John Cole

MBA 2014 - Marketing, Strategy, Entrepreneurship

Co-Founder & COO, Affirm Health

Could you provide a brief recap of your career since graduating from Vanderbilt?

After graduating, I went the investment banking route. It’s the typical “what you are supposed to do after business school.” I was in that seat of putting the deals together and working with entrepreneurs for about two years. I was in mergers and acquisitions and got a good education on entrepreneurship and, quite frankly, was sick of doing what I was doing and being on that side of the table. I previously worked on projects with Mitch, and we always had an inkling we would do something together. So, after two years of keeping in touch and brainstorming, it made sense for both of us to take the leap. 

What is your company and where did the idea come from?

To add, for both Mitch and me, our dads are both doctors and, especially for me, growing up I watched the shift from paper to electronic. And there was a hope that this great technological revolution would be better for everyone. I really saw that it wouldn’t necessarily be the case, especially for my dad, who is not tech-savvy, but he is a really good doctor. It actually negatively impacted the way he felt about going to work because what he enjoyed doing was sitting down with patients and really listening to them. When we look at healthcare technology, up to this point, the doctors themselves as the end-users have not had a seat at the table when technology has been architected, so therefore, there has always been this kind of poor user experience. So that’s kind of, I would say a jumping-off point for both of us – seeing healthcare as broken and technology not built in a “provider-first” way.

What are you most proud of about your business?

For me, it would be, number one, the team. That is the most rewarding thing. But hiring is incredibly difficult and the single most important thing in terms of what you need to do and learn how to be good at it. Also, that impacts peoples’ lives, so not only our customers but also those who we have been fortunate to hire. Then number two, I would say is just persistence. So, we started in early 2016, and effectively the first two to three years kind of equate to going through a tunnel having no lights. If we keep going, that is a good thing, but it is really difficult to do when it is hard and you are not necessarily sure you are going the right way. So, on this side of things, it’s just rewarding knowing that we just kept going.

What is the most challenging thing about being an entrepreneur and how have you worked to overcome those challenges?

We talk about this a lot. But, in the beginning, you kind of see every problem as equal. Stuff is always going to break, and there are always going to be problems. The key is minimizing the mistakes that can really impact the business and getting better at being ok with things not all being perfect. It is that decision-making process–which comes only with experience–that allows us to address mission critical issues but not waste our time playing whack-a-mole with every problem. 

What advice do you have for students as they launch their business? Are there any tools you consistently use as an entrepreneur?

I would definitely reiterate for those that haven’t made the leap or are thinking about it to take a long look at yourself in the mirror. There is a lot of romanticized stuff out there about startups. There is a bit of a “wanting to call yourself a founder” trap, and the reality is that the endorphin hit will only last for a very short period of time, and then reality sets in. Make sure you are doing it for the right reasons, and there are plenty of things to do to test whether the grit is there, and if you are really bought into doing it because you read about overnight successes and billion-dollar companies that started in garages, dorm rooms, etc… that is not even close to reality. In the first several years it can be incredibly lonely, so who you start the company with is incredibly important and it really needs to be a thoughtful process.  I played college sports and like to equate things to a team and who you would want on your team and to make sure those people are the right people and that your skill sets, and honestly just the way that you work, is really balanced. In a lot of ways, it is very similar to relationships generally. It is a crucial decision, so think long and hard about it before you start a company and think really long and hard about who you are doing it with and make sure those are the right people or the right person. 

What do you do to live a balanced life? Do you have any interesting or fun hobbies?

I guess that depends on your definition of balanced. One thing I would say is to hire really good people because it helps a lot. Another thing I was going to say before you do it is to make sure you know your weaknesses are going to be magnified and on full display and be comfortable doing that. But hiring really good people makes whatever a good work-life balance looks like a lot easier to get to. I would say finding ways to remain healthy. I enjoy being outside – taking walks and hiking.