Aesara Partners 

At Aesara Partners, our mission is simple: enable you to be the best version of yourself. We offer a range of focused services that unlock the potential of people, teams and cultures to maximise business performance. 

Collectively our Partners and Associates have decades of experience both in executive coaching and as board level leaders themselves working in multiple sectors across global markets.

Partner & Executive Coach

Doshisha University

Professor of Strategic Management, Global MBA Program

The CFO Coach K.K.

The CFO Coach K.K. is a boutique executive coaching firm specializing in developing High-Performance​ Financial Leaders and Teams.

Founder & Executive Coach

Kansai Gaidai University

•	Awarded President's Global Education Award (Teacher of the Year).

Professor of Leadership & Management

Benesse Holdings, Inc. (USD 4.5B; Tokyo Stock Exchange Code: 9783)

•	Member of the Board of Directors for Berlitz Corporation; Benesse Corporation; and Benesse Style Care.  Chairman of Audit Committee for Berlitz Corporation. Member of Benesse Holdings Pension Committee.
•	Global CFO covering all 40+ Benesse group companies
•	Championed and supported multiple cash generation initiatives including a CFO led "Save to Grow" initiative to improve Company Financial performance and to identify significant savings for business reinvestment
•	Enhanced Finance bench strength and hired a high potential team to start financial business consulting
•	Implemented several process and capability best practices to move group companies towards global standards

Global Chief Financial Officer & Corporate Senior Vice President

McCann Worldgroup Holdings

• Overall Responsibility for Operations (Finance, IT, Legal, and Administration - 10 legal entities) 
• Successfully turned around long term loss making lead agency by delivering double digit margin improvements within two years
• Delivered double digit margin improvements for all six MWG Group companies 
• Built a new Finance team and moved from Scorekeeping to Business Partnership and improved business performance
• Major projects within last two years include: 
  - Shared Service center creation/migration
  - New Financial System Migration
  - Acquisition & Divestiture
  - Business Turnaround
  - Retirement Plan consolidation/change
  - Office relocation/rent reductions

Group Chief Financial Officer, Executive Vice President, and Member of The Board

Becton, Dickinson and Company

• Led Finance, Procurement, General Affairs, and Rebates teams (43 staff) to deliver multi-million dollar cash and profit performance improvement for first year and beyond. Exceeded all budget expectations.
• Engaged Japan Management Team and Global Finance Leadership Team on company objectives to deliver best outcome (Finance Transformation initiative, Sales effectiveness improvement, Key Account Management, Business Continuity plan, and strategy/selection of backup distribution center).  Led process for 2012-16 Business Plan development
• Developed and executed Finance department strategy and vision to move from scorekeeping to business partnership. Implemented job rotation program and hired several high potential employees to improve bench strength.
• Championed multiple Finance and Procurement initiatives including definition and implementation of new 401k Retirement Plan; divestiture of non-core business; change of primary banks (reduced bank fees by over 30%); vendor reduction process, and new travel expense management system 
• Taught New Manager Essentials program and selected as leadership trainer for PEPFAR program in South Africa to teach Leadership and Change Management to African Health Ministry officials

Finance and Administration Director

Avon Products Inc.

•	Implementation project leader for Avon Sales Leadership Framework (ASLF) – Highest priority project for the Company to adapt to a new Sales Model.  Completed project implementation in record timing.  Awarded regional award as part of ASLF Team. Only person in Asia recognized for both Top-line and Bottom-line contributions in the same year.
•	Defined and executed new vision and mission and led Sales Support department to complete over 40 initiatives (within a six-month period) as part of Team’s new journey towards field motivational excellence. Incorporated new processes to deliver high impact incentives, and to create Sales energy and momentum for sales turn-around.    
•	Achieved highest employee engagement scores with Sales Support Department significantly exceeding country results in over 95% of categories.  Previously had also led Finance department to highest employee engagement scores.
•	Global Project leader for a high potential, multi-functional, multi-national team to study and recommend actions to improve Global Sales Incentive management/spending process.
•	Oversaw execution of a variety of Company and Public/Media events ranging from Sales Conferences to Philanthropic events including Annual Awards to Women, and Pink Ribbon Campaign support.

