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Stay courageous, my friends

By Dan D'Orazio, CEO, Sage Growth Partners | July 19, 2023

Remember the Dos Equis guy? Before beer-drinking became political, The Most Interesting Man in the World advised us to “Stay thirsty, my friends.”

My advice to those drinking from the healthcare investment firehose? Stay courageous, my friends. Because from the many conversations I’ve had at post-pandemic conferences this year, only the uncertainties are certain:

  • Will there be a recession? Maybe, but we don’t know.
  • Will Microsoft join Apple as the next $3 trillion company? Probably, but we don’t know.
  • Will the Fed halt interest rate hikes before 2024? Probably not, but we don’t know.

All these open questions make it surprisingly difficult to invest in ways that are slow and smart versus shiny but dumb. But we have to. It will take discipline, value, and courage. 


Just because the market behaves with inconsistency and uncertainty doesn’t mean we have to. We can hope for something different, but hope is not a plan.

What to do about it

  • Create real use cases — Remember when we cared about fit: problem-solution, product-market, business model? Sure you do, and it’s still important.
  • Ask Why X? Why now? Why me?— Three questions that are close cousins to fit. What feels like a moment of urgency may unravel if an offering isn’t interesting or important.
  • The rule of enough — An investment makes economic sense, but does it make enough sense? A product has fit, but does it have enough fit? Ask, then ask again.

The Big Takeaway: Remember what it means to make smart investments.


For the last 10 years, you didn’t have to be that smart to make money in healthcare. But today, the easy money that created easy wins is gone. Investments dropped precipitously during Q3 and Q4 2022 as yesterday’s molehills now look like mountains.

What to do about it

  • Math matters — And in a way that it didn’t before. Deals got done in the blink of an eye when we equated easy money with value. It’s probably a good thing. For those who disagree, interest rates will help curb irrational exuberance if (when) it rears its head.
  • IQ over EQ — Decisions driven by intel over emotion are easier when there aren’t that many A+++ deals to choose from.
  • Both/And not Either/Or — Data without a story is a headache. A story without data is BS. Data plus story is dangerous, and in a good way (thanks Jeff Studenka)

The Big Takeaway: Remember what good companies look like and don’t confuse valuation for real value.


Right now, people will need courage not to do deals. Period.

We have commoditized the smallest units of value for the earliest prospect of profit. But subdivide value too many times and you risk losing it.

What to do about it

  • Reckon with the reckoning — Funding runways are running out. Burning through cash isn’t a new problem for startups. Neither is the surprise when the money stops flowing.
  • Get real — Past performance is not a guarantee of future return, but boy do we want it to be. Who invests and always thinks they’ll win?
  • Step back — Want to master the prospective? Get introspective. Take a longer view of FOMO, one that permits investment in genuinely great companies.

The Big Takeaway: Remember that all roads lead back to discipline and value.

Let’s raise a frosty glass to wisdom.

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