Founder Stories

Scan.com founder Charlie Bullock on scaling one of Europe’s fastest growing healthcare platforms

Founder Stories

Scan.com founder Charlie Bullock on scaling one of Europe’s fastest growing healthcare platforms

Words Charlie Bullock

September 12th 2024 / 8 min read


Each step in my career has taught me something valuable about what it takes to build a successful business. 

From running an eBay reselling business while at school, I learned the joy of side hustles and an appreciation of entrepreneurship as a hobby as much as a career. From the graduate employment platform that I built at university, I learned the value of building on a shoestring and doing everything yourself. Even from my time at Pollen, the travel and live events startup that was one of Europe’s fastest-growing at the time, I got the inside track on high-growth businesses.

Across the sum of these experiences, one learning stands out—to build a big business, you need to think big. That is, you need to make sure you have a big enough total addressable market (TAM), with an exciting solution that’s scalable across that market. That’s how you convince the best people to join your team, and the top investors to back you.

So when the opportunity came along to found Scan.com, a business that promised to revolutionise diagnostic and preventative healthcare, it didn’t take a healthcare expert (which at the time I was far from) to recognise the potential of what we could create. Seven years later, with over $60M raised, a team of over 150 people, and 50x revenue growth over the last year, that potential is undeniable.

Here’s the story of building Scan.com, and the lessons I’ve learned along the way.

A chance to transform preventative healthcare

In recent years, we’ve seen the power of healthcare systems when they’re optimised and well-funded–and the stark inequalities and vulnerabilities they reveal when they aren’t. 

Preventative healthcare has come into focus as one of the biggest opportunities for innovation over the past decade. Growing populations, longer life expectancies, and the increasing prevalence of chronic illness demonstrate the importance of early detection and preventative treatment. 

That’s where the idea of Scan.com first emerged. My friend Jasper (Nissim, now our UK Clinical Director) had first-hand experience with the frictions around medical imaging (MRIs, ultrasounds, X-rays, etc.), one of the key methods for screening and diagnostics. 

As an osteopath, he was frustrated with the tiresome process of referring patients for scans and the administrative headache of accessing the results. That’s without even mentioning the patient’s experience of finding an appointment, arranging payment, and so on. The idea was simple—build a consumer marketplace that connected patients with imaging centres that had spare capacity.

I was eager for my next entrepreneurial adventure, but I was an outsider to the healthcare industry, even given Jasper’s expertise. So, I started by initially working on the business in the evenings alongside my full-time job, trying to understand the scope for me to lead this business to something of considerable value.

What transpired was a very clear example of product-market fit. Without putting in a ton of effort, we quickly saw a considerable amount of traction. The product was just 1% of what we are today, but the pull of the market was undeniable. At that point, I just knew this was going to be big—and for it to get there, I had to commit full-time. 

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The best early decisions I made

Startup success is the result of thousands of hours of hard work, but it also comes down to a number of very important decisions, many of which are made very early on. At Scan.com, a few of these pivotal decisions really stand out. 

First, talent—namely, assembling our founding team. I didn’t want to go it alone, and there were two key people I wanted to bring in. Oliver Knight (below, left), now my co-founder and COO, had already spent time as a Managing Director at Rocket Internet at just 24, and I knew he’d bring tremendous operational experience. Joe Daniels, who I knew both from school and my previous business Kaampus, brought serious tech experience from designing and building websites since he was in his teens. 

You really can’t spend enough time on recruitment. There’s this concept of ‘barrels’ (credit goes to Keith Rabois for this term)—people who just keep moving, without supervision, and who will just constantly impress you every day with what they’re doing. If you’re able to find and hire these people, they’ll keep the company moving too.

Secondly, international expansion. Our decision to launch in the US surprised many of our advisors. We were pre-Series A, just getting going in the UK, and many thought we should focus on cementing our domestic business first. But I stuck to my instinct about finding a big TAM, because we wanted to build a massive business. It was a roll of the dice at that stage, but one that we nailed. 95% of our revenue now comes from the US, and it’s growing every day. 

At the same time, our decision to launch in Germany went in the opposite direction. Volumes were strong, but our margins were terrible—we were making about €1 per scan. Even if we got to 10,000 scans a day, it was never going to be a big business. So we decided to pull the plug very early on.

I think that was another huge learning for me. If it doesn’t feel right, don’t procrastinate a hard decision—whether that’s international expansion, a new hire, a new product line, or otherwise. There’s a fallacy about sunk costs, where you can overemphasise the time you’ve already put in. But in general, I don't think we’ve ever regretted cutting something too soon–the biggest regrets come from cutting too late.

Then there was the matter of our business model. The original product we built was a consumer marketplace, helping connect patients to appointments. But we knew the consumer offering could only take us so far, and probably wouldn’t meet our aspirations for scale. The best piece of advice came from one of our advisors and angel investors, Lopo Champalimaud, founder of Treatwell. It looked like this:

Think about a model that you can build without any consumer spend. For instance, if tomorrow you turned off all of your marketing channels, your business would survive. If you can do that, you are building a really defensible business that you can scale. Otherwise, you are reliant on Google, Facebook, and so on as marketing channels, which will ultimately determine your fate. 

