Becca Shmukler is a Principal at Laerdal Million Lives Fund, which is a $100M venture capital fund investing in commercial-stage healthcare startups with disruptive, data-driven technologies that enable the right care at the right time to achieve maximum life-saving impact. She has extensive experience in the healthcare industry ranging from consulting and business development to investing. In March 2022, Becca sat down with Connie Chan, a Fund Manager at BRV, to discuss her diverse experience in the healthcare industry, share her perspective on the challenges women investors and founders face today, and provide tips for those who are interested in a career in VC.

What was your experience prior to joining venture capital (VC), and how has that career journey led you to your role as a healthcare investor today?

I landed into VC somewhat unintentionally – I’d call it a very happy accident. I started my career in consulting at the Advisory Board Company (ABC), working with hospitals and healthcare system executives on high-level strategic issues. In my early twenties with no work experience, I was forced to lead interviews and conversations with health system’s CEOs and this experience really allowed me to learn a lot about the healthcare industry and its many complexities. It was very clear for me early on that this was an industry that I wanted to sink my teeth into.

I was at ABC for three years, and then I did a brief stint at a specialty physician society. In contrast to my previous experience focusing on what health system CEOs were thinking about for ten years into the future, this experience brought me back down to earth to consider what an average physician is thinking about day-to-day, such as decreasing time spent on paperwork, in the EMR, and on operational issues relative to time spent with patients and performing clinical tasks. While in this role, I did a lot of thinking about how I can help to really solve one of the many problems our healthcare system is facing. I became very focused on the importance of price and quality transparency for healthcare consumers, which led me to join Castlight Health, and I moved to San Francisco.

At Castlight, I had learned about how a startup operates and better understood the dynamics between startups and big enterprise partners via my role managing Castlight’s payer partnerships. That led into my next role at Rock Health, a seed-stage digital health investment fund, where I led the Partnerships and Business Development teams. Although I wasn’t on the Investment team at Rock Health, one of the coolest things about Rock Health is that everyone can join the meetings with startup founders and provide their perspectives – I found this super fascinating and motivating. I don’t have it in my DNA to found a company, and I have tremendous respect for people who do, especially in healthcare when there is an impact, mission or personal story that is driving their desire to start something. I loved how this experienced allowed me to mix both the social and analytical parts of my brain, and after a few years at Rock Health was very fortunate to have the opportunity to move into healthcare venture full-time. That was two years ago. I joined the Million Lives Fund in March 2020.

What does your day-to-day look like and what’s your favorite part of your role as a VC investor?

There are 4 of us on the team – one Managing Partner, two Principals, including me, and one Associate. We all do a bit of everything. I came into this role with many relationships, mostly through Rock Health and some through Castlight, so I spent a lot of time nurturing those relationships, helping to source deals, talking to VCs, taking initial calls with the founders, and looking through decks, but every day is very different. I also spend a lot of time looking through companies’ data rooms, scrutinizing their financial model and business plan, and performing exit analyses as we get more serious about the startups. We spend a lot of time with our LP as well. With distribution across U.S. hospitals and expertise in the healthcare industry, Laerdal can provide immense value to our portfolio companies, so we spend a lot of time with the business units and leadership at Laerdal. As we are progressing with different opportunities for investment, we’ll also have third-party diligence calls to validate assumptions about the market and talk to customers, etc.

My favorite part of my job is the balance of my background in partnerships, business development, and relationship building, which I really enjoy, and the more analytical side – both qualitative and quantitative aspects of the decision-making process on an investment opportunity, and really pushing myself, both among other VCs and my own team. Honestly, I love this job.

What trends do you currently see and are most excited about in healthcare and venture capital?

One of our big focus areas for the fund is maternal health. As a new mom and given the sheer number of preventable deaths that occur around the world and in the U.S. related to childbirth, this is an area that I’m super passionate about. We have not yet made an investment in the space, but we’ve looked at many different companies and I’m especially interested in startups focused on the Medicaid population and serving Black women who are known to have far worse pregnancy outcomes in the U.S.  It’s not only an area of very high need but also high unnecessary cost due to pregnancy complications, such as preterm birth, preeclampsia or postpartum hemorrhage. NICU stays are also very expensive and traumatic for families. There’s a lot of avoidable cost that I believe can be removed from the maternity and infant care experience while simultaneously improving clinical outcomes and saving lives.

What challenges do you see female founders or female investors face today?

Venture capital is undoubtedly male-dominated, especially at the partner level. There are few funds with female partners, even in 2022. But there are many women rising through the ranks, and hopefully, that means we’re the future decision-makers in VC. I see it as it’s my role as a female VC to push my team, push our portfolio companies and push the companies that we are considering investing in to diversify their teams and boards. It’s not just the right thing to do, but it makes sense from a business perspective – 50% of the end users of most of the companies that we are investing in are women, and, sometimes, it’s more than that. It’s often said in healthcare that women are overwhelming the healthcare decision-makers for their families, but yet healthcare venture and startup leadership teams continue to be male-dominated. We need leadership teams and boards that can identify with the problems they are solving for their users and customers, and who represent a diversity of perspectives and experiences – from a gender, racial, ethnic, socioeconomic, etc. perspective. It’s our responsibility as investors to push companies and ourselves in that direction.

Sadly, only a fraction of the companies I meet with are female-founded, and I think there are many reasons for this. The age when one might be typically inspired to start a company coincides with when women might also be ready to start a family. I would imagine the idea of trying to do both at once is incredibly intimidating and probably seems impossible to a lot of women.

There’s also a role model issue for women – knowing that entrepreneurship is an option for them and seeing other women succeed as entrepreneurs. I think the more we can see women succeed as founders and fundraisers and eventually as public company founders, the more women will be inspired to start their own companies.

Having communities of women who can share ideas, collaborate, advise one another, and develop role models among one another is also important. I live in Atlanta now, but when I lived in San Francisco, I felt that it was much more typical to find other females in entrepreneurship and VC. In Atlanta, it’s mostly men when I go to mixers and events. But I recently joined a women operator & investor community in Atlanta and and it’s been really great. It’s small but everyone is super supportive of one another and genuinely wants to help. Some of us are moms and it’s really helpful to be able to share that experience, and I think it’s just not the same if you’re in a community that is mostly made up by men.

What tips could you provide to professionals or students who are interested in working in venture capital?

Being in VC is very competitive right now, and it’s largely been a founders’ market over the last couple of years. Founders want to work with investors who can add value. My advice would be to focus on building up a skill set, background and experiences that can be value-additive to a founder and startup. Someone who can provide advice and tactical hands-on support from day one is the kind of VC that startups are going to be looking to work with.

Verticalization in VC is also increasingly becoming the norm. For example, I work for a healthcare venture fund, and there are other focuses such as climate tech, crypto or fintech, etc. Thus, I would recommend having a specialization area and really grow your knowledge base in that area. Have your own investment theses and think about areas of any industry you believe are primed for disruption or have massive commercial potential.

Additionally, focus on developing your network. VCs are looking for people who can join and start sourcing high quality companies for them on day one and if you can prove that you can do that, that’s tremendously valuable.

BRV Fund Manager, Connie Chan, interviewed Becca Shmukler in March 2022.