Rethinking Healthcare: Adapting to the Startup Mindset

In this episode, we’re diving into how startups think and what we as physicians can learn from their approach to innovation. If you’ve ever wondered how design thinking, rapid iteration, and minimum viable products (MVPs) could reshape healthcare, this episode is for you. We’ll explore how startups thrive on speed, creativity, and disruption, and why adopting their mindset can empower us to challenge assumptions and drive meaningful change.

I’ll break down the key principles of design thinking, share real-world examples from my experience building care models, and explain how MVPs can save time and resources while delivering impactful results. 

Episode Highlights:

[0:00] - Welcome and introduction to the startup mindset: Speed, disruption, and innovation.
[2:54] - The five phases of design thinking and why empathy is at the heart of it all.
[4:25] - Exploring the concept of a Minimum Viable Product (MVP) and its value in healthcare.
[7:42] - The story of creating a clinical care model as an MVP at Imagine Pediatrics.
[9:20] - Challenging assumptions and how questioning “why” can uncover hidden opportunities.
[15:57] - Practical takeaways: Applying design thinking, MVPs, and assumption testing in your work.

Resources:

Check out our services at StartupPhysicians.com

If you enjoyed this episode, please follow the podcast, rate, and leave a review. Remember to share this episode with fellow physicians who might be interested in startups. Together, we can shape the future of healthcare! 

Transcript

Alison Curfman 00:00

The beauty of design thinking is that it's iterative. You don't have to get it perfect on the first

try. And quite the opposite, you almost want to be aiming for like C plus work on the first try,

because the goal is to, I'm going to talk about minimum viable product, but, but you really need

to start getting something out there to test it. And so this is very, very common in the

technology field and in any sort of product development, but it's not a concept we're very

familiar with as physicians, because we don't want to put c plus work out there when we're

taking care of patients. The goal with design thinking is to just keep improving. Hey, welcome

back to startup physicians. I'm Allison Kirkman, and I am so excited that you're here for episode

three. So last time, we talked about why startups need physicians, and we really explored some

of the incredible opportunities that are waiting for us in this space, and today, I'd like to dive

into how startups think differently, and what we as physicians can learn from their mindset,

because it's truly a very different way of thinking than the way we were trained in medical

school and in our practices. So if you've spent most of your career in a more traditional

healthcare system. You are probably used to a certain way of thinking. Change is very

incremental and slow, and risks are avoided, and the focus is often on preserving what's

already in place. Startups are the exact opposite. So they thrive on speed, experimentation and

innovation, and their goal isn't to preserve the status quo, it's to disrupt it. But here's the thing,

startups need the expertise that we as physicians bring to the table and to work effectively with

them. We really need to adapt to their way of thinking, and that's what we're going to explore

today. At times, I've seen physicians that want to work with startups and maybe are too rigid in

their thinking, and it leads to challenges in the relationship, or maybe they don't end up

working for them long term. And so it's super important for us to understand different ways of

thinking and how we can adapt to that mindset, while also really making sure that we're

standing up for the quality and safety that patients need. So today we're going to talk about

design thinking, the power of minimum viable products, and how to challenge some of the

assumptions that hold the healthcare back. And by the end of this episode, you should have a

better understanding of how to think like a startup and why this mindset is so essential for

driving innovation in healthcare. So we'll start with design thinking. If you're new to this

concept, it's a problem solving approach that puts the end user, whether that's a patient,

physician or a system, at the center of the process. Design thinking has five main phases. Firstis empathize, then define ideate prototype and then test so I'm going to break these down

quickly. So the first step is empathize. This is all about understanding the end user's needs and

experiences. For us as physicians, that means listening to patients, observing their challenges

and putting ourselves in their shoes. Next is define. Here you clearly identify the problem that

you're trying to solve. For example, let's say patients are struggling to navigate your clinics

online portal. That's the problem you would define, and then ideate. So that's the brainstorming

phase, where you generate as many potential solutions as possible, and there are always other

ideas. No idea is too big or too small at this stage, after that is prototype. So you build a simple

version of your solution, something quick and inexpensive that allows you to test your idea.

