From Iron Rice Bowl to Innovation: Stories of Doctors Who Left the System to Build Health-Tech Startups

In recent years, we have frequently heard discussions about “global economic contraction” and a “severe domestic employment landscape.” Amidst widespread concern, the advantages of holding a “bianzhi” (state-sanctioned permanent position) have once again come to the forefront. The allure of this “iron rice bowl” lies in its stable income and benefits, broad career development opportunities, and notable social status.

Yet a group of professors, physicians, and researchers have voluntarily chosen to leave their “iron rice bowl” jobs, striving to carve out a niche for innovative research in the marketplace.

Three old friends shared their stories with VCBeat: Peng Yan, a former physician at a top-tier tertiary hospital, is now fully engaged in entrepreneurship in the field of digital therapeutics; Lu Feiyi, once a cardiologist, is now dedicated to operating a medical device company; and Zhan Yingcai, who previously worked in the burn department, is now fully committed to launching his own medical device venture.

They were once clinicians who chose to leave the “system” to start their own businesses. What choices have they made along the way?

I once worked at a top-tier tertiary hospital in Beijing. Every day, donning my white coat felt like winding up a clockwork mechanism, with my mind solely focused on how to save patients in the most efficient manner possible.

One day, the idea of starting a business suddenly came to me. There was no dramatic turn of events, nor any so-called soul-shaking epiphany; the thought simply emerged spontaneously. I deliberated for a long time over what venture to pursue, and ultimately chose the healthcare industry. After all, having studied medicine for many years, I am more familiar with this field.

For many people, the first hurdle in starting a full-time business is balancing opposition from their families, but I was lucky in this regard.

After returning home from work, I first shared my entrepreneurial plan with my parents. They did not immediately respond with a firm “No!” Instead, they advised me to proceed with caution—a reaction that was entirely expected. I was born into a military family; my father was among the first cohort of Chinese students sent to study in Japan after the founding of the People’s Republic of China. As a result, my upbringing was characterized by both open-mindedness and strict discipline. Later, my father meticulously analyzed the pros and cons for me. I still vividly remember how he put on his glasses and densely filled sheets of letter paper with a detailed comparison of the advantages and disadvantages of starting a business versus continuing in my current job, even extending his analysis to future development trends.

In that era (around 2003), a position as a physician in a Grade A tertiary hospital was considered an “iron rice bowl” job, highly coveted for its stability. Abandoning such existing “stability” to venture into the unknown required careful deliberation. Submitting my “letter of resignation” meant that nearly all my accumulated achievements would be reset to zero; nevertheless, I chose to embark on entrepreneurship.

From the moment I made my decision, my parents never again tried to dissuade me; instead, they have consistently supported me. My father could even be described as my first “angel investor.” Recently, I embarked on my third entrepreneurial venture. My previous two companies were ultimately acquired by well-known state-owned enterprises, which can be considered successful outcomes.

I have grown from a “startup novice” to someone capable of sharing entrepreneurial experiences with others. In my view, family support is crucial at every stage of entrepreneurship; at the very least, during critical moments when the business faces existential crises, it is the driving force that sustains my perseverance.

Approximately a decade ago (in 2013), I joined the hospital as a graduate student. Although this hospital does not carry the same widespread renown as Peking Union Medical College Hospital or Beijing Chaoyang Hospital, it ranks among the top institutions in the treatment of cardiopulmonary and vascular diseases. Here, I completed my master’s and doctoral research projects, encountered mentors and friends who greatly influenced my career, and was later fortunate enough to secure a position on the hospital’s staff.

If I were to trace the origins of my earliest entrepreneurial dream, I would say it began to take shape during my master’s studies. At that time, I worked on numerous research projects under my supervisor, most of which were interdisciplinary in nature. As I conducted this work, I often wondered: Could these research findings eventually be transformed into products and brought to market? Back then, the trend toward commercializing academic achievements was not as fervent as it is today. My inclination in this direction was not due to any forward-thinking mindset on my part, but rather because my supervisor intentionally steered our projects toward translational applications from the very outset.

Looking back, my mentor’s guidance on my research direction was also a significant factor in my eventual decision to pursue entrepreneurship full-time.

By the time I reached my doctoral studies, I had accumulated a network of contacts within the field and believed I was familiar with the process of translating scientific research into commercial applications, so I began attempting to do so. Unfortunately, luck was not on my side, and as expected, I failed. Undeterred, I made several more attempts, but the outcomes were largely similar: some projects failed to attract corporate interest; others, although noticed by companies, were not necessarily developed after acquisition, ultimately ending up as mere sheets of paper gathering dust in file stacks. At that point, I realized that relying solely on universities and hospitals was insufficient for successfully bringing products to market.

