Bootstrapping Vs Raising Outside Capital
There's no right or wrong. But no matter how you start, the way you learn along the journey is the same.
One of the biggest pieces of advice you hear in business is:
“Start with the exit in mind.”
But when we started our business, we had no idea what the exit was.
And that’s because the exit wasn’t why we got into business in the first place.
I’ve been rereading Simon Sinek’s Start With Why, and it’s reminded me of something core to our journey. We built our business not because we had a predefined endgame, but because we were passionate about helping others and educating people on the value of physical therapy.
We told ourselves we’d figure out the exit strategy later. Or rather, we would start shaping what an exit could look like as we grew. But in the beginning? That wasn’t our focus at all.
We didn’t start with an exit in mind—we started with a problem we couldn’t ignore.
Leading With Passion vs. Process
While both passion and process are necessary ingredients for any successful founder, in my opinion, most founders start with one predominantly leading the way:
• Leading with passion – These founders are deeply connected to a problem, often because they’ve personally lived it or worked within it. They feel like the status quo is broken and unlivable, and they’re driven to fix it—at all costs.
• Leading with a strategic business process – These founders identify opportunities first. They analyze markets, look for underserved problems, and build solutions towards where the greatest potential for scale (and exit) exists. Sound process and strategy wins out over unfiltered emotions.
Both approaches can lead to successful businesses, but I believe bootstrapped founders often start with pure, unfiltered passion, whereas VC-backed founders inherently have to start with the endgame in mind because of what taking outside capital requires.
For us, we fell into the first category.
We saw firsthand how dysfunctional the healthcare system was—not just for our patients, but for ourselves too.
While we are healthcare professionals, we are also patients—navigating the same broken healthcare system like everyone else.
I spend over $1,000 a month on healthcare as a self-employed individual. And what does that get me? Next to nothing.
I still see the majority of my providers out of network because insurance doesn’t cover the care I actually want. And if I ever do need labs, imaging, or other medical intervention, my deductible is so high that insurance barely helps at all.
That’s what pushed us to start [P]rehab in 2016 when we were Doctoral students at USC. We weren’t looking for an industry to enter—we were trying to solve a problem we were living through ourselves.
And because we had deep insider knowledge—years spent studying, practicing, and refining our expertise in the field—finding the right problem (and solution) wasn’t hard.
Traditional physical therapy treats pain and injuries after they occur. But [P]rehab takes a proactive approach, empowering people to care for their bodies now to improve results and prevent future issues.
That’s why, for us, starting the business was the easy part. We already knew the problem, we were passionate about solving it, and we had the expertise to back it up.
Scaling it? That’s where things got a lot harder.
Starting a Business vs. Growing a Business
Starting a business is very different from growing a business.
When we first started [P]rehab, we weren’t trying to start a business. We were literally in the business—as Doctors of Physical Therapy, we were living and breathing this work every single day.
[P]rehab was an extension of what we were already doing in the clinic with our patients. The only difference? We packaged it into a more widely accessible format—videos, blogs, podcasts, and now mobile and web apps—so we could amplify the impact of physical therapy beyond the four walls of our clinic.
But to scale our impact, we had to adapt and grow. As a byproduct of the countless challenges we faced, we were forced to evolve into entrepreneurs.
Growing a business is where the real challenge begins. And our journey was, and still is, extremely tough.
We didn’t go to business school or have any other formal business training before this. We weren’t serial entrepreneurs with a track record of exits and playbooks for scaling a company. We had to learn everything from scratch—operations, hiring, financial modeling, leadership.
We made so many mistakes along the way. And we’ll continue making mistakes. But as long as we learn from them, adapt, and do better next time, we’re happy with the results.
Contrast that with a VC-backed founder, who is (supposedly) given all the tools and resources necessary to grow and scale a business—they’re just looking for the right problem to solve.
I believe these founders have a much harder time finding product-market fit.
Why? Because they’re starting from a market analysis perspective rather than having been deeply embedded in the problem with firsthand experience.
They’re often looking for the biggest opportunity, rather than solving something they’ve fought with or have extensive industry knowledge on. Constantly pivoting until they find the right problem AND the right solution.
The number of VC-backed solutions I see in the physical therapy space that are ‘cool’ on the surface but don’t actually solve a problem speaks directly to this.
The products are extremely well-designed, the UI/UX is so slick, and the tech is built on a foundation ready to scale, but it doesn’t mean anything if it doesn’t first address a real problem.
But once these founders find that magical product-market fit, they hopefully have the playbook, resources, and network to execute and scale to unimaginable heights and potentially join that vaunted list of unicorn companies we have all grown up to love: Google, AirBnB, Uber, etc.
Final Thoughts: Two Ways to Build, One Way to Learn
There’s no single “right” way to start or grow a business. Some founders raise outside capital, others bootstrap. Some lead with passion, others lead with process.
But no matter how you start, the way you learn along the journey should is the same:
✔ Iterate quickly. The fastest path to success is failing fast and learning even faster.
✔ Identify your strengths and double down. Be unapologetically bold about them.
✔ Fill your gaps. Hire for blind spots, not your comfort zone.
Both paths require learning, adapting, and evolving. The real question isn’t which one is better—it’s which one makes the most sense for you.
At the end of the day, the best business to build is the one you’re willing to bet on, commit everything to, and enjoy the journey—no matter what the end result is.