How These Two German Entrepreneurs Handle The Pressure of Building a Company Far From Home

“As immigrants, we’re here on work visas that are tied directly to our own company. So if our company fails, there’s no plan B for us, we…

“As immigrants, we’re here on work visas that are tied directly to our own company. So if our company fails, there’s no plan B for us, we have to leave. That obviously puts a lot of pressure on us, but it also gives us a lot of motivation to make it work.”

Co-founders of Citruslabs, Susanne Mitschke and Patrick Renner, are building a platform that simplifies the patient recruitment and retention process for institutions undergoing clinical trials.

This is part 1 of 5 in “The Immigrant Founder Series: Using Adversity as a Launching Pad for Leadership”, a series created in partnership with growth marketing agency Ideometry. We spoke with some extraordinary immigrant founders who shared how their journey to the U.S. influenced their journey as entrepreneurs. Tune in every 3 weeks for another installment.

Can you tell us a bit about Citruslabs?

Susanne: Citruslabs is an end-to-end platform for patient recruitment and retention. We’ve seen that the patient recruitment market is currently in somewhat of a lull. Pharmaceutical companies are spending a ton of money on research and development for their clinical trials. They’re also spending billions on recruiting patients for the trials, and usually putting that money into TV ads, radio ads, magazines, and social media marketing.

Of course, you can reach a lot of people through this approach, but it’s very expensive and the ads aren’t relevant to 99% of the people they’re reaching. What we’re doing is using an app-based approach, amongst others through our app MindMate. Quite simply, our app aims to help users find suitable patients for their clinical trials.

Patrick: We currently have 15 employees, and have offices in Santa Monica and Glasgow. To date, we’ve raised close to $5 million.

What’s the company’s origin story?

Susanne: Originally, we started as a company called MindMate. The reason we founded MindMate is that our third cofounder, Rogelio Arellano, had a grandfather who was suffering from Alzheimer’s. Rogelio cared for his grandfather for seven years, and it was a hard time for him and his family. As someone living with Alzheimer’s, seeing that your memory is declining is not a good feeling, so we wanted to build a tool that engaged Alzheimer’s patients in a very meaningful way. The tool we built does this through mental exercises, nutrition profiles, stimulating games, and educational content.

Early on, as we began to build MindMate, we had to find a business model that worked. We tried a subscription-based program, in-app purchases, and even selling directly to nursing homes, but nothing was really working.

Our business model eventually came as a result of an Alzheimer’s convention that we attended. We were gaining a lot of traction in the Alzheimer’s community, and were approached by a pharmaceutical company that said they could use some help with their patient recruitment efforts. We looked into this market more and saw tons of inefficiencies and immediately decided that this is the market we actually want to be in.

How did you end up starting a company in the U.S.?

Patrick: So we’re kind of double immigrants, because we first immigrated to the U.K. and then to the U.S. We first started a company in the United Kingdom, after we finished grad school there. It was a good starting point for us, and we had a lot of support from the local ecosystem in Scotland, especially in regards to funding and initial prototyping.

However, we felt that in order to build a bigger business and serve a bigger market, we had to move on to the U.S. We were able to make this move through the support of Techstars. I think making the move to the United States and having the support of others gave us confidence and made us believe that we could build a business here.

Susanne, you traveled all over the world before eventually settling in the U.S. Can you walk us through your journey?

Susanne: I’ve always had a travel bug, and never wanted to settle down in the place where I grew up. As I got older and was still living in Germany and attending school, it made me a little sad to not be exploring the world. So I decided to move to Austria because I really liked Vienna; the city is amazing, and they have a great university there as well. Then, I did an exchange semester in Italy, and then moved on to the University of Glasgow — Adam Smith Business School to get my master's degree. They offer great classes as a university, and compared to London, the cost of living was much more reasonable.

Throughout all my travels, the goal was always to eventually move to the U.S., simply because I always had an entrepreneurial mindset and felt that the United States was the best place to build a business. If you want to build a company in Europe, it’s much more difficult. In Europe, if you’re not older and more established as a professional, it’s hard to convince people to believe in you and support you.

What hardships or difficulties did you encounter as a result of living in a foreign country?

Susanne: When I was living in Europe, I never felt like I was a foreigner. No one in the U.K. treated me like a tourist. One part about living in the U.S. that makes me sad is, because I have an accent, people always assume that I’m a tourist, and that I’m eventually going back to Europe. Even when I’m telling someone that I live here, their next question is always, “When are you going back?”. It’s not a hardship, but sometimes it feels like I don’t belong in the U.S. because I don’t have an American accent, which can be frustrating.

How do you work through those experiences? Do you leverage them as fuel for motivation or is it something you’re still working through?