“Establishing a company to commercialize my own research” was what I had long aspired to do. However, holding a tenured position at the time made resignation far from easy. While the act of submitting a resignation letter was straightforward, the mental shift required was considerably more complex. Within the state system, workload and leisure are largely self-determined; one could indeed “coast” until retirement, albeit with reduced bonuses. In contrast, in entrepreneurship, any tendency to “coast” would lead to genuine unemployment.

What truly solidified my resolve to start a business was during the pandemic. Our hospital deployed doctors to the front lines of the anti-epidemic effort on a rotational basis, and after each shift, we would return to hotels for quarantine. During this period of isolation, I suddenly found myself with ample personal time, which allowed me to reflect on my future career plans.

I realized: It is extremely difficult for young doctors to stand out, as many physicians born in the 1970s have already secured senior positions. I also reflected that many of my PhD classmates ultimately did not pursue clinical careers; had I joined a hospital immediately after completing my master’s degree, I would likely hold an administrative or leadership position by now. In the end, I decided: I cannot let things drift by; I must give it a try.

After the pandemic, my mentor and I compiled our previous research achievements into a business plan (BP). Looking back now, it was quite rudimentary. However, some investors found our project promising, so I was fortunate enough to receive my first angel investment in 2021, marking the true start of my entrepreneurial journey.

In the early days of my startup, I didn’t actually work on it full-time; I continued working at the hospital, dedicating all my spare time to the venture. After a year of this arrangement, as the company gradually gained momentum and demanded more energy, I found myself stretched too thin and ultimately submitted my resignation to the hospital. Sometimes I look back and wonder: if the company hadn’t been performing well back then, would I have returned to practicing medicine? Perhaps I would have.

When I submitted my resignation to the hospital, my colleagues were quite surprised—having worked in clinical practice for nearly a decade and participated in numerous large-scale medical projects, I was arguably doing quite well. Nevertheless, I chose to embark on an entrepreneurial venture.

The impetus for entrepreneurship was, in fact, hidden within the minutiae of daily work. I previously worked in the burn unit, where I witnessed considerable human suffering, and the treatment processes often caused significant discomfort to patients. In the early stages of my career, my hands would tremble with nervousness when attending to severely injured patients. Over time, however, I gradually became accustomed to such situations. Occasionally, we physicians would discuss among ourselves in the office: if there were dressings capable of achieving hemostasis more rapidly, patients could endure less suffering; if the equipment were more advanced, wound recovery outcomes could be improved...

At that time, I often paid attention to the sparks of inspiration that emerged during casual conversations, eager to bring them all to fruition. Unfortunately, my ambitions exceeded my capacity, as my primary mission remained the treatment and care of patients.

Later, I participated in the emergency response for major casualties from a large-scale explosion. During the rescue efforts, nearly everyone in the burn department was working around the clock; I lost count of how many burn patients I treated. Due to significant attention from all sectors of society, the burn victims of this explosion received excellent medical care.

But this also raises a question: what should burn patients do when township hospitals with limited medical resources lack specialized burn departments?

In general, there is only so much an individual physician can do. It is by translating research findings into clinical practice that we can enable more people to benefit from advances in medicine. Thus, the idea of entrepreneurship once again came to mind.

What truly prompted me to take the leap into entrepreneurship was a friend I had known for ten years. After graduation, he embarked on an entrepreneurial path, building several moderately successful companies over the years. When he ventured into the burn rehabilitation sector, he reached out to me in my capacity as a clinician. Upon hearing his plan, I agreed without hesitation.

The idea of starting a business has been buried in my heart for too long, and this time I finally found the opportunity to “sprout”. Besides, after being “stable” for so long, I always want to go out and see the world.

My friend is a seasoned entrepreneur who oversaw multiple market-oriented functions, including building our commercialization model, managing the company, and securing partnerships. Under his leadership, we navigated the journey relatively smoothly, though it remained a cautious, step-by-step process. We encountered several crises; without his experience and professional network, my “startup initiation” might have ended prematurely. Consequently, I initially hesitated to resign from my hospital position, fearing I would be left with nothing.

My part-time engagement continued until the company secured its first round of financing. I felt that our startup was gaining market recognition, and as business operations grew increasingly demanding, I found myself stretched too thin to manage both roles, which ultimately led me to leave my position in the public sector. I am certain that without the guidance of friends who paved the way, I would never have embarked on the entrepreneurial path. After all, among novice entrepreneurs, failures still constitute the majority.

Although my father had warned me beforehand that the path of entrepreneurship would be difficult, I only truly realized upon starting my own venture that entrepreneurship is no trivial matter.

I still maintain strong relationships with many of my former colleagues from my days as a physician. Occasionally, they mention their interest in leaving clinical practice to start their own ventures. In such cases, I usually advise them to think carefully, emphasizing that the most critical consideration is whether they have the capacity to bear the risk of failure.

