Toolbox: Problems Of Growth (And Some Handy Solutions)

Problems of Growth and Some Handy Solutions

From Start-Up to Stays-Up: When Dublin MedTech start-up tripled in size, it raised a bunch of problems. Here’s how they solved five problems of growth.

When Caelen King founded WhatClinic back in 2007, he did it the old fashioned way: three guys in a bedroom, writing code. Today, more than 60 full time staff occupy three floors of their Dublin city centre HQ, and their operations support consumers and business all over the world. 1.7 million patients use their site every single month, and they have paying customers in over 70 countries. WhatClinic’s Emily Ross shares five of the many, many challenges they faced along the way.


This has been a real pain for us here in WhatClinic. From a bedroom in Clontarf to an office block in Dublin 2, we’ve moved office twice in 6 years: each move has meant blood, sweat and tears on an escalating scale.


  • Plan for growth – how long will the space you’re in work for you? And be efficient with the space you have. Do you really need a reception area, or can you get four more desks in there? A central lunch space is important, too – somewhere for people to eat, make coffee and mingle with colleagues.
  • Go paperless! Every time we move, we recoil in shock at the amount of wasted paper that gets shredded. With 60 people, we still only use two printers.
  • We consciously decided to search for space in Dublin’s city centre – just off Grafton Street, Dublin’s main pedestrian thoroughfare. Easier to find, easier to hire great people, and it’s influenced our culture and our atmosphere for the better.


As you grow, it can be hard to hang on to the sense of family. Parents and/or non-drinkers don’t get to socialise as much, groups tend not to mingle outside their teams and remote workers get excluded from outings and water cooler conversations.


  • Encourage a mix of events that can bring everyone together. Every year, in WhatClinic the CEO has a BBQ in his back garden. Dublin City has some great events that give us the excuse to get out and about – try running, for starters! The Grant Thornton 5K race around Dublin’s Financial District was great fun last year. Another 5K event, Darkness Into Light in May, raises funds for Suicide Awareness.
  • One of the ideas that has worked to increase collaboration and interaction within WhatClinic has been regular ‘Innovation Days’. Interdepartmental groups are set up in order to plan, design and pitch ideas that could improve life for different stakeholders of the business. Part hackathon, part brainstorm, part team-building, it’s a great way to get to know people.
  • Once a week, a bunch of us get together for some lunchtime yoga – one of the few regular activities that gets all departments involved. Also: it reduces stress and improves productivity!


Startups don’t usually have a huge amount of experience in effective hiring practice, nor do they have the resources to invest in senior HR support. They also tend to avoid recruitment agency fees, which can save money, but may not deliver the right person long-term.


  • Hire a HR manager, sooner rather than later. A bad hire is at best, a waste of resources, at worst, a lawsuit. Hires create paperwork, and after a certain point, it’s a false economy to have your CEO double checking payroll. WhatClinic was lucky enough to hire a great general manager who was training in HR, and so we had a skilled multitasker who could provide support for multiple functions. Also: read THIS Wired article about interview tactics and implement an internal reward program for new hires to avoid recruitment fees.


After a round or two of funding, it’s tempting to run out and buy a truckload of nice office furniture. Don’t. It’s officially a cliché to be the startup with bean bags in the meeting room.

Things you need:

Industrial grade coffee machine

Ergonomic chairs (2nd hand)

Business cards for sales people


Up to date software licences

In post-boom Dublin, startups have a knack for being lean. Revenue and profitability are everything: if you’re not spending to further business goals or increase efficiency, then it’s a vanity project.


Oh my word. Meetings. Monthly forecast meetings, Quarterly reports, Board meetings, Weekly progress report meetings, Daily huddles and interdepartmental scrums. It’s horrible.


  • Smart companies will make efforts to reduce meeting frequency and duration, to make sure everyone sticks to a set of ground rules (ones promoting active listening) and to set tasks and deadlines. Read THIS great post from Forbes about meeting guidelines.

IN CONCLUSION… So, you have a startup, and it’s actually staying up – congrats! Now you have a whole heap of other problems to worry about.

A quick recap:

  1. Grow smart
  2. Stay family
  3. Hire well
  4. Stay lean
  5. Manage meetings
  6. Open your office in Dublin!

 One more thing… good luck!


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