Executive Director and Member of the Board

•	Responsible for Financial policy making/implementation and reporting for Avon Japan as a public company (including statutory/public, and Board Meetings). All year-end financial documents audited with no comments/exceptions.
•	Defined and executed new department Vision and Mission, and recruited, trained and developed a completely new Finance team (80% new hires within a six month period) to move from scorekeeping to business partnership. Finance team formed core of country high potential list.
•	Consistently over achieved profit performance commitment under adverse conditions of sales decline by aggressively managing strategic business needs with cost cutting; Delivered zero overhead growth during all years; Japan winner of regional awards for best cost management performance, and for boldest transformation strategy.
•	Provided leadership and support for critical decisions and strategy development as Japan Leadership Team Member.  Actively led change management process within company.
•	Consistently achieved best internal control results in Asia-Pacific/Avon over a period of eight audits.  Japan one of only two countries with highest audit rating. Outstanding performance generated support to remove Japan from list of High Coverage countries.
• Co-developed strategic/financial business case, and obtained approval for number of campaign reduction in 2006 making Avon Japan only country ever in Avon to undergo campaign reduction. 
• Independently analyzed and provided strategic direction for Plant study which challenged and reversed previous recommendation by outside consultants on plant closure.
• Provided leadership in several restructuring initiatives by providing an achievable plan to achieve 12% people related cost reduction.  Played lead role in this study representing Finance, Supply Chain and HR 
• Consistently achieved highest performance rating and nominations to several high potential programs
• Elected (and re-elected) to Board of Directors

Executive Director, CFO and Member of the Board of Directors

Delphi

• Prepared Asia-Pacific regional messages / presentations for Delphi Strategy Board, and for Delphi Board of Directors.
• Supported development and implementation of critical Asia-Pacific strategies.  Performed competitive intelligence and other special studies to identify risks / competitive threats and outlined regional / corporate response.
• Provided Miller Heiman strategic selling process training to Asia-Pacific personnel to improve value propositions and increase sales effectiveness.

Director Asia-Pacific Planning

• Management responsibilities for Finance, HR, General Affairs, and Six-Sigma.
• Active member of the Japan Strategy Board and Japan management team.  
• Six-Sigma Deployment Champion for Delphi Japan.

Delphi Japan – CFO & Administration Director

Country Responsibilities:
• Managed all finance functions including accounting, budgeting / forecasting and treasury.
• Lead development of cross-functional and cross-divisional Internal Control Review Board.
• Lead and supported strategic initiatives including venture development support, site enhancement, competitive analysis, transfer pricing, and cost reduction studies.
• Represented Japan in Asia-Pacific Financial Task Team.

Regional Responsibilities:
• Coached country CFO and staff to implement common financial reporting processes.
• Supervised and provided training for engineering / commercial / plant / site analysts.  Coordinated regional financial training programs for the sector in the Asia-Pacific region.
• Coordinated the regional budget, business plan, and capital management process.
• Supported development of common financial practices among ventures including:  Loan monitoring, F/X and cash management, compliance with accounting principles, report submission, etc. Provided regional oversight of venture risk exposure.

Asia-Pacific Senior Finance Mgr.

Executive Coach | MBA Professor | Ex-Global CFO

I help senior leaders master complexity, elevate strategic impact, and lead with authentic authority.

I bring over 25 years of C-level and boardroom experience as a former Global CFO for a $5B publicly traded company, combined with a deep commitment to human-centered leadership development.

Today, I coach global executives, CEOs, and leadership teams — specializing in executive transitions, strategic leadership, high-performance teams, and Asian leadership development.

I am also an MBA Professor of Leadership and Strategic Management, blending research-driven frameworks with boardroom-tested insights to develop transformational leaders.

Based in Kyoto, fluent in English, Urdu, and Japanese.

Connect with me: arif@thecfocoach.jp

Website: www.thecfocoach.jp (please sign up on my mailing list to receive future announcements and newsletters)

