How Physicians Become Health Tech Founders with Dr. Jhonatan Bringas Dimitriades

In this episode of Startup Physicians, Dr. Alison Curfman interviews Dr. Jhonatan Bringas Dimitriades, a Peruvian physician whose global journey led him from clinical practice in Latin America to recertifying in the Netherlands and ultimately becoming a health tech CEO.

Jhonatan shares how he navigated the challenge of learning Dutch, rebuilding his medical career abroad, and entering the world of health tech without a formal business background. His curiosity and clinical expertise propelled him through roles in product management and business development before co-founding Keiku, an AI-powered digital stethoscope and ambient scribe designed to transform how clinicians capture and interpret patient data.

Together, they explore the realities of building hardware as a physician founder, the power of partnerships, the importance of embracing imperfect MVPs, and the many translatable skills physicians already possess that prepare them for startup leadership. This episode offers a clear, inspiring look at what’s possible when physicians step into innovation.

00:00 – Introduction & Global Background
01:10 – Training in Latin America & Moving to Europe
03:05 – Recertifying in Dutch
04:55 – Entering Health Tech as a Medical Advisor
07:15 – Physicians’ Translatable Skills
10:20 – Growing into Business & Startup Roles
13:35 – The Origin of Keiku
18:10 – What Keiku Is & What It Does
22:50 – AI, Auscultation, and Documentation
26:15 – How Hardware Gets Built
29:25 – Advice for Physician Innovators
30:50 – Startup Physicians Pathways & Closing

Jhonathan's LinkedIn: https://www.linkedin.com/in/jbringasd/

Keikku Smart Stethoscope - https://www.keikku.health/

Transcript

Alison Curfman (00:01.016)
Hi, everyone. Welcome back to Startup Physicians. This is your host, Dr. Alison Curfman, and I'm joined today by my third international guest, Dr. Jhonatan Bringas in Amsterdam. Thank you so much for joining us, Jhonatan.

Jhonatan Bringas Dimitriades (00:16.4)
I'm so honored. I'm your third international guest. It's, you know, top three. Can't be better.

Alison Curfman (00:21.28)
Yes. Well, the really funny thing is you and my other guest that was in Vienna, I didn't quite realize that you were in Europe until we started talking right before this call. But just to give some background, we met at the health conference in Vegas in October, and I was immediately so interested in the product that you've made and then your journey of how you've gone from

being a practicing physician to actually CEO of a pretty amazing device company. So today we are going to get into his journey, but also some of the specifics about like, what does it actually mean to make a device and how do you actually do that? So can you start by sharing a little bit about your background and your training and your career?

Jhonatan Bringas Dimitriades (01:13.266)
100%. So I am Peruvian by background and I started my medical journey well way before I went into medicine. I actually met a Medicine Nobel Prize when I was a teenager at the Intel International Science and Engineering Fair in Cleveland, Ohio. That was one of the pinnacle moments of my youth. know, I thought

This is the path that was traced for me. I always wanted to be in science and meeting a Nobel Prize in medicine that eventually became my mentor meant so much for a Latin American student and gave me so much courage to be able to go through the medical career. And my medical career in Latin America was really fantastic. I learned so much. mean, we have their fantastic School of Medicine in Latin America.

as well. And you can really learn so much semiologically. You know, there's not a lot of technologies there. So you have to become a very semiologic doctor. then a couple of things of training and academic pathways took me to Europe and eventually love made me stay. So I basically fell in love with my colleague, another physician.

And then she dragged me to the Netherlands. And when I arrived there, I had to recertify. So that was a very difficult task. I think that the recertification pathway in Europe is pretty much like the American one. So there are multiple exams. And you have to go through also practical exam. But I think the nuance is that you have to do it in Dutch.

which meant for me that there was another language that I had to learn before I could start my process. But that happened and it was great. Thank you so much.

Alison Curfman (03:08.526)
That is incredible. I definitely, I do not think I could have done that. So you were physician certified elsewhere and then moved to the Netherlands, decided to learn Dutch and do all your medical training exams again in Dutch.

