Five Mistakes I Made Building a Healthcare Startup (So You Don't Have To)

By Victoria Lahutskaya, CEO and Co-founder of Tori Health

Note: This is an edited transcript from the MedTech Summit talk Victoria presented on July 8, 2025.

Today, I want to share the real, messy process of building a startup. We call it internally a "no bullshit" process, and I think this is what all early-stage startups actually crave to hear—not some polished advice or story that you might read in published articles.

Whether you're building for the first time or entering a new area, your first year of building a startup will be very messy. You will have to make a lot of decisions fast, and some of them will turn out to be quite painful learnings. Making mistakes when building a company is like learning how to walk—the more you fall, the sooner you actually learn how to get back up and start running.

Today I'm going to share five mistakes that we made that might save you a little bit of time, especially if you're very early in your journey, so you have more time to make your own mistakes.

About Tori Health

At Tori Health, we are building the next generation of high-severity mental health and crisis risk reduction care, powered by artificial intelligence. Our mission is to increase access to care for folks with complex mental health challenges, including suicidal ideation, who today are unfortunately the most underserved and avoided population within mental health.

We do this by offering group therapy augmented by an AI-powered skills coach between therapy sessions and supported by 10 months of AI aftercare and adherence monitoring. We recently entered a provider network called Trilogy in the Midwest, serving their 115,000 members, and we are reimbursed by several regional payers in the Midwest as well.

I'm incredibly lucky to have a team of seasoned technologists, psychologists, and healthcare experts. We are supported by medical advisors who are former chief medical officers at Aetna and United Healthcare. Before Tori, I co-founded a remote adherence monitoring platform for behavioral health therapists and spent 12 years in tech building products for companies like Meta and Instacart.

Mistake #1: Expecting the Hockey Stick (Instead of the Rollercoaster)

When you start a company, you have a classic expectation of what your journey will look like. In my head, it looked like happiness, money, mission, team, and revenue would all hockey stick and immediately go up, and everybody would be happy all the time.

In reality, when I look back at my journey—no matter how long and how many startups you've founded—the journey looks completely different. Money goes up and then it goes down. Then you find the perfect person for your team, then they ask for $12,000 a month. Revenue goes up and then it goes down. A client leaves. And happiness actually does not correlate with any of these things at all.

The only thing that stayed pretty consistent was actually the mission, because that was a very important thing that we defined early on, and it stayed true no matter what was happening.

Why is this important? Because many founders, when they start their journey (especially for the first time), expect the first graph. And when it comes to hiring and building a product, they hire and make decisions based on that expectation—not reality.

In truth, when hiring your foundational team (and even your co-founder), you have to ask yourself: Will these people stick around through this mess? When the money, the revenue, and the clients all inevitably go down, what will keep your team together?

Mistake #2: Hiring for Resume Over Personality and Fit

If you have a gap in your skill set early on, you're going to go to your network and find somebody who can close this gap. In the early days, we actually focused a lot on resumes and skills. We thought the logo would solve all our problems. We really wanted to hire the best of the best.

And it is important, of course, but we did not focus enough on personality and fit for an early-stage startup. It truly takes a special kind of person to join an early-stage startup—not only because of the unpredictable pay, or sometimes no pay at all if you're just starting out.

All you have for these people when you're just starting is a goal, a timeline, and trust that this person can figure it out and will not expect you to tell them everything they need to do.

We tried different types of talent. We tried new grads, senior people, and former executives. We've seen it all. No matter what seniority the person has been, we've seen all levels of people sitting and waiting for tasks to be given to them. We've seen people who asked for $12,000 a month. We've seen people who asked for 10% equity for one role, like marketing.

But we've also seen both junior and senior executives—including our now Chief of Growth, who came from Johnson & Johnson and Aetna—who told us, "I don't care what I will be doing in this startup. I really want to join this mission." This is the signal that we now look for, and I suggest you look for when you're hiring your first foundational team.

What we learned: No matter the level of seniority, the first hires should be people who have an incredible sense of agency. They should be proactive self-starters who not only won't wait for you to tell them what to do—you want people who will tell you what you need to do differently because they have the energy and desire to be part of this mission. These people are really, really hard to find.

Working with Senior Advisors

Sometimes you will need help from very senior people who are either several stages ahead of you or who are executives. In healthcare specifically, we found that payers (especially larger payers) want to have a chief medical officer on the call. They want to have a chief financial officer on the call.

As you're building your early-stage startup, sometimes you might not be able to afford these people or you simply don't have them yet. We found that hiring and partnering with these people as advisors and mentors is very important. If you're able to align with them on your mission and inspire them, you will be very surprised how much these incredibly senior people are willing to do for you and how much they're willing to help, even if it's for free.

