, which is more active in the way people do that. And that's cognitive behavioral therapy, which is a type of therapy. You've then got a whole range different other therapies that are— that you can specialize in, um, as a clinician, uh, as a therapist. And then you've got the sort of clinical psychologist as well, who kind of sees some of those more complex cases. Um, as I say, there's lots of other— there's lots of other roles in mental health, but obviously we're mainly a predominantly a sort of therapy type business. You've got mental health nurses, you've got lots of things, um, from that perspective. And then, do you mean for in our business who we hire? I mean, I mean, to hire someone, they didn't necessarily— like, for me, it's all about the passion and drive that that person might have. Um, sometimes the most experienced person isn't always the best person, um, because they want to learn and grow. Obviously, they need, depending on the roles that they're having, um, they need the experience that they might need for that role. Of course, if, if they're a clinician, they obviously have to be qualified and vetted et cetera, et cetera, accredited. But yes, if you're hiring from a graduate perspective, if that graduate has, you know, real drive and passion and you can see that through and they're going to work their arse off, really work hard to actually try and learn and do the best that they can, sometimes those are the best hires that you can. I mean, in a business you've got lots of different functions, right? You've got your customer success team, you've got your accounting area, you've got your, um, lots of different other backend admin functions, HR, um, yeah, and obviously technology as well, and lots and lots of different other roles. So people, you know, there's, there's different areas in a business as you scale it.

I think the other side of that as well is like marketing, like how are you actually taking this really amazing product and team you've got and getting it to the people that need it? I mean, yeah, potentially I guess yours is more within the world of like within hospitals and doctors, but like, how are you actually reaching your customers and where can people find you?

Yeah, um, so with the, the main, the main work that we're doing at the moment, um, obviously from a tech-enabled service or service perspective, is working alongside the NHS. So we get referrals from the NHS, um, it will then depend as well if we're— if patients are coming to us from the NHS, we have to do some marketing to say this is available. But normally in talking therapies, which is the main route that you would access therapy, um, you may— you can self-refer, uh, to the local service to, to do that. The GP also, if you see your GP, they will direct you to that talking therapy service as well. Um, and yeah, the— you know, we, we take referrals from the NHS, so there's, there's a vast array of patients there. We do do some private work as well, and people can just register an account via app.dr-julian.com, by the way, or just download our iPhone app, and people can, can find the clinician for themselves. So we do do some private work, but our mainstay is, is in the NHS and increasingly also in the corporate space as well, working alongside partners and occupational health companies, etc., and, and directly with, with some corporates where they can access the network and get that help.

Is there anything you wish you were told as some sort of more final advice towards graduates and people who are at medicine school? Is there anything that you'd give for inspiration, um, but also just to help them get through what they're going through?

Yeah, well, I think the biggest thing is to accept that you're not going to feel amazing all the time, uh, and it's a massive roller coaster and Sometimes it's really like, life is really crap basically, and it will get better. And you've got to find out what you're passionate about. Also, coping techniques, like for me, you know, cold water, doing high-intensity exercise, that's the way that you can start to cope. Trying to surround yourself with good people that actually, you know, that make you better. And just trying to, you know, be in tune with yourself, I think is really important. And just find out how, you know, a lot of people, they don't— they're not sort of comfortable with themselves, and it's just trying to find that, I think, is important. But just accepting that, you know, life is hard and you're not always going to feel great, but it will get better.

And my final question to you, which I ask every single one of my guests, is when you first started off on this career of yours, you might have had a certain idea of what success might go on to look like for you. But, you know, fast forward everything you've learned and achieved the business. What is your definition of success and how has it changed?

So that's a really interesting question. I think problem with an entrepreneur is that they're never happy or content, which is a problem. They always want to, to try and do more all the time, right? So, um, I— sometimes it's good to sort of sit back and reflect and be, you know, and, and say, okay, no, we've achieved that. I think it's completely different for different people, to be honest. Success is being happy, right? Right, in that sense, and doing the best that you can. That's what success is. It doesn't matter what you're doing. If you're happy, then that's success.

And it's always been that for you?

Well, yeah, I mean, but you're not always happy. But if you can try and live the life that you want to live, and you don't have to be some crazily successful person. It's not, you know, however we define success. Success is what you define it as for what makes you happy, essentially.

Julian, thanks so much for coming on. I appreciate it.

All right, great to have you. Thanks. Thanks. Great to have— thank you.