One of the biggest success stories of the French startup landscape is Doctolib.
The software company, which was founded in 2013 by Stanislas Niox-Chateau and his three co-founders, helps healthcare practitioners with administrative duties, namely scheduling and managing appointments.
Patients can make online appointments and check availability with Doctolib instead of contacting providers directly.
This may seem like a small breakthrough in a world where everything is booked online, but in the bureaucratic, slow, and data-sensitive healthcare sector, any program that can consistently reduce complexity and free up time is a welcome shift.
Patients can use Doctolib for free. Medical professionals can utilize the core software for €139 ($151; £120) a month, with upgrades and add-ons available. Additionally, hospitals and other professionals like physiotherapists have their own packages.
By the time the pandemic struck, Doctolib was already doing well. The company profited from the unexpected surge in telemedicine, and its collaboration with the French government to streamline the Covid-19 vaccine deployment helped establish the company’s reputation in France.
According to the company, it serves nearly the whole French population and was valued at approximately £5 billion in March 2022, when it held its most recent investment round.
It has proven difficult to replicate that success in other markets, though.
Although Doctolib entered the German market in 2016, the company has just lately started to make headway after eight years.
German healthcare professionals make up 200,000 of the 900,000 healthcare providers and 80 million patients that have registered to use Doctolib.
The first of several challenges that put the platform’s adaptability to the test was the transition from the centralized French system to Germany’s federal structure.
The managing director of Doctolib Germany, Nikolay Kolev, states that there isn’t just one German market entry.
The company had to adjust to a varied market in each of Germany’s sixteen federal states.
But the same obstacles that first make it difficult for businesses to establish themselves in Germany also shield well-established businesses from newcomers and prevent them from being a serious danger.
Dr. Carol von Wildhagen, a physician and health venture partner at Caesar VC in Munich who formerly oversaw Platform24’s German division, a Scandinavian telemedicine service, claims that closed systems already in place in practices represent another significant barrier to entry.
The manufacturers and distributors of the countless [practice management system] systems build them like fortresses, making it exceedingly difficult to integrate any outside software with a physician’s practice software. That makes providing value to the doctor extremely difficult,” she claims.
“I understand the concerns of the large incumbents that have historically produced practice information systems. Their systems are outdated, feel dated, look dated, and are not very user-friendly. They risk being quickly overtaken by something cloud-based that prioritizes the user experience.”
According to Liam Boogar-Azoulay, co-founder of Waypoint AI and the creator of France’s multilingual startup site Rude Baguette, “home field advantage always plays a big role in the European start-up scene.”
It’s indisputable, in my opinion, that Germans prefer to do business with other German enterprises. Almost all countries have the same situation, according to Mr. Boogar-Azoulay.
The idea that only domestic businesses can comprehend German demands for high levels of data security may contribute to this reluctance toward non-German businesses as well as a general hesitancy to embrace digitization.
The purchase of French data encryption firm Tanker by Doctolib in 2022 might be an attempt to allay concerns about data security.
However, Mr. Kolev doesn’t think the German system has changed slowly because of data security.
We should start with the best security and privacy available if we’re serious about advancing this sector. Therefore, I don’t believe that the issue facing the German healthcare industry is data privacy. It’s more the fax machines, in my opinion.
He’s not making this up. According to a Bitkom research from 2023, 82% of German businesses still regularly use fax machines. Bitkom is a German digital advocacy group. Fax is frequently the preferred means of transmitting medical information.
The German government has long been considering increasing its digitalization. According to the National Association of Statutory Health Insurance Physicians in Germany, medical practices incur around 61 days per year on work alone.
Doctolib depends on the shift from paper records to online services.
“[Outdated tech is] not an insurmountable issue. Adoption is merely hampered by it, claims Mr. Boogar-Azoulay.
“I think they’ll be able to throw money at the problem for a long time just because they have the French tailwinds and that market behind them.” Efficiency is not a must. To overcome the fax machine barrier, they could lose money in the German market for ten years.