Arif Iqball

My path:
Age 12: I built my first computer
Age 15: I started a small business making first websites for local orgs with HTML and JavaScript
Age 16: I learned C++ and made some primitive games
Age 22: I graduated from RPI with a degree in computer and electrical engineering and took a job that seemed cool working on designing and building a US Navy destroyer
Age 23: Finished chemo and hit remission from Hodgkin's Disease and took a hard look in the mirror
Age 25: Finished a masters in biomedical engineering at Hopkins, focusing on AI and machine learning for medical imaging 
Age 26: Had my first big win in engineering & medicine – invented a modular MRI-compatible exercise device for muscle testing and digital biomarkers
Age 27: Got into UMass medical school on my 3rd try, pursuing neuropsychiatry
Age 30: Built an electronic health record (EHR) while in medical school for a Boston-based company, my first foray into healthcare entrepreneurship and technology-enabled care models
Age 34: Built my first health-tech company, NeuroLex, using voice as a digital biomarker to detect neurodegeneration and disease earlier
Age 36: Finished residency and fellowship at University of Washington and founded a specialized dementia clinic for EvergreenHealth, applying clinical neuropsychiatry expertise
Age 37: Sold NeuroLex and helped build BrainCheck, a digital cognitive assessment technology company pioneering digital biomarkers for dementia assessment
Age 38: Founded and bootstrapped Frontier Psychiatry and grew it to 75 staff and 5k patients/month diving into innovative technology-enabled care models and healthcare leadership
Age 40: Raised a series A and transitioned to scaling mode, implementing value-based care approaches and quality improvement methodologies
Age 41: Handed off Frontier Psychiatry and Founded MedFlow, a workflow automation company for healthcare transformation and optimized care delivery systems

It's been a journey. 

My goal here is to share what I've learned in clinical neuropsychiatry, digital biomarkers, healthcare entrepreneurship, and healthcare leadership to move the needle on outcomes in healthcare, especially dementia care. Healthcare needs absolutely everyone's help to change the status quo. We need to demand better from our systems through technology-enabled care models and organizational change management.

For more information please follow me here and visit rezahg.com

Reza Ghomi

Alzheimer's doesn't start at 75.

It starts at 45.

You just don't notice until 30 years later.

Autopsies show: People in their 40s and 50s already have brain changes.

No symptoms. But the damage is accumulating.

By the time you notice memory problems at 75, you've had pathology for decades.

This is why midlife matters.

What happens in your brain at 45:

Amyloid plaques begin forming
Tau tangles start accumulating
Neuroinflammation increases
Vascular changes begin

All invisible.

All progressive.

All happening right now if you're in your 40s or 50s.

The 20-year head start:

Alzheimer's gives you 20 years to prevent it.

From age 45-65: Brain is accumulating damage, but compensating.

From age 65-75: Compensation fails, symptoms emerge.

By 75: Too late to prevent, only slow.

At 45: You have time.

What to do in your 40s and 50s:

1. Control blood pressure (<120/80)
↳ High BP in midlife = 60% higher dementia risk
↳ Every 10mmHg matters

2. Fix your sleep
↳ 7-8 hours nightly
↳ Same schedule every day
↳ Brain clears toxic proteins during sleep

3. Build VO2 max
↳ Cardio fitness protects brain
↳ Target: 150 min/week moderate exercise
↳ Or 75 min vigorous

4. Manage insulin resistance early
↳ Test fasting insulin (goal <5)
↳ Time-restricted eating
↳ Strength training

5. Stay socially engaged
↳ Social isolation = 60% higher risk
↳ Regular meaningful interactions
↳ Not just screen time

These aren't "healthy aging tips."

These are Alzheimer's prevention strategies.

What I tell 45-year-old patients:

"Your brain in 30 years depends on what you do today."

Not genetics (only 5-10% of Alzheimer's is genetic).

Daily choices.

Sleep. Exercise. Blood pressure. Social connection.

The bottom line:

If you're 45-65 and think "I'll worry about dementia later":

Later is now.

The damage is starting.

But you have time to stop it.

⁉️ What's one thing you're doing in your 40s/50s for brain health?
♻️ Repost to help someone in midlife prevent Alzheimer's
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for midlife brain health

Reza Hosseini Ghomi, MD, MSE

Neuropsychiatrist | Engineer | 4x Health Tech Founder | Cancer Graduate - Follow to share what I’ve learned along the way.

Dancing is linked to a reduction in dementia risk by 76%.

Not walking. Not weights. Dancing.

76%.

I've diagnosed over 1,000 dementia cases. I tell every patient to exercise.

But I often give incomplete advice.

The research (Albert Einstein College of Medicine, following adults since the 1980s):

Dancing more than once weekly = 76% lower dementia risk
Playing instruments = 69% lower risk
Board games = 74% lower risk
Walking daily = 35% lower risk
Swimming regularly = 0% risk reduction

Why dancing wins:

Your brain does four things simultaneously:

Keeping rhythm (timing)
Remembering sequences (memory)
Navigating space (coordination)
Reading your partner (social cognition)

It's the only activity that challenges all four.