Jhonatan Bringas Dimitriades (03:28.218)
in Dutch. It's crazy because the first test, so they really don't want to miss with medical students. They want to be able to immediately of like screen you from the beginning. So the first medical exam you do is something called Medical Dutch. And it's basically you have to read journals in Dutch. And then there's like an interview where you have to discuss them with other physicians in Dutch. So that was a very eye-opening experience to me.

But on the other hand, it kind of like forced me to learn a new language in a country where I was going to be staying. So was perfect for me and it has helped me tremendously. And then while I was doing my recertification, I, of course, as any physician would do, you don't want to be just sitting on the couch with your arms crossed waiting for the results of your exam. You want to do things. I think that's something that we have in our spirit. Like we really want to do stuff.

So I started to apply to a bunch of companies to be able to be a medical advisor. And eventually I became a medical advisor in a company that was doing a hematology lab tests. And it went from that towards health tech. At the moment when my recertification came out, I was already very deep into health tech. And I said, I'm just going to give myself the chance to see how much can I learn and how far can I go in the world of health tech. And here's where I am now.

Alison Curfman (04:55.022)
Wow. And so when you say you were looking for positions as medical advisors, what did that actually mean? Like, where were you looking and how were you connecting with these opportunities?

Jhonatan Bringas Dimitriades (05:07.132)
Honestly, I had no idea really what that meant. I was just thinking companies must need doctors, companies that have technologies that are meant for healthcare, that have lab companies or AI companies. By that time there was no AI, so was mostly health tech and some software companies. But I was always thinking there must be a place where a doctor gives you or advise.

or clinical advice, or maybe they can help build business based on the connection between colleagues. Of course, who else can be a better business representative of a company than another doctor that actually understands your pain points and has probably lived the same experience that you have lived and can tell you how the technology can fit your practice better than anyone else? And at least that was my train of thought. And eventually that was true.

Alison Curfman (06:05.708)
Yeah, that's a really good point because I think some of the credibility that we're able to lend to companies that we're advising goes not only externally if you want a doctor associated with you for marketing or business development, but when you think about, like you said, doctor to doctor conversations, if you were running a busy practice and some...

random tech founder reached out to you was like, hey, I've got the best thing ever for your practice. You would not even respond. But if somebody's reaching out and saying like, hey, I'm a physician, I'm in your same specialty, I would love to share a solution with you. Yes, it still is salesy, but there's like an understanding that you're already past a bunch of layers of resistance.

Jhonatan Bringas Dimitriades (06:57.446)
I also believe that we physicians are very ethical in how we approach sales. We don't just go ahead and blindly propose something to be sold to another physician without previously having validated it ourselves, being completely prepared. I think that we are sort of like completely trained to do that. We do the same with patients. believe it or not, I believe that we are selling healthcare to patients.

Alison Curfman (07:14.254)
Mm-hmm.

Jhonatan Bringas Dimitriades (07:27.078)
So we are sort of salespeople every single day, right?

Alison Curfman (07:29.014)
Yeah, you're trying to pitch someone on taking their blood pressure meds or, you know, what's the reason behind it and what's the plan.

Jhonatan Bringas Dimitriades (07:34.031)
Exactly.

Jhonatan Bringas Dimitriades (07:37.946)
and eating healthy. mean, if you're an endocrinologist and you are pitching eating healthy to a diabetic patient, you are an amazing sales rep. Like, because you have to do it every day.

Alison Curfman (07:47.885)
Yeah.

Well, that's a great example of what I like to call translatable skills, things that we may not even realize that we have developed as physicians. We have very, very high standards in the physician world. you said, for the sales stuff, I think that for the most part, like you said, we wouldn't endorse something that we didn't validate ourselves. And I do that. So when I work with companies, I

usually start with more of like it internally focused more strategy work to really get to know the company and their, their background and what they're, what they're, sorry, my watch is talking to me. What, what the, sorry, that really distracted me. I'll have them edit that out. Siri like just interrupted me and was like, I don't understand.

Jhonatan Bringas Dimitriades (08:41.686)
No worries. This is like the fifth time that this happens to me today, by the way. I was in another meeting and Siri interrupted like six times. That's crazy.