Mistake #3: Building Before Selling

This is a classic one. When I was building my first startup (a software product for mental health private practices), we did everything the textbooks tell you to do. We talked to users. We thought we validated the demand. We got great feedback, and people were very excited. They said things like, "Wow, this is so great. This is exactly what I need. I would definitely buy it."

This sounds like incredible validation, right? So we went back and built an MVP. Then when we came back to the same people and asked them to buy, those early validators were not ready to part with their money. We realized that we had great feedback and praise, but not commitment.

If there's anything you can take away from this presentation, it's this: Read the book called The Mom Test if you haven't already. It teaches you how to avoid praise and how to recognize that praise is not a signal to buy.

Our New Approach

When we started Tori Health, we completely flipped the approach. We actually pitched to our first payer (our model is to sell to payers and health systems, which is how we reach our patients) with a Figma prototype of the member experience. We did not have a finalized product.

Once we had our first letter of intent signed, that's when we started building.

In healthcare, you know the sales cycles do not end when you sign a contract. There's always an implementation period, no matter what you sell—a service or a device. There's a period for education and implementation. You can always consider this buffer or even ask for a buffer of implementation to finish your product. That's what we did.

Another big mistake we made in sales was not qualifying our clients and being too afraid that the client would leave us as soon as we started asking questions or asking for money. This truly leads to building the wrong thing or spending all this time building something they will never buy.

Mistake #4: Underestimating How Slow Healthcare Moves

This one is painful for a lot of folks coming from outside of healthcare. I'm coming from tech, and I had to learn this really quickly.

Like a lot of people from outside of healthcare, when I started my journey, I thought that healthcare just needs better processes and innovation, and everything will change. There's just so much opportunity. Partially, it's true—there are certain processes that we now see being disrupted. But when you sell to payers, TPAs (third-party administrators), or hospital systems, you quickly realize that you're not just selling a product or service—you're entering their system.

This means you will have to deal with:

10 email follow-ups before getting a meeting
6-month sales cycles
Preparing the right person for each call (if they want to speak with a chief medical officer, you better have a chief medical officer on that call)
Waiting weeks for internal approvals

This is just the reality of selling services to healthcare.

What We Do Now

We always expect 3-to-12-month sales cycles, which means you have to plan your funding differently. You have to plan your fundraising and your revenue differently from what you would do if you sold B2B SaaS for non-healthcare-related products.

For larger payers, we start conversations now for deals we want to close next year. We try to build relationships before we even start pitching. We always try to match their structure and lead with credibility.

Most importantly, we never rely on just one customer. We always have parallel conversations because customers might disappear, and because of these long cycles, we don't want to put all our eggs in one basket. We always diversify.

Mistake #5: Trying to Be a Startup You're Not

This is very good feedback that I wish I had in my first steps as a founder. Many Silicon Valley founders I speak with (and I was definitely in this category early on) fall into the trap of modeling their journey after a handful of startups that became successful 15 years ago. They read about those journeys in polished articles, and sometimes, unfortunately, a lot of founders quit when their journey looks different because they think they're doing something wrong.

In reality, that messy graph I showed in the beginning is the path for everybody—no matter how much money you've raised, no matter how long you've been on the journey. I've spoken with a lot of folks who are Series D and beyond, and this process is never a straight line. It's always a mess.

The Problem with Generic Advice

There's just a lot of noise that early-stage founders have to navigate. Y Combinator, for example, tells founders that if they don't have traction in five months, it's a red flag. Some investors will tell you that as a founder, you have to do all of your sales alone, and that's the sign of a great business.

Partially it's true, but in reality, sometimes healthcare companies expect a sales process driven by a medical officer. You need to understand what your customers need and match their process—not what your investors or some industry standard expects of you.

If I could give one piece of advice today, it's this: Do not listen to all the advice you read about how you should be running your company. Focus on understanding your customers and what their expectations are.

You cannot build a company that is unique by doing everything that people did before you. You have your own path, and this is where the uniqueness and unique value lies—not from reading what others did. You learn how to do it by doing and failing, not necessarily by listening to how others have done it.

Conclusion: Embrace the Experiment

Many early-stage startups (and I did too) try to over-prepare and avoid as many mistakes as possible. In reality, learnings only come from failure and from trying things. The more learnings you acquire, the better you become as a leader, and the better your business will be.

What is helpful for me is to think of everything I do in the business as an experiment. This mindset has really changed how I react to failures or setbacks that inevitably happen in business.

All you need to do is find a team who will be willing to experiment with you.

MedTech Connect