This is a very realistic concern. After all, jobs within the state system offer security; at the very least, one will never face the predicament of being unable to afford basic necessities. Entrepreneurship, however, is different—it is a high-stakes endeavor where survival rates are extremely low. No one will go easy on you because you have formal professional training or because you are a woman; everyone is engaged in fierce competition. Sometimes, a minor decision-making error—such as choosing the wrong market segment, selecting the wrong partner, or even failing to secure a small contract—can trigger a butterfly effect that impacts the company’s development, or at the very least, plant hidden risks. Of course, no matter how cautious one is, setbacks are inevitable. I often tell my colleagues now, “If everything goes smoothly for a day, I actually feel it’s unreal.”

If you have clearly thought it through and can accept the sleepless nights before starting a business, the anxiety during its operation, and the steady decline after failure, then you may truly have what it takes to be an entrepreneur.

Beyond psychological resilience, I have observed that entrepreneurs share a common trait: strong learning agility—this was the first lesson “entrepreneurship” taught me.

When I was still a novice entrepreneur, I attended numerous lectures and sought advice from many industry leaders to integrate into new circles more quickly. I observed that successful entrepreneurs are swift in capitalizing on emerging trends; as soon as a nascent “hotspot” emerges in an unfamiliar field, they rapidly master it. Some cross-industry entrepreneurs quickly acquire new knowledge, at least enough to engage in preliminary discussions with insiders without exposing their lack of expertise.

At first, I could only learn by working overtime and burning the midnight oil. Later, I gradually found my footing: it was essential to distill a personalized methodology for learning, rapidly synthesizing new knowledge into formulas. No matter how successful one becomes, entrepreneurs must maintain a “beginner’s mind” to innovate amidst homogeneity.

If I were to offer some advice to aspiring entrepreneurs, I might say: “Entrepreneurship is a path of mutual selection. Your willingness to accept its risks signifies that you have chosen it, while your strong learning capacity indicates that it has chosen you. Moreover, there are many paths in life; success is not exclusive to entrepreneurship. The best path is the one that suits you.”

From Doctor to CEO: My Greatest Realization Is That There’s No Room for Slacking Off.

It would be disingenuous to claim that holding a position within the state-established personnel system is uncomfortable. Although the pressure of clinical consultations is substantial, requiring daily time commitments to stay abreast of new developments and handle tasks beyond direct medical care, one’s livelihood is invariably secure, regardless of how exhausting the work may be.

Entrepreneurship is not necessarily the case.

The hardships of entrepreneurship are no less than those of being a physician, yet the risks are far greater. I am accustomed to jotting down reminders in my phone’s calendar to avoid missing important appointments. Looking back at the calendar from the early days of my venture, each date is marked with a string of colored dots, each representing a critical meeting. Even during holidays, it was rare to have a single day entirely to myself.

In the early days of my startup, to avoid appearing inexperienced in front of investors, I would study “market jargon” at night after a full day of meetings—at least enough to project an air of “knowing the market.” Beyond acquiring market knowledge, I often took the initiative to understand developments in other sectors and learn about business management practices. After all, “learning” is the aspect of entrepreneurship that founders can control most effectively; lacking the ability to learn means losing a founder’s most fundamental competency.

However, effort and reward are not necessarily directly proportional. Sometimes, startup failures result not only from internal factors but also from external ones. For instance, shifts in policy direction, a decline in the chosen market sector, market contraction due to force majeure events, or fluctuations across the upstream and downstream supply chain can all lead to startup failure.

Yet I have always believed that as long as a product is solidly developed, it will always find new opportunities amid external changes—“where willows are dark and flowers bright, another village appears.” This is precisely why I have continued to prioritize scientific research and product innovation throughout my entrepreneurial journey.

Sometimes I wonder if my entrepreneurial path was actually paved by the fact that I didn’t achieve “major accolades” in the hospital. Had I attained fame and success there, I likely would have had no desire to start a business. Therefore, whether you are a physician or an entrepreneur, if you find yourself at an impasse, consider making some changes. This shift might just open the door to new opportunities.

"Read extensively but select carefully; accumulate deeply but release sparingly." Although I am currently just a "novice entrepreneur," my entrepreneurial journey has taught me that once the idea of starting a business takes root, one must prepare well in advance.

Having spent nearly a decade in clinical practice, I have accumulated extensive clinical experience and gained the deepest understanding of the pain points faced at the frontline.

At work, I always carry a notebook and pen, a professional habit shared by many physicians. When I encounter clinical challenges or have sudden insights, I jot them down. Occasionally, I also record my colleagues’ ideas for upgrading and improving existing products.

