How Figure 1 plans to go global with its “Instagram for doctors”

Cofounder Gregory Levey talks about building a user base the right way, and the company’s global ambitions

Figure 1 cofounder Gregory Levey

Figure 1 cofounder Gregory Levey. (Figure 1)

Recently, Toronto-based health care startup Figure 1 reached an important milestone: more than 500,000 medical professionals are now using its app, up from 150,000 users a year ago.

Joshua Landy, Richard Penner and Gregory Levey launched Figure 1 in May, 2013. Landy, a physician, came up with the idea while he was studying the smartphone habits of doctors at Stanford University in 2012. Shortly after, he invited Penner and Levey to join him and run the technical and business sides of the company.

The purpose of Figure 1 is to allow physicians to upload and share pictures of a brain scan or a patient case from their smartphone, so they could easily show it to their colleagues or consult with other verified medical professionals. Since the launch, it’s become a hit among medical students and physicians in North America. Four out of 10 U.S. medical students use the app, and members have now collectively viewed shared images one billion times.

Figure 1—named one of Canadian Business’s 15 most innovative companies of 2015—has raised more than $10 million from investors in North America, and currently has 26 employees. Gregory Levey, one of the founders responsible for Figure 1’s business operations, shares with us his advice on how a tech startup can grow its user base, and how Figure 1 plans to reach even more medical professionals in big cities and rural regions.

What’s your first advice for a startup trying to achieve more users?

An early lesson I learned from one of our investors is that you don’t want a leaky bucket. If you’re getting tons of new users, and they’re all leaving—use the app once and never come back—that’s useless, and not what you want. That top-line number, 500,000 users, is kind of a vanity metric in some ways. We’re proud of it, but we’re far more proud of our engagement and how many users continue to use it. So we’re at 50,000 daily, and that to me is far more important, because people actually use it.

We were pretty lucky right from the get-go. We had pretty good retention and engagement numbers compared to most apps that follow a predictable curve that diminishes down pretty quickly. We want to prevent that, because there’s no point in putting top line numbers if they’re all going to leave anyway.

Lesson two is to get out of the building. A lot of people, especially developers, are just interested in building what they believe is a great product. Maybe they’ve talked to a friend or two, or just think it’s a great product, then they go build it and wonder why no one is coming. I took a class in business school with a guy named Steve Blank, who’s like the startup guru. His mantra is to “get out of the building.” Just stop sitting there coding or whatever it is you’re doing and get out of the building and talk to users. We spent a ton of a time on that, way before we launched, beta-testing with lots of doctors. Luckily, my co-founder Joshua Landy is a physician, so he has a wide network of them. We also reached out to others who we thought were technologically savvy, so way before we launched, we were making sure they were on there, getting feedback, and making sure that they could see this is useful, and it wasn’t just a leaky bucket.

Now two years out, we continue to do that, almost daily, where we have phone calls with users. Yesterday, we had a user here doing testing, where we watched how they used the app on the phone. People say and do different things and make subconscious decisions they’re not even aware of. Let’s say your app is a bit slower than it should be, then the user might not come back because they’re annoyed by it. But they may not even realize that’s why they leave, but you can test those things using data. So really digging in and see what users want, and getting out of the building to make sure the app is what the users want and is solving a problem in their lives.

Too many apps, especially in healthcare, try to solve a problem that doctors don’t actually need. Now, we have a second full-time physician on our team, in addition to our co-founder, and a practicing nurse who splits their time at the hospital and at the company, and a nursing student doing the same thing. So we got these people embedded in the field who are giving us feedbacks, and our users.

And lesson three is to make sure the product is good enough that people tell each other about it. I hate the term “growth hacking” where you use tricks to tactically increase your numbers. The bigger way to do it is to just make sure your app is good enough that people are actually telling their friends and colleagues. Rather than these short-term superficial growth hacks, it’s much better to make the product awesome. Because we can track where a lot of our growth comes from, but there’s a ton of it where we have no idea where it comes from. But when we ask people how did they hear about Figure 1 in our user interviews, they’d say “my med school classmate showed it to me,” or doctors who hear about it from residence and med students. There’s no way for us to track these word of mouth referrals, which happened because our product fills a need and people like it, and that’s the most important thing. We learned that once the product is in a hospital or med school, it just spreads like wildfire.


You were quoted by The Globe and Mail saying Figure 1 wants to own healthcare, and get tens of millions of medical professions from around the world using the app in the future. How do you intend to do that?

We’re going to continue doing much of the stuff we have been doing and optimize it. After we raised more money, we hired a data scientist and more developers so we can follow the data and use it to guide us. Another important thing is we’re going to start localizing and get the app in various languages. We already have a ton of Brazilian users, but if it was in Portuguese, they’d probably use it more. We’re going to start localizing and prioritize Portuguese, Spanish and Mandarin, because of the large population, and also because we’ve had a great reception in Brazil, in particular, so we want to cater to that. That’s going to be our big emphasis in the coming six months. We just hired one person, whose full-time job is going to help us grow internationally, because we really see ourself as a global app.

How do you plan to deal with the privacy and legal issues that come with expanding into various countries?

It’s a big headache, but it’s also our competitive advantage because we dealt with it early on aggressively, making it harder for our competitors to catch up. Our 16th employee was a lawyer, and people raise eyebrows, but I have no doubt it was the right decision. Our lawyer has a background in international law and interacts with 30 lawyers globally, so we now have lawyers all over the world. Right now, she’s dealing with lawyers in South Korea to get ready to launch there. We have done the legal diligence in 100 countries, so while it’s a headache and it’s costly, but we know that we’re on firm footing legally all over the world. One more thing, right from the get go, we’ve structured things such that they’d be applicable globally, where we could quickly make small changes to the app in various countries to fit their own legal systems.

All the journalists have been asking you this: how do you plan to monetize Figure 1?

We have famously patient investors. Our investor Union Square Ventures has also funded Twitter and Tumblr, two very successful services that took a long time to concentrate on monetization. and we’re no different. We get requests almost daily for various monetization strategies and we started having these conversations, but we’re not pulling the trigger yet. The focus right now is to build a large, engaged network, and these are extremely valuable eyeballs and users. But we want to treat them with respect, and make the user experience the most important thing, but we know from the emails we get everyday that there’s a lot of people who have things in mind that they’d be willing to pay for. So we’ll get there, but probably not for at least a year.

You have a law degree and an MBA, and have worked as a journalist, a professor, and a speechwriter for the Israeli Delegation to the United Nations before Figure 1. Do you intend to stay in your new role at Figure 1 for a long time?

This maybe the most exciting thing I’ve ever done, and it’s not because of economic reasons. We’re doing something really meaningful. Literally every day, we’re hearing about lives that were saved, not because of Figure 1, but helped by Figure 1. And it’s just so cool. You mentioned my background is very diverse, but this really employs a lot of stuff altogether. I use both my law degree and MBA on my job, and am probably more involved in our communication than our communications team would like. Also, the international aspect of this is very interesting to me, as my first job was with the UN in my early 20s. This year, I’ve gone to Prague, London and India for Figure 1 business, so I’m having a great time and also doing something really meaningful. I’d love to be doing this 20 years from now if we’re lucky and successful in what we do, and have Figure 1 be a noble and helpful force in healthcare.