Patrick Kersten founded DOCTENA, a medical booking application used to make appointments with doctors. In the span of just three years, the Luxembourgish entrepreneur has launched the application in four countries—Luxembourg, Belgium, Netherlands, Switzerland—and a fifth market will be announced by the end of the year! The startup has become a European leader and a spearhead of the Luxembourg startup ecosystem. Having recently raised EUR 4.5 million and acquired DocBook, DOCTENA’s growth seems unstoppable.
(Featured Image: Patrick Kersten, CEO and Founder of DOCTENA / Image Credit © Olivier Minaire)
How are you, Patrick?
Very well, thank you. Everything is looking good at DOCTENA. We just opened in the Swiss market and already have our first customers. We have recorded growth of over 100% per year and are now a team of forty people. We lack space in our offices in Luxembourg! Our launch in 2013 already seems so long ago.
Did you expect DOCTENA to be such a success?
Not at all. I hoped for it, of course. But I did not expect that everything would happen as quick as it has. I can remember back to January 2014, when you interviewed me at an event that you organize—the famous Silicon Talk—and we had not yet even broached the subject of international development. Soon after, everything changed quickly and we embarked on the Belgian market barely a year after that.
“In Luxembourg, the high market penetration is thanks largely to use of the DOCTENA application. Fifteen percent of physicians in Luxembourg—which equates to about 2000—have an e-agenda.”
Why was your first international expansion in Belgium?
Because there was no one in front there! It makes sense to first develop where there is no competition. It was (and is still) not possible to go into France because there are already seven or eight players on the market. One thing is for sure, not all those players can survive.
How is the coordination of the four countries you’re in today going?
The development is going very well. We are present in Luxembourg, Belgium, the Netherlands and Switzerland and, by the end of 2016, we will announce the opening of a fifth country. The coordination of all these entities has made me travel a lot of kilometers. Just like most every other business, our business is based on people. We must put processes in place that help them to excel, and these processes will differ depending on the size of the business. The expertise of our CFO on this subject matter offers us a huge advantage.
“When joining a startup you’ve got to be prepared to be challenged and to not always feel 100% comfortable, as there are usually not formal processes in place at the beginning.”
Do you think putting such processes in place can kill the startup spirit?
The processes do not necessarily kill the startup spirit; we must find the right balance. You cannot grow a company without having clear processes in place. For example, organization of your finance team changes as it handles 10, then 100, then 1,000 contracts per month. It’s all about how you manage the workload. It’s not complicated to set up the processes, although DOCTENA has developed at breakneck speed. It is important to communicate this new organization both internally and externally. Whether young graduates or experienced employees, people may not be used to such rapid change. However, it is also what makes working with us exhilarating. When joining a startup you’ve got to be prepared to be challenged and to not always feel 100% comfortable, as there are usually not formal processes in place at the beginning.
And payroll and expenses?
It is clear that we are responsible for payroll, but the implementation of payroll and related costs does not slow down the development of business activities. This is especially the case in Luxembourg. In France, I might feel differently! Everything is a matter of planning. We must plan resources based on desired progressions. Even if you have intrapreneurs in your structure, they manage a budget and they know they must reach a goal on a budget.
“In Luxembourg, we say “a good donkey hits his head once. This means that we must learn from our mistakes and not repeat a mistake a second time.”
Let’s get back to the European development of DOCTENA. Did you plan for it?
We knew there was an opportunity. In fact, I expected there to be more entrepreneurs in this sector in other countries, as it is an exciting sector.
Yet this is an area in which you did not have experience, right?
Indeed, this is a new area for me. However, the job is exactly the same. We sell subscriptions. That’s what I previously did with real estate offers and job vacancies. My past experience taught me a lot. In Luxembourg, we say “a good donkey hits his head once.” This means that we must learn from our mistakes and not repeat a mistake a second time. It is a maxim that has remained true as I launch new projects.
What are the prospects for DOCTENA?
Grow, grow and then grow some more. In Europe, in our field, there are only two or three players who are credible and we are amongst them, which, for a company that started business in Luxembourg is quite rare. We intend to maintain our position.
“The recent growth of startups in Luxembourg is already impressive. I really feel and see it. I like to say that Luxembourg offers many more opportunities to entrepreneurs now than what was available five or ten years ago.”
What is your opinion regarding Luxembourg’s position on the European startup stage?
Abroad, people I meet do not even consider Luxembourg as a startup scene. There is simply not yet the critical mass for it. Why are the VCs in London? Because they have a larger pool of innovative projects on hand there. Nevertheless, the recent growth of startups in Luxembourg is already impressive. I really feel and see it. I like to say that Luxembourg offers many more opportunities to entrepreneurs now than what was available five or ten years ago. There are more and more support, incubation and acceleration programs, as well as financial investment. Media like your magazine and website was not there three or four years ago!