Alison Curfman (08:51.214)
They're getting really activated. What was I talking about? Anyways. yeah. So when I work with companies, I usually try and do more of an internal assessment first to work with them before I associate my name with them or start trying to help them sell their product. I think that it's very important to me that I only associate with companies that I deeply feel are

Jhonatan Bringas Dimitriades (08:56.932)
about validating ourselves.

Alison Curfman (09:19.042)
really doing something meaningful. feel like I'm driven more by impact than anything else. And so you can approach this ethically. And a lot of people feel anxious about sounding salesy, but I feel like that's kind of a non-issue.

Jhonatan Bringas Dimitriades (09:37.318)
I completely agree. I've been actually advising a couple of companies, startups outside of the world of my own companies. And one of the interesting things is, you know, when a founder comes in and they're like, I want you to be my advisor. I'm like, I would love to be your advisor. Number one, I would like to read as much as I can about your technology and I would like to test it myself. And then I come back with a bunch of feedback, right? And they hate it.

Because they are like so in love with your technology and then I just come with a bunch of feedback I think this doesn't work. This doesn't work. This doesn't work But I do have to say that that angle of a doctor being so honest and so ethical It's probably what companies need to be able to succeed

Alison Curfman (10:20.507)
Yeah, absolutely. So after you did this impossibly hard thing of learning Dutch, doing all your medical exams in another language, and then getting started in these health tech companies, what sort of role were you just advising at that point, or once you kind of started taking off and decided to take health tech as the career path, what were you doing?

Jhonatan Bringas Dimitriades (10:45.362)
So I started first as sort of like a product manager, which is, I would say, it's an intersection between a little bit of business development and a little bit of product knowledge mixed with clinical knowledge. So you are in that intersection where you say, this is how I would implement it. This is relevant in your clinical practice.

you can also sort of be a little bit of a business developer yourself. But I started to become a little bit better at the business development side. So at some point, I started to score roles that were more business development than product management until I arrived to basically lead an entire business units that was basically entire geographies. So I was for a big health tech company in the Netherlands. I was the business director.

taking care of the entire Americas, the entire South Europe, and the entire Middle East. So that

Alison Curfman (11:47.384)
Did you have business background?

Jhonatan Bringas Dimitriades (11:50.37)
I had nothing of business background. And I think that we...

Alison Curfman (11:52.878)
So you had your clinical knowledge and a brain that's really good at learning things.

Jhonatan Bringas Dimitriades (11:59.474)
that and I think that because we can really connect with our colleagues and more importantly, I feel that doctors, we already have a degree in communication as well. And this is because we really have to be adapted to all sorts of patients. When we go into a hospital and went into a clinical space, we can't choose our patients. The patients, they come and they can be the most highest PhD graduate or maybe a person that has a more humble education.

We have to be able to connect with them, regardless of who they are. We have to be able to communicate with them and, you know, bring this, this content of information, convert it into the shape that they can assimilate and be able to deploy it so they can understand it. So when you can do that as a clinician, then doing business is basically adapting yourself in real time to the, to the other person's, a person's type of communication to it.

be able to achieve a goal. So that's what I understood when I started to work at business. this is actually good. If I just really read this person during this conversation, I'm going to be able to transform my message the same way that I do with my patients, to be able to achieve a goal. And eventually, it resulted in success that allowed me to be able to grow in my career.

Alison Curfman (13:22.168)
That's amazing. And I really love the analogies there because I think, you know, we do a lot of training in our communication and that is a skill that's very important in this space as well. So at what point did you decide to build something of your own?

Jhonatan Bringas Dimitriades (13:38.458)
So I was, I had been already in multiple startups at that point. I was invited by really fantastic leaders to be a founding team member of their startups. I went into a company called Corzano as a chief medical officer, and we were building wristbands with PPG sensors that were in hospital monitoring for admitted patients to be able to monitor their entire vital signs with one simple wristband.

And then we went from that company. I went into another one that was doing wearable devices for sleep medicine. And they had a HS class four, so home sleep testing class four device that was very miniaturized. was like color along your neck and was monitoring PPG and movement, heart rate, SPO2. So was a fantastic technology company as well. And in that company, I met

So the CEO of that company, he was the founder of a company called Haltium, which is a very big tech company in Finland. And at that company, they basically created the first and second generation of the Oro Ring. And so he was that guy that was the mind behind engineering and the embedded systems of the Oro Ring. And I was, there you are.