Here's what surprised me most:

You don't need to be good at it.

The benefit comes from the cognitive challenge, not the performance.

Bad dancing might be better because your brain works harder.

What counts as dancing:

Ballroom, salsa, swing, line dancing, folk dancing, even terrible wedding dancing.

20 minutes, twice weekly minimum.

What doesn't count:

Zumba classes where you follow an instructor (less cognitive demand)
Dancing alone (loses the social/coordination element)
Same routine every time (brain needs novelty)

The practical problem:

Most 70-year-olds won't sign up for dance classes.

"I have two left feet."
"My knees hurt."
"That's not for people like me."

But they'll walk. They'll do aqua aerobics. They'll lift weights.

All good. Just not as protective.

One approach:

Still recommend walking for cardiovascular health, strength training for fall prevention, swimming for joints.

But add: "Find a way to dance. Even badly. Especially badly."

Senior centers offer free classes.
YouTube has beginner videos.
Community centers run weekly socials.
Your living room works fine.

The evidence is clear:

45% of dementia cases are preventable through lifestyle changes.

Dancing is one of the most powerful interventions we have.

And it's free.

Best time to start was 20 years ago. Second best time is this week.

⁉️ When was the last time you danced?
♻️ Repost to convince one person to start dancing
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for evidence-based brain health strategies

Citations: Verghese et al. Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine. 2003.

The 5 lab tests I order for every patient worried about Alzheimer's.

Not the tests you'd expect.

Most doctors order specialty referral or brain imaging first.

I start with these blood tests.

Cheaper. Faster. Actionable.

Test 1: Hemoglobin A1c

Measures: 3-month average blood sugar

Why it matters: Every 1% increase in A1c increases dementia risk by 20-40%. Even in people without diabetes.

Target: Under 5.7% (ideally 5.0-5.5%)

What I do if elevated: Diet modification, exercise, metformin if prediabetic. See results in 90 days.

Test 2: ApoB (Apolipoprotein B)

Measures: Number of atherogenic particles in your blood

Why it matters: Better predictor of cardiovascular disease than LDL. Cardiovascular disease doubles dementia risk.

Target: Under 80 mg/dL (some experts say under 60 mg/dL)

What I do if elevated: Statins, ezetimibe, supplements, lifestyle modification depending on level.

Test 3: High-sensitivity CRP (hs-CRP)

Measures: Systemic inflammation

Why it matters: Chronic inflammation drives neurodegeneration.

Target: Under 1.0 mg/L (ideally under 0.5 mg/L)

What I do if elevated: Look for source. Treat sleep apnea. Optimize diet. Address metabolic dysfunction.

Test 4: Homocysteine

Measures: Amino acid that damages blood vessels when elevated

Why it matters: Elevated homocysteine independently increases dementia risk. Often easily correctable.

Target: Under 10 μmol/L (ideally under 8 μmol/L)

What I do if elevated: B vitamins (B6, B12, folate). Recheck in 3 months.

Test 5: APOE Genotype

Measures: Genetic risk for Alzheimer's

Why it matters: APOE4 carriers have 3-12x increased Alzheimer's risk. Changes prevention strategy.

Target: This is information, not a target

What I do if positive: More aggressive prevention. Earlier screening. Closer monitoring.

The tests I don't routinely order:

Specialized imaging (e.g. amyloid PET): $5,000+. Not covered by insurance. Doesn't change management in asymptomatic people.

Brain MRI: Useful for diagnosis. Less useful for prediction in healthy people.

Lumbar puncture: Too invasive for screening.

Total cost for my panel: $200-400 out of pocket if insurance doesn't cover.

Here's what this panel tells you:

Your metabolic health (A1c)
Your cardiovascular risk (ApoB)
Your inflammation status (hs-CRP)
Your vascular health (homocysteine)
Your genetic risk (APOE)

With this information, you can build a personalized prevention plan.

If your A1c is 6.0%, you know metabolic optimization is priority #1.

If your ApoB is 120 mg/dL, cardiovascular risk reduction becomes critical.

If you're APOE4 positive with high hs-CRP, aggressive anti-inflammatory strategies matter more.

You don't need $100,000 in testing to prevent dementia.

You need $300 in the right tests. And a plan based on what they show.

⁉️ Have you had any of these tests?
♻️ Repost to help others understand which tests actually matter for brain health
👉 Follow me (Reza Hosseini Ghomi, MD, MSE).