After launching our startup, a friend advised me that product pipeline strategy should not only follow market trends but, more critically, address unmet clinical needs. My notebook, in which I documented these clinical pain points and proposed solutions, unexpectedly became the “compass” guiding our entrepreneurial journey.

This is the advantage that “early preparation” has brought me, while I also suffer from some instances of “lack of preparation.”

Had I known earlier that I would embark on the path of full-time entrepreneurship, I would have actively expanded my professional network. Before a friend asked me to co-found a startup with him, I had hardly any contact with individuals in the “marketing circle.”

This is, in fact, a very realistic issue; every profession likely has its own “information cocoon.”

"As a burn care clinician, my social circle is largely confined to colleagues within my hospital or other physicians working in burn departments elsewhere. This insular network has limited my exposure to the market knowledge essential for entrepreneurship, making the transition from clinician to CEO particularly challenging."

Most fundamentally, had it not been for the invitation from the market circle, I might never have had the opportunity to enter this industry, let alone embark on an entrepreneurial journey as I have done today.

Everyone is familiar with the idiom “burning one’s boats.” Indecisiveness often hinders success; it is better to press forward with unwavering determination from the outset, leaving no room for regret. Thus, I have never experienced regret since embarking on my entrepreneurial journey—perhaps due in part to the military-style upbringing I received in my family.

During the entrepreneurial journey, numerous decisions must be made. Poor decision-making can sometimes lead to financial losses or plunge a company into crisis. However, I believe that as long as errors are not fatal, they are reversible. At times, plans may appear promising on paper but fail to deliver in practice; in such cases, it is crucial to cut losses promptly. Entrepreneurship is essentially a continuous process of correcting mistakes. It suffices to strive for resolution during crises, learn from these experiences, and minimize future errors.

Frankly speaking, I have had moments of regret. This was not because entrepreneurship is exhausting—after all, working as a clinician is no easy feat either—but primarily because the risks involved in starting a business are substantial; I essentially staked everything on this venture. Fortunately, my determination to succeed was strong enough to overcome those feelings of regret.

My determination to start a business stems primarily from the pursuit of self-actualization. In hospitals, especially during the first decade of their careers, young doctors are prone to “functional narrowing,” whereby they become capable only of practicing medicine within the hospital setting and struggle to function outside it, with their perspectives confined to the operating table. I am well aware that this is not what I aspire to.

Entrepreneurship is distinct; while it may end in failure, the skills acquired and the broader perspective gained by entrepreneurs are invaluable. Even if one fails, one can always start anew. Life requires challenges to reveal different vistas.

Since starting my venture, I have never had any regrets. Of course, it may also be because I am too exhausted to have the leisure time to dwell on regret.

The exhaustion of clinicians starting businesses lies not in the intensity of work, but in how to get used to the transition of identity. As a doctor before, I only needed to face patients and diseases. Once the patient was cured, my task was completed. However, being a CEO is different; every day requires focusing on R&D, observing the market, and dealing with employees, shareholders, investors... To be honest, when I first became a CEO, I almost had a breakdown.

I embarked on full-time entrepreneurship in 2021, and it was not until the end of 2022 that I gradually adapted to the pace of a CEO’s work. This year, I have slowly begun to find my footing. Overall, the transition in identity has been a painful process, but only by breaking free from the cocoon can one emerge as a butterfly; only by stepping out of one’s comfort zone can one discover a broader horizon.

After speaking with three friends, we found that while their triggers for starting businesses varied, they shared one common goal: to leverage entrepreneurship to extend the benefits of healthcare to more people. Physician entrepreneurs holding this vision are far from few. With favorable policies promoting the commercialization of scientific research achievements being introduced frequently, the “roadblocks” to physician entrepreneurship are being cleared away step by step. An increasing number of doctors are “bravely” venturing out, becoming a veritable “symbol” of industry development.

Furthermore, everyone emphasized the importance of learning agility. It is essential to acquire new market knowledge while also learning to embrace mistakes. Setbacks are inevitable; only by fostering a tolerance for error can one dare to experiment, and it is through such experimentation that one moves closer to success.

Peng Yan’s third entrepreneurial venture has reached a critical juncture; she is focusing on the mental health of children and adolescents, leveraging digital therapeutics to tackle brain disorders.

Lu Feiyi’s company secured tens of millions in financing this year. He continues to work under his former master’s and doctoral supervisor, who is now the co-founder of the company, exploring innovations in the field of implantable and interventional medical devices.

Zhan Yingcai is no longer bewildered by the changes in his identity. Under his leadership, the company has obtained approval for three products and reached multiple Grade A tertiary hospitals, driving innovation in wound repair.

Unknowingly, they have been moving closer to their original vision of “enabling more people to benefit from the conveniences of medical innovation.” And since they are only “approaching” it, they are still on their journey.

Note: All names used in this article are pseudonyms.