Alison Curfman (15:02.406)
Got mine on right now. Yeah.

Jhonatan Bringas Dimitriades (15:04.516)
You got yours done. And it got me really inspired. When I left the company, told him, hey, you know what? I've been discussing this with my co-founder, which is my wife. The person that I actually came to the Netherlands with, she's the one that had the idea for Lab C and for Keiko and all the other products that we're going to be building in the future. I said, know, Diane and I, have these great ideas, and we would like to build the company. So why don't you join us?

And by then I had already drafted a sort of proposal with Diana. We had two other co-founders that was Rodrigo, which is a fantastic CTO that comes from Accenture. And then Seamus that was, is an Irish businessman and he's been in business development all his life, including in tech companies. He founded six companies before Lab C. So the four of us, we came to Tony and we were like, this is the guy from Aura.

why don't we partner together and we build up some amazing technologies? I think early on in our journey, we realized that even though we're two doctors that have academic and business backgrounds and that we understand very well what technologies have to be developed, we realized that we can't do it ourselves, especially in hardware. If you would look into all the parts that are inside of one of these devices,

is absolutely crazy. we, of course, didn't know the name of the semiconductors, didn't know how to even put together a printed circuit board or anything like that. How do we develop any firmware or software? So we needed the support of engineers and developers that would understand our vision. And we would place together what we call our functional specifications or the requirement.

for specifications, for functions, and then they would develop it for us.

Alison Curfman (16:59.106)
Yeah.

Alison Curfman (17:03.214)
So I think one of the things that you're pointing out that's so important for any aspiring physician founder to hear is the importance of partnership. So like you said, you can't do it alone. Even if it is more of a care delivery model, you often need a whole lot of other skill sets represented. But particularly when you're getting into tech, whether it's a SaaS model or an actual product like a device.

I don't know about you, but I sure can't And so, and I also don't know what a semiconductor is. So I think that it's really a great visual of bringing different skill sets together, whether that's by taking on a technical co-founder or a partnership or, you know, a third party development or product team that you could hire. But, you know, I think sometimes we will have ideas like, wouldn't it be great if something could

do this or have this function, but we just, it's hard to imagine how you would actually like put a thing together. So when you started doing this, actually, maybe you can start by describing what the device is and then talk through like, what was your role in helping develop that?

Jhonatan Bringas Dimitriades (18:16.786)
Yes, so the device is called Keiku. I have it here in my hand. Keiku is a multimodal device that has, on one side, it is a digital smart stethoscope powered by AI, and it helps you to listen to hard and longs. On the other side, it has a microphone system that listens to ambient, and it does your notes. It documents your notes automatically. So in real time, it can basically deploy the entire scribe, ICD tent codes, and CPD codes.

seamlessly while you're taking care of your patients. And it can also be a clinical tool. Everything goes together into our app and then it gets deployed in our web application from which you can edit your notes and then deploy them into the EHR. There are more usage to the sensors that we have currently that will be unveiled in the next couple of months. So the device will continue to evolve and obtain more qualities. We built it with that

specific design. So when we launched it for the first time in the end of 2024, it was a digital stethoscope. Then by mid 2025, it became also a scribe technology product. And by 2026, there will be another unveiling of more functionalities. All the sensors are already inside. And that's actually one of those things that we love the most is that your device evolves, even though you don't need to change your hardware. So we built it.

The idea came from Diana, my chief medical officer. She is a pediatrician, a pediatric resident currently about to finish a PhD in the Kawasaki disease. And she is a former synchronized swimmer from the Dutch national team, so is very disciplined person. And she's always had these ideas of why don't we replace subjective tools, analog tools, convert them into something that can give you a lot of data.

And, and we thought about the typical practice of a doctor having a stethoscope and SPO2 device. And, you know, you have your blood pressure and you have your keyboards and your mouse and your computer and your assistant. So we said, why don't we just bring all those things together into one device that can be powered by AI that could allow you to basically bring your, your practice in your pocket. And, and that's what Keiko is and that's how Keiko is becoming. Now how we started.

Jhonatan Bringas Dimitriades (20:42.416)
The first generation of this device, so the first prototype didn't look like this. was just a square with a plug. was terrible. But you have to start somewhere.

