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South African CFO’s Leap of Faith to Join Texas Health Care Startup

Brett Tromp, former CFO of South Africa’s largest health insurance carrier, discusses why he left his country to join a startup in Texas.
Sandra BeckwithDecember 8, 2022
South African CFO’s Leap of Faith to Join Texas Health Care Startup
Photo: Getty Images

“If you want to grow, you have to stretch yourself to do something different and learn new skills.”

Brett Tromp’s high school classmate had been trying to lure him to the United States for years. 

The friend, Clinton Phillips, emigrated to the U.S. soon after college and quickly became a successful healthcare entrepreneur, founding several businesses. One of the newest, Medici, is an Austin, Texas-based virtual healthcare system working to transform healthcare delivery by using mobile technology to connect doctors and patients more quickly and frequently. 

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Philips wanted Tromp, the CFO of South Africa’s largest health insurance carrier, to join Medici’s finance team to handle mergers and acquisitions. But Tromp, in his 15th year as CFO of public company Discovery Health, was at the pinnacle of his profession in his home country. 

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  Brett Tromp

Honored as South Africa’s Young CFO of the Year in 2015 and recognized by KPMG as one of six alumni impacting the business world in 2016, he was widely recognized as a finance expert. A monthly contributor to a national accountancy magazine, Tromp was a frequent international conference speaker and a regular guest lecturer at UC Berkeley post-graduate classes. And, as his role at Discovery Health expanded to include CEO of the company’s home care, pharmacy, and wellness division, he had no urge to leave.

Even so, his friend was dangling a tantalizing carrot — an opportunity to join a team poised to revolutionize how Americans engage with healthcare providers. Medici’s personalized virtual interconnected healthcare system allows consumers to get access to a primary care provider or specialist in just a few hours. The approach advocates for early and ongoing engagement with providers so that healthcare problems are identified and treated early — and are less costly as a result. 

The Decision-Making Process

Tromp finally agreed in late 2021 to join the six-year-old startup, but his decision to accept the offer and apply for the exceptional ability green card that would make it possible wasn’t a quick or easy one for the finance leader and his wife. With twin teenage sons and a pre-teen daughter to think about, they had to examine both what they would gain from a move as well as what they stood to lose. In the end, three conclusions led the family to relocate across the Atlantic Ocean. 

It started with prayer. “I’m a very faith-based person, so a lot of this was around my belief in God and trusting that there is a bigger purpose for us on this planet,” Tromp said.

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  Brett Tromp and his family

Next, Tromp and his wife discussed opportunities in America for their children. With politically unstable South Africa’s unemployment rate currently at almost 34%, they agreed the U.S. offered more hope. “If I had to give my kids a better future, where would it be? That weighed heavily,” he adds.

The third factor was the opportunity the job presented to make a difference in people’s lives. “I could really do something significant,” he said. Ticking all three boxes made the decision to relocate more clear.  

Culture Shift

Leaving family, friends, and the culture they grew up with on another continent was difficult for the family, but a few lifestyle changes have made it easier. One of the biggest has been the lower crime rate in Austin, Texas. In Johannesburg, Tromp said, “Everyone lives behind big walls, security sensors and alarms, and burglar bars on the windows. Walking in the streets in South Africa is not something many people do without fear. While I love South Africa, there’s a freedom here I think many Americans don’t fully appreciate unless they have seen other parts of the world.” 

Tromp has observed workplace cultural differences, too, including less worker permanence than he’s accustomed to. Because South Africa’s unemployment rate is so high, people keep jobs they feel lucky enough to find. In addition, notice requirements when leaving a job give employers a well-defined window for capturing institutional knowledge before an employee departs. 

Everyone [in Johannesburg] lives behind big walls, security sensors and alarms, and burglar bars on the windows … While I love South Africa, there’s a freedom here I think many Americans don’t fully appreciate unless they have seen other parts of the world.

South African regulations require staff to give at least 30 days’ notice; it can be 90 days or more for senior staff. Employees can’t be fired quickly there, either, he said. “Texas has a sort of hire and fire on the same day without cause process, whereas in South Africa, labor laws favor employees much more than they do employers.” 

Does that make him anxious about his six-person finance team’s stability here? “Absolutely. What really scares me is that people can resign and leave on the same day, taking that institutional knowledge with them. On the flip side, though, you can retrench poor performance immediately,” he said.

Bringing Innovation Across the Ocean

Named CFO in June after starting with the company as head of partnerships in April, Tromp brings more than financial expertise to his role at Medici. He’s leveraging his immersion in South Africa’s healthcare insurance industry to bring innovation to the award-winning startup. “How can we do things that we did in South Africa that worked really well and that members will enjoy at a much lower price point? I think I’m bringing a lot of that sort of value into this business,” he said.

In addition to introducing AI technology that scans a patient’s face during virtual visits to record vital signs and generate a health score used as a benchmark, he’s contributing to the important conversation around patient engagement. “I’ve grown up with a lot of behavioral economics experience around how to get people to engage in healthcare,” Tromp said. “The big issue here is that some people engage too much so it costs more, and some engage too little. I’m bringing those learnings from what we did so well and applying them here.”

How can we do things that we did in South Africa that worked really well and that members will enjoy at a much lower price point?

That ability to examine American healthcare from a different perspective is appreciated, he said. “I’m feeling valued. You come here and people say, ‘Wow, we’ve never seen it like that. That’s a good way of doing it.’ It’s exciting,” Tromp adds. 

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This is the first article in a three-part series about Brett Tromp’s CFO journey. Read part two of his story.