This Week in Startups
This Week in Startups

E34: “Angel” Podcast: George Zachary, General Partner at CRV shares insights on cancer scare shifting his focus to investing in health-tech, passing on Google at MDV, CRISPR & “designer babies”, coronavirus threat, origins of Sand Hill Road & more!

0:50 Jason intros CRV's George Zachary 2:20 Passing on Google at MDV and coming to peace with the anti-portfolio 5:51 Differences between leadership & management, where Steve Jobs, Larry & Sergey fell on that scale 10:27 Why 1990's VC was sales & marketing-driven instead of pro

Featured Speakers

Jason Calacanis HostGeorge Zachary Guest

Topics Discussed

Episode Summary

Executive Summary: George Zachary reflects on venture capital’s evolution from sales-led hardware/software investing to product-led consumer internet, using Google, Zip2, Odeo/Twitter, PayPal, and Shutterfly as case studies. He argues great founders need strong leadership, not micromanagement, and explores how fund size, age, and consumer intuition affect VC returns. The conversation later shifts to his health scares, healthcare inefficiencies, early disease detection, bioengineering, and pandemic/coronavirus preparedness.

Main Topics: How venture capital changed from sales-driven to product-driven investing: George explains that in the 1990s VCs prioritized sales and marketing because software and hardware were packaged and distribution-heavy, but consumer internet shifted power toward product quality and user experience. Leadership vs. management in founder-led companies: He argues VCs often confuse weak management with weak leadership; companies need visionary founders, while operational management can be added separately (e.g., Google, Apple). Google, the bust cycle, and why VCs miss breakout winners: George revisits the Google pass at Moore Davidow and the cognitive biases that make investors dismiss crowded categories, especially after market busts. Fund size, ownership, and why returns get harder at scale: He explains why large venture funds struggle to produce 3x returns: ownership dilution, the need for very large exits, and the rarity of fund-returning outcomes. Zip2, PayPal, and backing future giants early: George recounts early bets on Elon Musk's Zip2 and the broader lesson that seed investing is about founder quality and iteration more than the first idea. Health scares, patient advocacy, and the flaws of healthcare: After describing a tumor scare and other health issues, he argues patients need more agency, more second opinions, and better coordination than the current system provides. Biotech, early detection, and coronavirus/pandemic risk: He discusses AI, organoids, immunotherapy, cell-based meat, and the risks of fast-moving viruses, warning that global connectivity increases outbreak danger and may reshape behavior and travel.

Key Arguments: Founder-led companies need vision and persistence; management can be hired later, but leadership cannot. VCs overvalue what they passed on and undervalue the skill of saying yes to non-obvious opportunities. Crowded categories still produce winners; 'there’s always room' for breakout companies if the market exists. Consumer internet changed venture because users, not enterprise buyers, became the decision-makers, elevating product quality over sales force strength. Big venture funds are structurally disadvantaged because a 20% ownership stake gets diluted and requires massive exits to return capital. Investor age matters in consumer internet because older, wealthier partners can become detached from mainstream users. Patients should not treat doctors as all-knowing authorities; they need second opinions and advocacy, especially for complex diagnoses. AI/biotech may dramatically accelerate drug discovery, early cancer detection, and personalized medicine, but biology is still too complex to fully simulate. Pandemics are more dangerous in an interconnected world because air travel and global mobility allow fast spread before symptoms appear. Social and economic systems are pushing toward 'connected aloneness,' which worsens health, anxiety, and social fragmentation.

Data Points: Google post-money valuation referenced: $48 million post - The Moore Davidow Google investment discussion that was passed on. Implied missed ownership in Google: 16% - Used to illustrate the size of the opportunity missed by not investing in Google. Google carry illustration: $2-3 billion each - A hypothetical explanation of what the missed Google investment could have meant for partners. MDV fund size when George joined: $105 million - He describes this as the fund size at Moore Davidow in 1995. Median fund size at the time: $120 million - Used to contrast with larger later funds. NEA fund size mentioned: $220 million - Cited as unusually large at the time. Zip2 initial investment: $3 million - George says MDV invested $3 million in Zip2. Zip2 ownership estimate: ~30% - He notes this was roughly the stake size in the company at that time. Google's search engine competition: 11 search engines - He mentions the crowded search market when Google was being considered. Seed-stage mortality rate: 70%-90% - George says most seed and Series A companies go to zero or near-zero. Top-fund 3x return prevalence: 11% of top quartile funds - He says only a small share of top-quartile funds achieve 3x returns. Median fund size for 3x-returning funds: $531 million - Used to show why scale makes strong returns harder. PillPack acquisition: Over $1 billion - George cites PillPack as a major win; he says he cannot disclose the exact amount. Drug development timeline: 12-15 years - He gives this as the average time to develop a drug. AI-driven cell imaging throughput: 240,000 pictures per second - He describes a company taking massive numbers of cell images to test drug responses. Average prescriptions for people over 50: 3 prescriptions - Used in discussing PillPack and medication complexity. U.S. healthcare spending: 18% of GDP - He cites this to argue the U.S. is spending heavily while outcomes worsen. U.S. life expectancy trend: 79 to 78 years - He says life expectancy went down in recent years due in part to diabetes and other factors. Diabetes/pre-diabetes prevalence: 40% of the population - He links this to overconsumption and metabolic disease. Coronavirus U.S. severe care capacity: 100,000 critical care beds and 500,000 acute beds - He uses this to warn about hospital capacity limits in a severe outbreak scenario. Coronavirus severe-case estimate: ~18% severe to critical - He says this was the observed share in early data. Coronaviruses on surfaces: Up to 5 days - He says the virus can survive on surfaces for days on average. Coronavirus case growth example: 10,000 to 65,000 cases - He cites this early outbreak growth as evidence of rapid spread. Statin-related mass found in his body: 9 cm x 7 cm x 4 cm - He describes the size of the mass discovered during a scan. Heath scare timing: 2015 - He says the tumor scare began in 2015 after taking a statin.

Pivotal Quotes: "There’s always room for improvement and for a breakout success, even in a category that’s crowded." — George Zachary: He explains why Google could still win despite many existing search engines. "You need the leader for vision, for drive, for persistence, for execution." — George Zachary: He defines why founder leadership is essential and distinct from management. "Connected aloneness." — George Zachary: His phrase for people being digitally connected but physically isolated, especially relevant to health and social wellbeing.

Implications: Listeners should take away that venture success depends on founder judgment, category timing, and disciplined fund construction. The episode also argues for stronger patient advocacy, faster diagnostics, and serious pandemic preparedness in a globally connected world.

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About This Week in Startups

Jason Calacanis covers startups, tech, markets, media, and all the hottest topics in business and technology. He also interviews the world’s greatest founders, operators, investors, and innovators.

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