I track 12 biomarkers every 6 months.

Because I've diagnosed 1,000+ dementia cases and I'm terrified of becoming one.

Metabolic:
A1c: 5.2% (target: <5.7%)
Fasting glucose: 88 mg/dL (70-90)
Fasting insulin: 4.2 μIU/mL (<6)

Why: Every point A1c increase = 20-40% higher dementia risk. Insulin resistance drives neurodegeneration years before diabetes.

Cardiovascular:
ApoB: 60 mg/dL (<80)
LDL particle number: 920 nmol/L (<1000)
HDL: 61 mg/dL (>50)
Triglycerides: 68 mg/dL (<100)

Why: CV disease doubles dementia risk. ApoB and LDL particle number predict this better than standard cholesterol. Small dense LDL is more atherogenic.

Inflammation:
hs-CRP: 0.4 mg/L (<1.0)
Homocysteine: 7.8 μmol/L (<10)

Why: Chronic inflammation accelerates brain aging. Elevated homocysteine damages brain blood vessels.

Brain-specific:
Vitamin D: 59 ng/mL (40-60)
Vitamin B12: 680 pg/mL (>400)
TSH: 1.8 μIU/mL (1.0-2.5)

Why: Low vitamin D correlates with cognitive decline. B12 deficiency mimics dementia. Thyroid dysfunction impairs cognition.

Genetic:
APOE: ε3/ε3 (average risk)

What I do with this data:

When A1c crept to 5.6%:
Cut refined carbs, added 30 min daily walking. Dropped to 5.2% in 3 months.

When hs-CRP was 1.2 mg/L:
Adjusted or increased diet and exercise and addressed stress. Inflammation normalized.

When ApoB was 110 mg/dL:
Started low-dose rosuvastatin + ezetimibe. Now stable at 60 mg/dL.

Pattern: Measure. Find problems early. Fix before damage.

Cost: $300 every 6 months out of pocket. $600 annually.

Compare to $100,000+ annual cost of dementia care.

What you can do:

Ask your doctor to add ApoB, hs-CRP, homocysteine to annual labs.

If they won't, pay out of pocket. Worth it.

Get A1c checked even if not diabetic. Check vitamin D and B12. Track trends.

The mindset:

I track biomarkers to catch problems 5-10 years before symptoms.

That's the window where intervention works.

After symptoms: managing damage.
Before symptoms: preventing damage.

I'd rather prevent.

⁉️ Do you track any biomarkers regularly? Which ones matter most to you?
♻️ Repost if prevention beats treatment every time
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for practical longevity strategies

I diagnosed my first thousand dementia cases before I realized I was doing it wrong.

The diagnosis was right. The timing was wrong.

By the time patients reached my clinic, the window for meaningful intervention had mostly closed.

The patient: Robert, 73. Retired engineer.

His wife: "Forgetting things. Repeating questions. Confused paying bills."

Standard workup:
MOCA 21/30 (moderate impairment)
Brain MRI: Moderate atrophy (especially in a pattern consistent with Alzheimer's)
Diagnosis: Probable Alzheimer's, moderate stage

I prescribed donepezil. Discussed prognosis. Provided resources.

Standard care. Good care.

But symptoms started "maybe 2 years ago."

By the time he reached me, he'd lost 2+ years of brain function.

Fast forward 10 years. Now I see Robert's equivalent 5 years earlier.

"Bit more forgetful. Takes longer to find words. Nothing dramatic."

MOCA 27/30 (mild impairment)

But I look differently now:

A1c: 6.2% (prediabetic)
ApoB: 125 mg/dL (high CV risk)
hs-CRP: 3.2 mg/L (inflammation)
Sleep study: Moderate apnea

His brain isn't failing from Alzheimer's alone. His body is failing his brain.

The intervention:

Treat sleep apnea. Lower A1c. Reduce CV risk. Address inflammation. Mediterranean diet. Exercise program.

Did this cure early Alzheimer's? No.

Did it buy 3-5 years of better function? Probably yes.

The difference:

Old: Diagnose when obvious. Prescribe meds. Manage decline.

New: Identify when subtle. Address reversible factors. Optimize brain health.

Same patient. 5 years apart. Different trajectory.

What changed my practice:

By the time dementia is obvious, I've missed the window.

The goal is earlier identification plus aggressive treatment of everything making it worse.

I can't cure Alzheimer's. But I can treat sleep apnea, hypertension, diabetes, inflammation early.