Alison Curfman (20:52.43)
So that's called an MVP, minimum viable product. we as doctors like to do A plus work. We would love it if the very first thing we put out was as beautiful as the thing that you put in your hand right now. But the truth is when developing tech or software that usually you really want to start with like a C work. Like it's just got the core things that it needs to do so you could see how it works and.

Jhonatan Bringas Dimitriades (20:54.599)
Yes.

Jhonatan Bringas Dimitriades (21:14.77)
100%.

Alison Curfman (21:21.174)
and identify how to make it better and do that with real user feedback.

Jhonatan Bringas Dimitriades (21:28.218)
Yes. And you know, I also would say that sometimes when we are giving a technology to pilot, we also expect it to be an A+++. And we have to understand that whenever we are piloting a technology that is better, that means that we probably will have to encounter loads of imperfections. And our role as advisors or

doctors in a beta test, for instance, is not necessarily to judge the technology from its perfection, but to give feedback and to continue to use it to make it perfect.

Alison Curfman (22:04.962)
Yeah, exactly like what you were talking about with the founders that you support. mean, feedback is the most important thing as a founder. You need to get so many different viewpoints on your model or your device. You need to get a large volume and very broad directions of the feedback because, and you don't have to take all of it, but that's the only way to actually make a product.

real, an A plus product.

Jhonatan Bringas Dimitriades (22:36.358)
You're completely right. Yeah.

Alison Curfman (22:38.904)
So tell me a little bit more about the business. Tell me a little bit more about the AI component, I certainly understand how subjective auscultation can be.

Jhonatan Bringas Dimitriades (22:55.226)
Yes, so we digitize the signals in both ways. Either the ambient sound is digitized as well as the sound from within the body. are digitized. So there are first digital tools that you obtain. Of course, on the exultation side, you can record it, you can stream it, you can share it, you can label it. Those things are basically just digital functionalities. And then we have

a with a company called eMURMUR in Canada and Austria. And they have an FDA cleared murmur detection algorithm and crackle detection algorithm. So for CART and LONG.

Alison Curfman (23:34.171)
interesting. So you didn't even build that from scratch. This is again an example of partnership.

Jhonatan Bringas Dimitriades (23:39.28)
Yes, that was a partnership. So what we did is we created a very solid infrastructure for our data composition. How clear is the sound? How good is the active noise cancellation? How crisp is the acquisition and the actual deployment of the sound? All those things we build ourselves. The entire audio pipeline is built by us. And then we partnered with another company to deploy their models through the device. On the ambient part,

We have also our own set of processing technologies that we have developed because you need to do that. So we cancel the noise of the ambient. We focus on the voice. We enhance the voice. All those things have to be done so that transcription AIs and LLMs can actually hallucinate less because the quality of the data is better. And that is super important. And then what happens is that ambient data is transcribed.

with voice to text technology. And after that, there's a transcription. Then there are a couple of agents that basically read that data, contextualize that data. Let's say that you had a conversation with a person that was telling you a lot of gossip and a lot of things that were not relevant to the clinical case, right? Which happens a lot with Latin American patients, for instance. And basically the AI agents would take that information, would take it out.

of the summary because it's not clinically relevant. And they will bring only the relevant information into the soap note. So we create that soap note. That soap note is also deployed in the objective part. We write with natural language the findings of the excultation. So that's something that is unique to our product versus any other product that you can find there in the transcription space. And then everything gets together in the app or in the web application so far.

Alison Curfman (25:36.238)
So I have a really dumb question. I have more experience working with software development, so I fully understand how development teams work. But when it comes to an actual physical product, like as soon as you start talking about, I actually have your website open and it's got that little graphic of the stethoscope coming apart. There looks like there's like thousand pieces inside of it. Like what sort of person...

figures out all those pieces and then makes a way to manufacture it. Like how do you oversee that? Like if you don't even know what all these little pieces are, or you probably don't know a whole lot about manufacturing, like what sort of people do you have on your team that help with the physical product?

