U.S. Presidents Failed to Solve This, But I Can't Quit. | MedMe Health, Purya Sarmadi
In a Nutshell
Purya Sarmadi built MedMe Health through four pivots because he had deep conviction in the pharmacy market, learning that founders should persist with the right market while iterating to find the right wedge. His mother's heart valve surgery and lifelong reliance on pharmacists revealed that pharmacies are underutilized community healthcare hubs, and MedMe's software now enables clinical services like INR monitoring across 4,500+ locations. The most critical lesson is protecting co-founder relationships—blame and criticism can extinguish motivation, whereas mutual support through ups and downs is essential for long-term survival.
These notes were generated by AI and may contain inaccuracies.
Purya Sarmadi went through four different pivots with MedMe, but conviction for the market only grew throughout. The advice given is: if you have conviction around the market, don't give up on the market. Healthcare and vertical SaaS may appear unsexy from the outside, but the decision to build in healthcare was driven by personal experience—Sarmadi's mother had a heart valve failure when he was around 6 or 7 years old.
Every pivot provided more information about pharmacies, pharmacists, and their patients. This information helped narrow down which wedge was most important. The key lesson is: if you're a first-time founder, don't mistake being in the wrong wedge as being in the wrong market. You might be in the right market with conviction about that market, but simply on the wrong wedge.
Purya Sarmadi is the CEO and co-founder of MedMe Health. MedMe serves over 4,500 pharmacies across North America. The company powers operations, integrations, and automations to transform drug dispensaries into community healthcare hubs.
Sarmadi was born in Cologne, Germany. The family moved from Germany to Canada when he was around 6 or 7 years old. Not long after the move, his mother experienced heart valve failure, creating a complicated period for her and the family. Many surgeons were hesitant to operate due to the risk. They presented things in an optimistic yet realistic light.
A vivid memory from that time was the fear in Sarmadi's father's eyes—the fear that he might have to raise two kids alone if things didn't go well. There was significant uncertainty. As a child around age eight, Sarmadi could feel the situation but lacked the ability to enact change, creating a feeling of helplessness.
One surgeon stood out with confidence in his ability to help—Dr. Tyrone David, a legendary surgeon. After the surgery, Sarmadi had the opportunity to meet Dr. David and shake his hand as a young child. This created a vivid memory and realization that Dr. David, through his impact, not only saved Sarmadi's mother's life directly but had a rippling effect on everyone who relied on her—including Sarmadi, his father, his sister, and his mother's younger siblings (she is the oldest of five).
The feeling that through healthcare you can have large impact on people stuck with Sarmadi. Growing up, he wanted to be a cardiovascular surgeon because of that experience. Later, he realized he did not have the steadiest hand and had trouble with sleep, which would not make for a great surgeon.
Sarmadi was always passionate about technology. He concluded that making a really scalable impact might come from doubling down on technology and data science to create impact at a larger scale. Combining that with his passion for healthcare drove his career and eventually led to starting MedMe.
After heart valve surgery, Sarmadi's mother received a mechanical valve. People living with mechanical valves must check their INR (a measure of blood viscosity) through diagnostic testing weekly or bi-weekly. A strong memory throughout his life was his mother saying that while she saw new specialists, it was always the pharmacist who knew the most about her holistic treatment.
What did not make sense was why his mother could not receive that diagnostic service at the pharmacy. Sarmadi developed strong conviction that pharmacies were underutilized and that there was an underserved need for what pharmacies could do for the public, as they were functioning only as drug dispensaries. He believed they could be far more. 95% of North Americans live within 5 miles of a pharmacy.
The very first iteration of MedMe, conceived in 2018 (pre-LLMs), was to scan prescriptions and automatically handle data entry. The business problem was real, but the technology was not viable at the time. This led to a pivot to a physical product related to drug adherence. Hardware is hard due to high starting capital costs, which is why they pivoted away from that iteration.
Through conversations with pharmacists and pharmacies, they realized there was a need for clinical care for the community and patient panels, but pharmacies lacked time to provide it. This led to the pivot closest to what MedMe is today: providing software to pharmacies to give them capacity and tools for consultative care to patients.
Sarmadi was looking for the one problem that could be served with one solution for one customer. The test was: if you said "Hey, we won't exist tomorrow" and they responded that their life would be worse, then you knew you had the right wedge. In Ontario, they were introduced to someone in Alberta who canceled four different subscriptions he had been using and switched entirely to MedMe. This confirmed they had solved an underserved problem with their solution for that one ICP.