When I treat those early, cognitive decline often stabilizes.

Thousands of Roberts I diagnosed correctly but too late. I can't give them those 5 years back.

But I can change how I practice and tell other doctors: Stop waiting for obvious dementia before you intervene.

⁉️ If you could detect dementia risk 5-10 years early, would you want to know?
♻️ Repost if early detection matters more than late diagnosis
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for clinical insights from 15 years of dementia care

Study published 6 days ago: Hearing aids reduce dementia risk by 61% in people under 70.

The study (JAMA Neurology):

Framingham Heart Study followed 2,953 people for 20 years. 583 developed dementia.

Finding: People under 70 with hearing loss who used hearing aids had 61% lower dementia risk.

Why this matters:

Hearing loss is the largest modifiable dementia risk factor. Accounts for 8% of all dementia cases. More than smoking or hypertension.

But less than 20% of people who need hearing aids use them.

How hearing loss causes cognitive decline:

Brain works harder to decode unclear sounds, diverts resources from memory. Social isolation doubles dementia risk. Auditory areas shrink when not used.

The ACHIEVE trial (2023): 977 people aged 70-84. Hearing aids slowed cognitive decline by 48% over 3 years.

New finding: Younger people (under 70) benefit even more. 61% risk reduction. Earlier intervention = better outcomes.

What to do:

If over 50 and notice: asking people to repeat, trouble hearing in crowds, turning TV up, missing conversations, avoiding social situations.

Get hearing tested. Now.

Cost barrier dropped: OTC hearing aids legal since 2022. $200-1,000 vs $2,000-6,000 prescription. Available at Costco, CVS, Amazon.

What doctors miss:

I've diagnosed 1,000+ dementia cases. Rarely see hearing test results.

We check blood pressure every visit. Never hearing. System failure.

Prevention window:

Hearing loss at 55, get aids: Reduce dementia risk decades later.
Wait until 70: Missed 15 years of brain damage.

My practice changed:

Ask every patient over 50: "Trouble hearing?"
If yes: "Had hearing tested?"
No test: Order testing before focusing on memory.

Treat hearing loss BEFORE cognitive problems.

The numbers:

65% over 60 have hearing loss. Most don't know it.
Untreated: 2x dementia risk (mild), 3x (moderate), 5x (severe).
Treated: Risk drops to near-normal.

My take:

Spent years on brain scans, spinal taps, blood biomarkers.

Simplest intervention was hearing aids all along. $500 device, 61% risk reduction. No side effects. Over-the-counter.

Should be public health priority. Instead, Medicare doesn't cover. Backwards.

Start:

1. Get tested (free at Costco, audiologists)
2. Try OTC hearing aids
3. If OTC doesn't work, see audiologist
4. Wear consistently

Goal: Prevent 15-20 years brain damage from untreated hearing loss.

⁉️ When was last time you had hearing tested?
♻️ Repost if hearing aids should be covered by Medicare
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for practical dementia prevention

Citations: Francis L et al. Self-Reported Hearing Aid Use and Risk of Incident Dementia. JAMA Neurol. 2025.
Lin FR et al. Hearing intervention vs health education control to reduce cognitive decline. Lancet. 2023.

90% of healthcare startups fail within 3 years.

I've been the clinical advisor for dozens. Seen the pattern repeat.

They all make the same mistake:

They solve problems that don't exist.

Last month, a founder pitched me their AI tool.

"It predicts which dementia patients will decline fastest using machine learning."

Me: "Who pays for that?"
Them: "The healthcare system saves money by knowing."
Me: "Which department's budget?"
Them: Silence.

Dead company. They just don't know it yet.

The health tech graveyard is full of "revolutionary" ideas that failed basic business questions:

Google Health: Shut down twice
IBM Watson Health: Sold for parts
Microsoft HealthVault: Dead after 12 years
Theranos: Fraud
Forward Health: Bankrupt 2024

And these are just the ones that make headlines, there are thousands more that quietly fade.

Billions invested. Perfect technology.

Total failure.

Here's what kills health tech companies:

1. They build for the system they wish existed

Not the one that actually exists.

Example: AI diagnostic tools that are better than doctors.

Sounds great.

Except doctors don't get paid to be better. They get paid to see more patients faster.

Your tool makes them slower? They won't use it.