Jhonatan Bringas Dimitriades (26:20.188)
my God, like I didn't know this either. and there's one thing to say to physicians that want to embark in this type of route is even if you don't know it, you're going to learn it by doing so. If you have a partner that has the technical background and you will learn. So I, when we started, I had no idea, you know, who are these engineers? And, what I can tell you now that I know is we have, we have an embedded systems engineer. We had a mechanical engineer. We had.

a couple of electronic engineers. And they all basically put together the design. So the first thing that comes out is, OK, what are the functions that you want? In our case, we said we want to be able to have both points of acquisition. And they were like, OK, those are two different microphone settings and two different microphone systems. So they have to be both connected to one printed secret board. That's the green thing that you look at every time you open electronics. It's like some people call it the chip. It's not really a chip, but

is like a big piece of green with all these different chips inside. So then we said, OK, we want it to last this amount of time. So there's a battery component. Because they are audio sensors, it means that you have to have a processor inside. So there has to be a processor that's attached to the battery. If you want to deploy that sound to Bluetooth, you have to have a Bluetooth chip inside. And then we started to realize, OK, so for every single function I want,

in this device, you need a little thing in there. Yes. So eventually, there's someone that draws it on a simulation and CAD type of system software. And then from there, it's 3D printed and semiconductors are ordered. That's like the number one thing. And then you put it in sort of like a shell, something simple, the MVP that you said, and you test it. So that was our first step, printing that PCB, bringing all the semiconductors together.

Alison Curfman (27:48.76)
You need a little thing in there.

Jhonatan Bringas Dimitriades (28:17.244)
printing the shell testing. When we realized that that worked, then we were like, OK, well, step one is done. So now we need to really make it functional. So it is about time to build up an app. That app needs to have all those configurations. You need to be able to control the device. So there's a firmware, which is basically the software that runs on the hardware. And then there's the software on the app. And then we started to test that, and that takes another time. And then you have your other team, right?

You have your software developers, your backend developers, and all these other ones. So yeah. Yes.

Alison Curfman (28:51.232)
Yeah, that's the type of teams I've worked with is more the software side. That's incredible. actually, that totally made sense to me when you described it. So, and the fact that you have learned all this through experience and through finding people that knew the things you don't know is just, you know, a great testament to the fact that we're very good at learning things. And I really, truly feel like there's a really important place for physicians voices in this space. So.

As we wrap up, do you think you have any last thoughts or comments for people that may be listening and interested in this sort of career path?

Jhonatan Bringas Dimitriades (29:29.894)
I would say if you have the chance to be able to build something innovative, you have to at least try. You owe it to your patients and to yourself to try. There's a lot of different technical co-founders over there that would love to be able to work with a person that has vision for an innovative product. And if you can find them, you can always find me. Maybe I can help you to find those technical co-founders. I think that physicians, have so many amazing ideas currently.

In the space of health tech, we see more and more physician entrepreneurs, founders, having such great success. It's not coincidence. They are working from their clinical experience, and that makes a big difference.

Alison Curfman (30:13.678)
Yes, absolutely. And that's part of the vision of what we're building here in this startup physicians community beyond the podcast. We have training programs for people who want to dip their toe in by becoming more of an advisor or a fractional CMO. How do we train you and equip you to do that sort of work and to find those opportunities? And then we have an incubator program for aspiring physician founders who really want to learn how to make

an end-to-end business plan and financial plan and maybe the foundations of creating a product. I think that my vision is that we can just create so many pathways for physicians to enter into this space so that people aren't just sitting there thinking, well, that sounds nice, but I don't know how I would get involved.

Jhonatan Bringas Dimitriades (30:47.09)
Wow, that's amazing.

Alison Curfman (31:02.648)
Thank you so much for joining me all the way from the Netherlands. And I am so excited to share this information with our audience. for anyone who is interested in connecting with Jhonatan on LinkedIn, we'll put his LinkedIn in the show notes. And then the product itself is Keiku, right? Is that how you say it? Keiku? It's K-E-I-K-K-U dot health. Correct? Awesome.

Jhonatan Bringas Dimitriades (31:06.816)
Thank you.

Jhonatan Bringas Dimitriades (31:25.457)
Yes.

Alison Curfman (31:32.568)
Well, thank you so much for joining me today.

Jhonatan Bringas Dimitriades (31:35.388)
Thank you so much for inviting me.