Ventures Africa (VA): Kindly tell us about your background and the vision that formed CribMD
Ifeanyi Ossai (IO): I studied business and technology, and later went to Harvard and MIT. When I was a kid, my aunt died from an allergic reaction. This event stuck with me, as we tried to get her care. Everyone has a story of someone who this has touched. People just take this as normal. In the U.S, mass shootings are considered normal, unfortunately, the same applies to Nigerian Healthcare. People die every day and no one takes it seriously. We decided to build physical clinics to cater to patients, but that wasn’t scalable as we had too many customers. In asking, how can we better solve this problem, we decided to approach it like an ‘Uber’ or ‘Airbnb.’ We decided that instead of our patients coming to us, we would go to them-see patients at the comfort of their homes. We now also help them through telemedicine and doctor-home visits. With that, you’re no more than 30 minutes away from quality, affordable healthcare with CribMD.
VA: How would you say internet penetration has assisted in getting patients diagnosed and getting proper medical care?
IO: It has been exceptionally useful. It has been a great catalyst, it is an essential ingredient. Think about it this way, Flutterwave, Paystack, Amazon and Google all wouldn’t exist without the internet.
VA: What challenges would you say have been associated with telemedicine against in-person consultation?
IO: When seeing someone for the first time on a screen, it is usually impersonal and takes a while to get used to it. About 67% of the customers complained initially. As such, we decided to start with in-person consultation via home visits and then transition them to telemedicine sessions. When we sign up a patient, we do doctor-home visits for them. This allows the physician and the patient to establish a relationship. It is also a way for the physician to be able to look into the patient’s social determinants of health. What is in their fridge? How are they living? Armed with that information, it is easier to come up with a more effective health plan that both the physician and patient can stick to.
VA: Considering that Nigerians are particularly conservative, how would you say they were able to make a switch to digital consultations?
IO: When I was in Nigeria, we had a session for an elderly lady aged 85, and you could see how exciting the experience was for her. When it comes to dealing with millennials, they will be more exposed to online technologies and are more comfortable with those things. However, in rural areas, it is more challenging because the people look towards their pastor or native doctor to attend to them, believing their problems are more metaphysical than medical.
VA: How would you say that some of your past experiences prepared you for this innovation? What would you say in a few sentences?
IO: My goal in life is to leave the world better than I found it. Also to help people who like my Aunt, and friend cannot access good care. These traumatic experiences have made me extremely determined to solve healthcare for Africans.
VA: What are the common misconceptions that you have heard around digital consultations and medical care?
IO: Some patients expect you to walk them through how to perform dental procedures over the phone. You can’t perform surgery over a tele-session unless in a hospital with qualified medical personnel and a consulting physician present. Patients cannot perform surgery on themselves either.
Another area we have closely observed is reproductive health, especially with females. The patients may not be comfortable with a physician coming to their house, but in an atmosphere of privacy, they can reach out to a physician and get their problems solved. A lot of women use CribMD because of that.
In self-diagnosis, there is so much room for error. But with telemedicine, there is no need to self-medicate. You can call our dedicated toll-free line or use the app. It is always better to call and get medical advice than to start self-medicating and seeking medical help afterwards. Telemedicine allows you to call a doctor who will tell you the right thing to do. You can usually see the horror on the faces of the doctors when they get calls from self-medicating people.
VA: Could you describe the impact that the covid-19 pandemic had on CribMD, particularly in terms of delivering health services?
IO: In terms of delivering health services, we were never at a disadvantage as medical personnel could still move around to deliver healthcare even during the lockdown. The pandemic didn’t affect our operation as such. For the longest time, we operated purely on referrals so it didn’t affect us directly. It also didn’t affect our ability to raise capital as we were able to raise over $2.5 million in funding. However, we were impacted indirectly because some of our patients had lost their jobs as a result of the pandemic. In performing consultations for them, we discovered that the illnesses they had were induced by sheer anxiety over economic insecurity. Nigeria is already stressful, as such, we had to be both doctor and therapists to them. It has affected us indirectly especially since we are at the front-end of talking to people in the community and delivering care.
VA: Did CribMd gain more coverage during the pandemic?
IO: The first few phases of the lockdown did not have that much impact on us as we already had a pre-set patient population we were taking care of. What did, however, have an impact on growth from the consumer side, was a few weeks ago when doctors working in government hospitals all went on strike. In Nigeria, 90% of people depend on those public hospitals. That drove a lot of volume as the government was deserting them and we had to step in to take care of people in that situation.
Also, while Covid didn’t necessarily expand usage, you do have a point as people weren’t able to go to the hospital, and services like CribMD became their only choice. A year ago, people didn’t use zoom, but now even a 5-year-old knows what zoom is. The pandemic has made the adoption of teleservices of any sort commonplace. They have helped in the adoption of the digital lifestyle. People will keep using services like CribMD and zoom because they have seen how “no-hassle” it is. There is no point in spending time in traffic when you can call your doctor from the comfort of your home and have your prescriptions delivered to you. Why wait in traffic for hours and then queue up in a hospital, when the same service can be delivered from your home?
VA: With years of multi-site and P&L experience, what are some of the areas that business enterprises in Africa struggle and what are your recommendations to help change that?
IO: When you start any business venture, it is important to be properly capitalized. Most people struggle with funding. P&L, on the other hand, is simply profit and loss. In healthcare, it is like the provision of essential services. Healthcare is an essential service and as such, someone always needs that service. As an entrepreneur, build a service or product that people want, in the middle of the rainy season, an ice cream business won’t be successful. However, in the peak of the dry season when there is a lot of heat and thirst, the same ice cream business will do very well. Build a business or sell a product that people want at that particular time and that is suitable for that environment. Even a boy in a rural community can become a billionaire if he builds something everybody wants.
VA: In your opinion, how can the entire consultation practice benefit from technology?
IO: I don’t see that you can live without technology right now, it just doesn’t seem possible. It makes life easier. It allows for patients to reach you easily. Technology is indispensable at this point, it is interwoven with the fabric of everyday life.
VA: Where do you see the Telemedicine industry in the next 5-10 years?
IO: So I think eventually, it will become the preeminent form of healthcare as people get more comfortable with technology and rely on it for everyday needs. Except you need to seek facility healthcare, companies like CribMD prescribe and deliver your medication to your front door. Telemedicine and services like CribMD are the future and human beings will always keep looking to the future and not to the past.