2. They underestimate regulatory timelines by 300%

Founders think:
"6 months for FDA clearance"

Reality:
"2 years, $500K in consulting fees, three rounds of revisions"

By then, they're out of money.

3. They ignore workflow integration

Your tool requires:
↳ Separate login
↳ Different EMR
↳ Extra documentation
↳ New training

Adoption rate: 0%

Clinicians will use terrible software if it's already in their workflow.

They won't use perfect software if it adds friction.

The companies that survive:

Solve boring problems.
Save time, not lives (at least initially).
Work with existing reimbursement.
Integrate with current EMRs.
Make adoption frictionless.

Real example of success:

Simple ambient AI scribe.

Listens to patient visit. Writes note. That's it.

Saves doctors 1-2 hours daily.
Pays for itself in productivity.
Works with any EMR.
Zero training needed.

Not sexy. Massively profitable.

The pattern I've seen:

Healthcare rewards incremental improvement at scale, not revolutionary disruption.

The founders who understand this build sustainable companies.

The ones chasing moonshots join the 90% failure rate.

If you're building in health tech:

Ask yourself:
- Who pays for this?
- Which budget line?
- How much of their budget?
- Do they have purchasing authority?
- What's the implementation timeline?
- How many stakeholders need to approve?

If you can't answer all of these, you're building a hobby.

Not a business.

⁉️ What's the worst health tech pitch you've heard?
♻️ Repost if you've seen great technology fail on basic business questions
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for realistic healthcare entrepreneurship advice

"It's just normal aging."

Most dangerous phrase I hear from families and PCPs(!). Because half the time, it's wrong.

The difference between normal aging and dementia is critical. Getting it wrong delays diagnosis by years.

Normal aging (nothing to worry about):

Occasionally forgetting where you put keys, briefly forgetting someone's name then remembering later, walking into room and forgetting why, needing to write things down more often.

Annoying. Not alarming. And more about attention issues that can be fixed.

Early dementia (need evaluation):

Forgetting recent conversations completely, not remembering forgetting, getting lost in familiar places, difficulty managing finances previously easy, personality changes.

These are not normal.

The key difference:

Normal aging: You forget where you put your keys.
Dementia: You forget what keys are for.

Normal aging: You forget someone's name at a party.
Dementia: You don't recognize your daughter.

Normal aging: You walk into a room and forget why.
Dementia: You can't remember how you got there.

Real examples:

Sarah, 71: "I keep forgetting if I took my morning pills."
Me: "Do you use a pill box?"
Sarah: "Yes, I just forget to check it."
Diagnosis: Normal aging. Solution: Phone alarm.

Robert, 73: "I don't remember taking pills. What pills?"
Me: "Your blood pressure medication. You've taken it for 10 years."
Robert: "I have high blood pressure?"
Diagnosis: Dementia. His wife had been managing medications for 2 years without telling him.

One test (not perfect) I use:

"Are you worried about your memory?" If yes: Awareness intact.

"Is your family worried?" If yes, but person isn't: Lack of insight.

People with dementia often don't notice their decline. Family does.

The "it's just getting old" trap:

Families excuse problems because "Dad's 80, of course he forgets things."

But 80-year-olds with normal aging: Remember yesterday's conversation, manage finances, don't get lost driving home, recognize family, complete familiar tasks.

What to do:

Start with primary care. Simple cognitive testing. Takes 15 minutes.

The earlier you catch it: More treatment options, time to plan, better outcomes, more years of independence.

The tragedy:

I diagnose people in moderate stage every week. Family says: "We thought it was normal aging."

By then, we've lost 3-5 years of potential intervention.

Subtle signs families miss:

Repeating same questions in one hour, forgetting grandchildren's names, getting lost in own neighborhood, unopened mail piling up, forgetting to eat meals, wearing same clothes multiple days, unusual suspicion.

Not normal at any age.

Trust your instincts. You know your family member better than anyone.

⁉️ Do you know the difference between normal aging and dementia?
♻️ Repost so families don't miss early warning signs
👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for practical dementia insights

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The Battle

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Reza Ghomi

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taplio

The Battle

Arif Iqball

Reza Ghomi

Followers

Posts

Engagements

Likes

Performance Score.css-goub6s{font-size:var(--chakra-fontSizes-md);font-weight:500;color:var(--chakra-colors-gray-600);display:block;margin-top:var(--chakra-space-1);}Reza Ghomi's LinkedIn Performance

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Performance ScoreReza Ghomi's LinkedIn Performance