This was prescient at the time, given changes in the direction of digital marketing around Facebook ads and so on. More importantly, it taught us a great lesson about pursuing opportunity, rather than ‘glamour.’ Consumer is attractive to founders, partly because it's easier to feel the problem, and as a result, is more obvious (and therefore likely to be saturated). More often than not, the harder, complex areas (that might seem ‘boring’ by comparison) are by far where we’ve found the most opportunity. 

That led to a huge decision to pivot from consumer to B2B2C. This allowed us to target doctors, insurers, and other telehealth companies with existing cohorts of patients that they could refer directly to us – without spending heavily on consumer advertising. It completely shifted our way of thinking and has no doubt proved instrumental to the growth we’ve seen in recent years. 

To do this, we had to understand and crack the insurance industry. Partnering with Aviva through the Founders Factory Accelerator proved to be the perfect opportunity, giving us C-suite-level access (to their Chief Innovation Officer Ben Luckett, their Chief Medical Officer, and their interim CFO) and extraordinary insight into the health insurance market. On top of this, Aviva Ventures ended up co-leading our $12M Series A.

In general, Founders Factory proved an invaluable partner at this crucial point in our journey. With a team of just 5 at the time, they helped fill in gaps in our expertise in growth and talent, helping us make important early hires, as well as closely supporting us on fundraising. 

Cracking healthcare as an outsider

While healthcare and insurance are complex industries to crack, I think several factors contributed to our success. 

Firstly, there are a number of traits that we embody as a company, particularly when we’re hiring, that I think have propelled us forward. Curiosity is top of the list: by this, I mean an insatiable desire to learn about new markets. This is so important in healthcare, particularly US healthcare, where there’s a complex lattice of incentives, mechanisms, and providers. We really encourage this across all functions and geographies, from engineering to sales to product, as we want people to be curious about how things work and how they’re changing.

This is twinned with another important company trait: being problem-minded versus solution-minded. This means being curious about how the problem works, rather than having an ego about what you think the solution is. When we launched in the US, this was central to our strategy. We spent six months talking with different stakeholders—imaging centres, clinicians, patients—to understand what their biggest pain points were. We essentially ended up building a completely different product stack in the US, which only came from our curiosity and problem-first mindset. 

Patience has proved critical, too. In healthcare, things take time, less so in the US than in the UK, but it’s still slow. This runs counter to the ‘move fast’ mentality that you may be accustomed to in tech, so it’s really important that you set these expectations well for new employees and investors, who need to understand that it will take longer to find lift-off and reach escape velocity. 

Building your network is also crucial. This will be one of your major sources of learning. It will help open doors for you at the right time, and in an industry like healthcare will ultimately be how you influence change more quickly. Fortunately, this is a natural part of my personality, so it happened organically and enjoyably, without much additional effort or planning.

Reaching velocity and undergoing change

The last 18 months have seen us start to hit velocity and experience serious business growth. We’re live in the UK plus 3 hubs in the US (Atlanta, Boston, and Cleveland, with New York, South Carolina, and New Jersey launching soon). We found product-market fit early on in the States and turned over $1m in revenue in year 1. Since then, our transatlantic team has grown from 30 to 150 people, and our annual revenue has increased 50x.

So how has this changed the company? 

For one, we’ve seen a real specialisation of talent. Your early team should be dominated by generalists: people you can trust to wear many hats and feel confident going outside their comfort zone. As you scale, you need more specialists, people who can help you nail the specifics of certain areas of the business. 

This involves tough decisions, like letting go of people who have helped you get the business to where it is today, but whose roles just don’t exist anymore. Ultimately, founders reaching scale need to recognise that the company changes every 6 to 12 months, so it's understandable that you might need to restructure your team to evolve alongside it.

In general, structure and process come to the fore. Early on, you’ve got plenty of room to experiment, throw ideas at the wall, and pivot almost daily. But, as you scale to 150 employees, you need much greater coherence in your strategy because you need everyone rowing in the same direction. We’ve gone from daily objectives on a whiteboard in our office to quarterly OKR planning sessions that align the whole business.

My role as CEO has changed a lot. In terms of leading a 150-person team, I’m still learning every day, but I have great advisors to support me. I’m trying to get comfortable with letting go of day-to-day tasks, things like sales or product, which I love, but hiring great people to take on these tasks makes this a lot easier. 

Really, it’s about finding areas where I can add maximum value to the overall business. And all too often, this involves finding time to not do anything and just think. As a founder, it's easy to fall into the mistake of thinking that you should always be busy and doing something. But actually, some of the highest leverage work you can do is stopping, raising your head above the parapet, and thinking 12 months out and beyond. No one else gets the opportunity to do that in the business, and it can be one of the biggest impact jobs you do.

About Charlie

Charlie Bullock is CEO and co-founder of Scan.com. Prior to this, he founded Kaampus, which in 2019 was acquired by graduate employment platform GradTouch, which he then joined as Strategy & Finance Lead. He also worked as a Strategy Lead at live events and travel platform Pollen.

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