Every pivot provided more information about pharmacies, pharmacists, and patients—all part of the same dataset. What changed was the wedge. This helped narrow down the most important wedge. The lesson: don't mistake being in the wrong wedge as being in the wrong market. You might be in the right market but on the wrong wedge.
A few months later, COVID happened, proving out the thesis. A broad network of pharmacies across the continent had to become sites for physical clinical services—vaccines and point-of-care testing—to respond to the pandemic. In a 2.5-month period, MedMe grew from near 100 pharmacies to almost 1,200 pharmacies.
What was important was building conviction both personally and functionally pivoting through which wedge made the most sense. As long as you find the right wedge, you have an avenue to build on that wedge and capture a much larger market opportunity over time. The advice is to really spend the time to figure out you're building the right thing.
The rippling impact felt from Dr. David is a core part of what drives Sarmadi and is a core tenant of MedMe's mission: to systemically change healthcare access for over 100 million people.
Every dot on a referenced map represents a pharmacy that closed just last year. Sarmadi states the industry is not collapsing but being disrupted and transforming. One big motivator for MedMe's timing was the rise of online pharmacies that were direct-to-consumer with big marketing budgets and better unit economics and logistics. Drug margins were shrinking, online pharmacies were accelerating, there was a shortage of primary care, and chronic illness was increasing.
Patients were looking for proactive, personalized, and consumer-driven healthcare products and services. The resurgence will come from pharmacies investing in the clinical side—patients returning not only for drugs but for flu shots, A1C level checks, consultations on blood monitoring devices, glucose monitors, and blood pressure monitors. These pharmacies will thrive because of enduring lifetime value and patient relationships.
One thing that will never be replaced is the human element of patient care. The trusted healthcare practitioner who knows your longitudinal care history, likes and dislikes, and family is hard to replace. That is what makes pharmacies indispensable. In Nova Scotia, patients like Sarmadi's mother who are on blood thinners can go to the pharmacy for INR monitoring using MedMe today. Patients across growing jurisdictions in North America can now rely on pharmacies rather than emergency rooms, outpatient diagnostic centers, or urgent care centers.
In the AI era, optimistic early-stage founders see big market opportunities. AI is changing the playbook—old playbooks for industries may not be relevant today. However, for customers, AI is not changing their jobs to be done. Their jobs to be done remain the same. AI is giving the ability to solve a different or broader class of problems.
Most companies end because of co-founder breakups, which typically happen within a couple of years. Sarmadi met Nick via the Next 36, a startup accelerator in Canada. From the moment they met, they had complimentary skill sets, mutual respect, and mutual interest in the problem space. In the first week of the program in summer 2019, Sarmadi presented all the data collected through the pivots and convinced Nick to work on MedMe together rather than what Nick had been working on. Nick agreed.
Nick and Sarmadi have been together for 7 years and counting. There was a moment when Sarmadi became overly critical of something under Nick's purview. His frustration led him to frame it as "You're not capable of doing this, you've shown that you're not capable of doing this, I don't believe that you're capable of doing this." This type of messaging to a co-founder is really damaging. It can defeat the co-founder, and you never want to defeat your co-founder. Sarmadi learned this the hard way. That messaging can be very demotivating.
There is a big risk of defaulting to blaming the other person. That blame is counterintuitive and works against you. It works against the organization and against you because you are losing your number one ally. As a good co-founder, one main responsibility is to make sure both your and your co-founder's candle stays alight. The ups and downs of a startup will sometimes make that candle more fierce and the flame stronger. During down parts, the candle dwindles. You have to do anything you can to keep those flames alight because if you don't, it is very hard to reignite the flame once it goes out.
Sometimes during trials and tribulations, not many people understand you. Family and friends cannot fully empathize with what you are going through as a C-suite member or founder. The person you can lean on most through those ups and downs is your co-founder. Having a co-founder to lean on makes a huge difference. Sarmadi referenced saying this in his wedding speech at Nick's wedding a couple months prior.
When COVID happened, MedMe had built an early-stage web app with independent pharmacies. An enterprise came to them needing a solution at enterprise scale. Nick built a prototype, pulling two all-nighters (72 hours of non-stop work) with Sarmadi. They demoed it to the leadership team, who asked when they could go live. They then had to tell their team they had 6 to 8 weeks to make it real. That first enterprise customer built trust and credibility to win subsequent enterprise customers.
Working side by side with Nick during that 72-hour period showed Sarmadi that Nick was the business partner needed. No matter the constraints, they would be able to take them on head-on and not only survive but thrive. The final advice: don't contribute to your co-founder's candle dwindling, because you are just working against yourself and your startup.
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