What can we do in order to have more startups in Luxembourg?
There are no miracles, you have to get them. Without naming them, fifteen years ago, some startups came to Luxembourg. Since then they have become big companies, creating many jobs, often, in fact, hiring more foreign workers. Some of these foreigners will remain in Luxembourg for their rest of their lives. It’s a virtuous circle.
“A strength of Luxembourg is the country’s ability to open up and give more resources to private initiatives.”
How can Luxembourg attract them, given that the IP and VAT regimes just changed?
Every era has its arguments. I am confident that Luxembourg today has competitive arguments to attract startups and entrepreneurs. For example, an entrepreneur in Paris would likely be convinced that Paris is the most beautiful city in the world and that Paris is the best ecosystem for startups in the world. An entrepreneur in Amsterdam would tell me the same about his city. We need to be convinced (and convince others) that Luxembourg is a great place to start a business. There are private initiatives that are responsible for attracting startups in Luxembourg. I think we should support them. In general, I think the Luxembourg government can and should support more private initiatives. We cannot function as a welfare state that organizes everything and does everything itself; the State doesn’t have the human resources. A strength of Luxembourg is the country’s ability to open up and give more resources to private initiatives.
“If Luxembourg wants to be at the top of the Digital Health sector, it has got to position itself now. If not, in five years from now, the opportunity will have passed, and another country will have taken the lead.”
What is Luxembourg’s position in the Digital Health sector?
To me, Luxembourg has to be at the forefront of the Digital Health sector. Why? Because there are no more than two or three cities in Europe that are trying to position themselves in Digital Health. And Digital Health is a huge opportunity, so it would be a shame to let it pass. In Digital Health there are two elements that are very important: security and confidentiality. Today, medical data is worth more than credit card data. Luxembourg has everything to support growth in Digital Health. Luxembourg has the legislation. Luxembourg has the infrastructure. Luxembourg has the culture of confidentiality. Luxembourg has exceptional infrastructure for data storage. Everything is a matter of positioning. Today, the country has made ICT and BioHealth priority sectors. Digital Health is precisely at the crossroads of these two sectors. We do not create molecules and we are not in pure ICT, but rather we are in connectivity and in the business of allowing patients to focus on their health. This area is exploding. Take for example the United States where the digitized patient records penetration rate is incredible. Patients are seekers. If Luxembourg wants to be at the top of the Digital Health sector, it has got to position itself now. If not, in five years from now, the opportunity will have passed, and another country will have taken the lead.
How do the Ministries of Health and Economy position themselves on this?
The Ministry of Health’s mission is to care for the health of people living in Luxembourg. The subject of data interconnectivity is more the responsibility of the Ministry of Economy, which has the mission to care for the country’s economic development. When it comes to health and Digital Health, the Ministry of Health takes care of Luxembourgish citizens and the Ministry of Economy takes care of foreigners in Luxembourg. Global health has a direct impact on the economy. It is certain that the involvement of the two departments is an asset because we can implement actions in Luxembourg and enable the country to be at the cutting edge.
“Another favorable aspect of Luxembourg I want to highlight is the direct channel of communication between the government and entrepreneurs. We are fortunate to have a dynamic administration that listens to entrepreneurs.”
What precisely is the market penetration of DOCTENA in Luxembourg?
I’m going to try to convey a message that no one has focused on until now. Luxembourg is the European leader when it comes to comparing market penetration of physicians using an e-agenda. In Luxembourg, the high market penetration is thanks largely to use of the DOCTENA application. Fifteen percent of physicians in Luxembourg—which equates to about 2000—have an e-agenda. If we compare that percentage with other European capitals, it’s huge. In Paris, it is 5% and in Brussels it’s only 3%. Leverage is awesome here. We can reach 100%; everything is about to accelerate. We have realized that market maturity is higher in Luxembourg than in other countries. The expertise of DOCTENA leads us to be a unique player in Europe. We are able to do business in a number of countries even though medicine is a local market. Refunds differ whether you are in France, Germany, Belgium or Luxembourg. The scales and rules are different too. Having a European structure, as DOCTENA has in Luxembourg, that can handle all of these countries is a huge plus.
What are your wishes for the future?
I expect there to be a large event organized soon in Luxembourg on the topic of Digital Health. I think there is a real opportunity here. Luxembourg has everything it needs to attract startups in this sector, particularly since regulation is one of the main challenges faced by businesses in the sector and Luxembourg has a favorable regulatory environment. Another favorable aspect of Luxembourg I want to highlight is the direct channel of communication between the government and entrepreneurs. We are fortunate to have a dynamic administration that listens to entrepreneurs.
This article was first published in SILICON