And then finally, you test so you share your prototype with others, you gather their feedback,

and you refine your solution based on what you learn. And the beauty of design thinking is that

it's iterative. You don't have to get it perfect on the first try. And quite the opposite, you almost

want to be aiming for like C plus work on the first try, because the goal is to I'm going to talk

about minimum viable product, but, but you really need to start getting something out there to

test it. And so this is very, very common in the technology field and in any sort of product

development, but it's not a concept we're very familiar with as physicians, because we don't

want to put c plus work out there when. Taking care of patients. The goal with design thinking

is to just keep improving. So in healthcare, we often skip straight to solutions without fully

understanding the problem. Design thinking really flips that script. For example, imagine a

telemedicine platform that patients find confusing and hard to use. A design thinking approach

would start by understanding why are the instructions unclear, or is the interface too complex?

Are there too many clicks to get where you need to go? And once you understand the user's

pain points, you can design a solution that actually works. So as physicians, we're already very

skilled at empathizing with patients and solving problems under pressure, and design thinking

really gives us a framework to apply those skills in a startup setting. Now I want to talk about

one of the most important concepts in the startup world, which is minimum viable product, or

MVP. MVP is the simplest, most basic version of a product or service that allows a team to test

their idea and gather feedback. It is not about perfection, it's about learning quickly and

efficiently. Here's why MVPs are so valuable. So first, they save time instead of spending

months or years, perfecting a product. Startups release a very basic version to see if it even

resonates with users. Second, MVPs allow for rapid iteration. Once you have feedback, you can

refine and improve your product. And third, they conserve resources. So why build an elaborate

solution if the problem you're solving doesn't even exist in healthcare? We often resist this

idea. We're really trained to think that everything has to be perfect and fully vetted before it's

implemented. The reality is that Perfection is the enemy of progress in certain situations, yes,

we have to get something exactly right and use the very best evidence to determine a pathway

or a best practice. But when we're talking about software development or technology

development, the risks are not always as high, and we often need to realize that putting

something out there and iterating on it is the more efficient way to create new solutions. So

that may bring us to the question of what exactly is a product in the context of healthcare? For

many of us, the term product brings to mind a physical device or a piece of technology. But in

startups, especially healthcare startups, a product can be something entirely different. At

imagine pediatrics, our clinical product was the model we designed to deliver care for children

with complex medical needs the way we delivered care. Our clinical model was the product, but

it didn't start as a fully formed solution. It started as me standing in front of a whiteboard

mapping out everything I knew that these children needed based on my years of experience

caring for hundreds of children with medical complexity, I spent a lot of time visualizing what

we call a patient journey. So this is essentially a map that outlines exactly how patients move

through the healthcare system, who they interact with, where the barriers are, what their

parents have to do, and really who else is involved in their care. And this work was very

impactful for the firm I was working with. Their expertise was in finance, in contracting and inanalyzing claims data, but they didn't have the deep clinical knowledge or patient stories that I

brought to the table. By creating a patient journey map, I was able to show them not just the

challenges that these families face, but also where the opportunities were to improve their

care. And here's where the idea of a minimum viable product, or MVP comes in. Once we

understood the journey and the barriers, we could start testing solutions. So for example, one

part of the traditional model that I wanted to challenge was the assumption that most of the

care for these children needed to happen in person. If you think about what traditional care

looks like, making appointments, getting prior authorizations, arranging transportation, sitting

in waiting rooms and seeing multiple specialists who often don't communicate directly with

each other. Families are left with individual pieces of paper after visits, and sometimes don't

have someone who's truly coordinating the big picture, and when it's 2am and their child wakes

up with a fever, who's in charge of figuring out. What to do, and so we do not replace any of

these children's doctors or specialists, but we designed what we call a wraparound care model

to provide an extra layer of support. So by questioning some of these assumptions, I was able

to rewrite the patient journey map, and I started with a blank piece of paper and asked myself,

What does this child need? What does the family need? What drives them to seek care in high

cost settings, and what does high quality care actually look like for children like this and our

MVP was not a shiny app or fully integrated system, it was just the simplest version of the

redesigned care model, just enough to test whether we could deliver high quality care virtually

as a care coordination model, while also addressing many of the barriers that families faced.