Susanne: To be honest, I’m still working through it. But when I think of what we’re building with Citruslabs, it makes me very proud to see what we’ve accomplished. People who assume I’m a tourist and that I’m going back to Europe are actually just wrong. We’re building a big business in the U.S., and that makes me really proud.

What advice do you have for immigrant founders building companies outside of their native countries?

Patrick: I would definitely spend a lot of time with local customers and learn about their culture. It’s important to know how they approach buying new products, and just spending time out and about in the community can really help inform you.

Susanne: You definitely want to spend time learning about the city culture, especially if you plan on actually moving there. I suggest that you spend a good amount of time in a place before moving there. To give you an example, when I was younger I was on vacation in New York briefly, but hadn’t spent any additional time in the city before moving there to launch the company. After living there for a while, I realized that the city wasn’t my cup of tea. I had a really hard time in New York because it was so busy and I just couldn’t really get along with the city.

Eventually, we decided to move the company somewhere else. We spent six weeks looking at San Francisco, a few weeks in Los Angeles, and then decided we wanted to move to Los Angeles. We liked the lifestyle there, and the ecosystem that was popping up in LA in terms of supporting startups was really good. So I would definitely suggest that, before you decide to move somewhere, really get to know the place first.

As an immigrant founder, were there experiences of failure that you were able to overcome?

Patrick: Early on, it was pretty hard for us to establish a working business model for the app. We had so many users, and had to fail 3 or 4 times before finding the right business model that generated money and revenue for the business.

Also, as immigrants, we’re here on work visas that are tied directly to our own company. So if our company fails, there’s no plan B for us, we have to leave. That obviously puts a lot of pressure on us, but it also gives us a lot of motivation to make it work.

Susanne: Another thing I can think of is building up a tolerance to rejection over time. When we first began speaking with investors, we faced a lot of rejection, and we were devastated. The second time we tried fundraising, we still received a lot of no’s, but it didn’t hurt us as much. Even this year, we’ve still had to deal with rejection when it comes to fundraising, but it doesn’t affect us nearly as much as it used to. I think that persistence can diminish doubt over time.

Was there ever a time when either of you seriously thought you might be heading home?

Patrick: For sure. In my case, my visa actually runs out next year, so I’m currently in the process of getting my extension. It requires a lot of time and money to logistically keep us here in the U.S. The amount of money we’re having to spend on our immigration lawyers just to be here is pretty insane. But ultimately, I’m just focused on continuing to build our company in the U.S.

Do you have any advice for other people who may be in similar situations on how to approach immigration lawyers or staying on top of it?

Susanne: Personally, I don’t think it’s the immigration lawyer that determines whether you’ll be able to stay or not. It has a lot to do with the initial application process for the work visa. To give you an example, when we initially applied for the O-1 work visa, Patrick and I basically had the same application. Patrick was approved instantly, but I had to wait six months to get my visa.

Three separate times, I was requested to supply additional evidence to prove how “extraordinary” I was, and it was a very hard time for me because I was living in my childhood home in Germany. I just wanted to get to my team in the U.S., grow the company in the U.S., but clearly was having trouble doing so, because I was stuck in Germany. That’s not really a piece of advice, but I would say to just make sure you get a visa that aligns with what you’ll be doing.

If you live in Europe, you might think it’ll be so much easier to get your business off the ground when you’re living in the U.S. We learned that it’s actually not, and there are still plenty of challenges you’ll have to face. So for aspiring entrepreneurs that are coming to the U.S. from Europe, don’t assume that everything will be easier once you’re here.

Is there anything else that you’d like to share in relation to being an immigrant founder and building a successful company in the U.S.?

Susanne: If you’re someone who is hoping to grow your business, I would consider keeping your engineers overseas, especially if you own a tech company. We currently have a development shop in Glasgow, and we’re saving a lot of money compared to what some of our entrepreneurial friends are paying here in the U.S. for an engineer. Especially as a venture-backed startup, keeping your engineers in Europe can really decrease your burn rate.

Patrick: I still believe that the United States is the best country to start a business in. So while I would recommend coming here, you definitely need to make sure you have your visa situation figured out ahead of time. If you’re from Europe, you’re probably not used to jumping through tons of legal hoops just to be in a foreign country. Make sure you handle all of the logistical matters regarding your work visa, you’ll thank yourself down the road.

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Stay tuned for our next interview as part of “The Immigrant Founder Series: Using Adversity as a Launching Pad for Leadership”. In December, we’ll be sharing our conversation Yossuf Albanawi, co-founder of Pilleve. He’s working to tackle the opioid crisis head-on by providing a safer way to prescribe, distribute and use opioids.

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