Can a Physician-Led Startup Beat Billion-Dollar Competitors at Early Cancer Detection?

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Dr. Richard Bernert talks about competing against billion-dollar companies, finding an underserved market, and building a business around a problem that affects millions of families.

Richard Bernert, MD: The Startup Strategy Big Healthcare Companies Might Be Overlooking

Richard Bernert GTM Podcast (https://go.fullcast.com/e3t/Ctc/I7+113/d2lPTz04/VX48x-6gRgX_W40y52x3lYvnYW3QbRmh5WmJGSMtGxm-3prCCW95jsWP6lZ3mjW8zxfNw7nTr3bW1yCZRD6PGh7sW8h3mwD7NkPFjVtrC6j82jwhKW9dhNPS4qPMxLW2kTNfn7K7ShrW5Qt67_80LL6CW8ghBQ87BPTgHW5Cn-qK7XCTvqW5JrHgP4269QZW5j5Blq79j6nLW6QntWV94_NGDW5jf7RQ8xwPs_N1vFbdv7GMdYW3LQ1Y982wf4bW2_KcxP3spN7jW6XJzxp3RQdRSW5QQMxG1rc93TW2pHBkg2LkfWMW7ZXqvm7K_pmWW8-mkbs62ckQmW1tb0kM909x2rN2GGZRM_xp63W14F_xc3FhlKQVdvxDh5BGcPVVTXlT75VHnZFW1GFT4k21kQ2KW4hTMHb3MVs-4W4byKGW16MR9dW2YWfnw7tV6VWf4dYhKW04 )

Dr. Richard Bernert, Chief Medical Officer and Chief Operating Officer of Precision Epigenomics, isn't your typical startup executive. He's a practicing pathologist, an entrepreneur, a former Air Force physician, and, apparently, a pretty determined salesman. His company's EpiSeq blood test has produced promising results in a recent case-control study, including early-stage cancer detection rates that Bernert says compare favorably with those reported by much larger competitors.

But promising science doesn't automatically produce a successful business. In this episode of the Go-To-Market Podcast, host Dr. Amy Osmond Cook, CMO and co-founder of Fullcast, talks with Bernert about competing against billion-dollar companies, finding an underserved market, and building a business around a problem that affects millions of families. Their conversation offers a reminder that sometimes the most effective go-to-market strategy starts with knowing exactly whom you're trying to help.

Here are some interview highlights:

You've had a remarkable career in pathology and entrepreneurship. What made you want to move into early cancer detection?

I've been practicing laboratory medicine since about 2003, primarily in dermatopathology, which involves examining skin biopsies to determine whether something is benign or cancerous.

We built Arizona Dermatopathology around the idea of providing top-tier performance, and we had tremendous success because we had such a strong team.

But at some point, I started thinking about my role differently.

"I was sitting there like the umpire, calling balls and strikes. Okay, this one's benign, this one's cancer. And that's incredibly important work. But what if we could get on the field of play and actually bend the curve?"

What if we could start diagnosing cancer earlier, before someone develops symptoms and discovers they have advanced disease?

When you detect certain solid tumors at stages one or two, there's often a much better opportunity for curative treatment. Once cancer reaches an advanced stage, treatment can become far more complicated, expensive, and difficult for patients and their families.

Globally, we're talking about approximately 20 million new cancer diagnoses and 10 million cancer deaths annually. It's an enormous problem.

I wanted to be part of developing something that could make a meaningful difference.

You're competing against companies with enormous financial resources. How does EpiSeq compare?

We recently completed a case-control study involving more than 400 patients who had been diagnosed with cancer.

We focused heavily on stages one and two because that's where early detection can potentially make the greatest difference.

There are other companies developing similar tests, including some backed by billions of dollars.

We're a medically led organization with physicians, scientists, and experienced business professionals. But we're not a billion-dollar, venture-backed company.

"This is truly a David-and-Goliath type situation."

When we compared our early-stage detection results with published results from competing assays, we found that our sensitivity was roughly twice as high.

For stages one and two, our test demonstrated approximately 53% sensitivity, compared with figures of 28% and 33% for the competitors we discussed.

We've also detected more than 80 different cancer types.

That's tremendously encouraging, especially because so many cancers don't currently have established routine screening options.

You learned the founder-dependency lesson firsthand, didn’t you?

I did.

Three years before we sold my company, somebody came to me and offered me a ridiculously low number. That forced me to look at the business differently. I realized the problem was the guy in the mirror. I had made myself too important to the business. That experience changed how I thought about building the company and eventually selling it.

One of the things that stood out to me was your work detecting brain cancer. You mentioned that competing tests haven't demonstrated the same results. What's different about EpiSeq?

Brain cancer is one of the most exciting areas of our research.

One of the market leaders attempted to detect brain cancer in its case-control study and reported zero detection in that particular analysis.

In our study, we were detecting approximately 60% to 70% of brain cancers.

What's especially interesting is that we detected both high-grade and low-grade brain cancers.

High-grade cancers, such as glioblastoma, are aggressive and tend to grow quickly. Lower-grade gliomas grow more slowly and can be much harder to identify through blood-based testing.

We actually did great with the low-grade brain cancers too. That's probably one of the more exciting things. It's an area where we believe our technology has significant potential.

You're competing with companies that have enormous budgets. What has helped your smaller team gain traction?

I think the biggest advantage is focus.

We're a relatively small group of people, and we're all committed to the same mission.

We don't have unlimited resources, so we have to be thoughtful about where we spend our time.

That means understanding who needs our technology, explaining why it's different, and personally connecting with those communities.

We're also fortunate to have a strong team of physicians, scientists, and business professionals who believe in what we're building.

For me, the work is incredibly rewarding because the potential impact is so significant. We know why we're doing this, and we're not going to give up.

Listen To The Full Interview Now!
(https://go.fullcast.com/e3t/Ctc/I7+113/d2lPTz04/VX48x-6gRgX_W40y52x3lYvnYW3QbRmh5WmJGSMtGxm-3prCCW95jsWP6lZ3mjW8zxfNw7nTr3bW1yCZRD6PGh7sW8h3mwD7NkPFjVtrC6j82jwhKW9dhNPS4qPMxLW2kTNfn7K7ShrW5Qt67_80LL6CW8ghBQ87BPTgHW5Cn-qK7XCTvqW5JrHgP4269QZW5j5Blq79j6nLW6QntWV94_NGDW5jf7RQ8xwPs_N1vFbdv7GMdYW3LQ1Y982wf4bW2_KcxP3spN7jW6XJzxp3RQdRSW5QQMxG1rc93TW2pHBkg2LkfWMW7ZXqvm7K_pmWW8-mkbs62ckQmW1tb0kM909x2rN2GGZRM_xp63W14F_xc3FhlKQVdvxDh5BGcPVVTXlT75VHnZFW1GFT4k21kQ2KW4hTMHb3MVs-4W4byKGW16MR9dW2YWfnw7tV6VWf4dYhKW04 )

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Did you hear? Fullcast published a book!

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Amy Osmond Cook, PhD

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20 October 2026 · 18:00 UTC