And it worked. By starting small, we learned what was effective, what needed to change, and

how to refine the model over time. And quite frankly, the model we launched with very quickly

needed to be iterated upon and needed to change into what we called v2 so it was a totally,

totally different model that was based off of our learnings of implementing the first model. And

so this story is a great example of what a product can look like in a clinical setting. It doesn't

have to be software or hardware or a physical device. It can be a process, a model or a

workflow that fundamentally changes how care is delivered. And the MVP is the starting point,

and it's how you test whether your idea has potential without over building or over

complicating it. I definitely have seen examples of people building a very complicated and

developed product before launching, and a lot of it ends up being wasted time and energy,

because it maybe doesn't solve the problem they were trying to solve. Or sometimes I've seen

solutions that never even launched. They never even get to a point where they feel like they

can launch it, because they're so focused on making it exactly right, and by the time you build

that the problem has changed. So it's really about thinking about things in a more agile way. So

you can even think about this in your own practice. So you can ask yourself, what part of my

workflow or care delivery could be re imagined as a product, and how could I test a simpler

version to see if it works. That's the power of an MVP. Finally, I want to talk about challenging

assumptions. This is one of the most powerful ways that startups drive innovation in

healthcare. We often operate on autopilot. We follow protocols, because that's the way we've

always done it, but startups succeed by questioning everything they ask, why? Over and over

until they get to the root of the problem. I think about the example of the resistance to virtual

care before the pandemic. So I was very interested in implementing new solutions using

technology back before COVID and before it was very common. And I got a lot of pushback.

Many people assume that patients wouldn't embrace telemedicine and that you couldn't give

high quality care using video. And I really tried to help people understand that it's not a

different field, it's really just a tool we can use to help provide visual information. And when we

were forced to adopt it over COVID, we discovered that not only was it possible, but it also

solved some problems that we didn't even realize we had, like potentially reducing no show

rates or improving access for rural patients, and we were able to spend more time and energy

understanding which use cases it was good for and which it weren't, and which cases still really

needed in person care. So my challenge to you is what assumptions are holding you back ininnovating in clinical work, and what would happen if you question those assumptions. Another

example with that is that, you know, a lot of times quality of care is assumed to be the way

we've always done things. And so I think about, you know, the example of people give me a lot

of pushback that you couldn't do a full exam over telehealth. And I would argue that you know

in certain cases you can. So if, if you were going to do an ADHD med refill, like, do you really

need to palpate their abdomen in that use case? Or if some. Is contacting you to show you a

laceration and decide if it needs stitches or not. You know, maybe you don't need to look in

their ears for that visit. And one of the reasons we do full physical exams in most cases, is

because that's what's required for an insurance billing code. I'm not at all suggesting that we

ignore quality standards that have been put into place. But I think it's always okay to question

why we do something that we do as positions we really have the unique ability to identify which

assumptions are based on genuine safety concerns and which are simply habits or outcome of

the system that we work in, and that perspective is really invaluable in a startup setting. We

talked earlier about putting guard rails onto products, and innovation really depends on

breaking free from the status quo, but can only be successful if it is safe and effective. So what

can you take away from today's episode? So first, you can start practicing design thinking. The

next time you encounter a problem in your practice, you can take a step back and remember

these steps of empathizing with the user, defining the problem, brainstorming solutions and

then testing them. And second, you can also experiment with MVP. So look at your current

workflows or projects, and ask yourself, What's the simplest version that I could test right now,

and what sort of feedback would I need to get to then iterate on it, and third, start challenging

assumptions. So ask why? More often, push yourself and your colleagues to think differently

about care delivery. This is one of the things that startups are really looking for, and these

small shifts in mindset can actually have a really big impact, whether you're working in a

hospital or consulting for a startup or building something of your own. I want to thank you for

joining me today. I hope this episode has given you a little bit better understanding of how

startups think, and how you can adapt to that way of thinking. In our next episode, we're going

to dive into clinical products and have a very special guest who is a very close friend of mine

and one of my mentors, and we're going to talk through the startups perspective of developing

clinical products. So if you are enjoying this podcast, I'd love for you to subscribe or leave a

review or share it with a colleague who might find it helpful, and don't forget to check out our

resources@startupphysicians.com and together, we can shape the future of healthcare. Thanks

for listening, and I will see you next time you.