Why Healthcare Startups Need Physicians Who Understand the System with Dr. Jennifer Miles-Thomas

Physicians are trained to follow clear pathways—but innovation, advisory work, and startup leadership rarely come with a playbook.

In this episode of Startup Physicians, Dr. Alison Curfman sits down with Dr. Jennifer Miles-Thomas, urologic surgeon, former private practice CEO, MIT MBA, and healthcare innovation leader at Northwestern Medicine.

Jennifer shares how she navigated the transition from academic medicine to private practice, led a large surgical group through the COVID-19 crisis, and ultimately moved into system-level innovation, incubators, and startup advising.

This conversation is a grounded look at how physicians create value outside of patient care—without burning out, giving work away for free, or abandoning medicine altogether.

In this episode, we discuss:

• Why physicians underestimate their value in startups and innovation
• What becoming a CEO during COVID taught Jennifer about leadership and pivoting
• How private practice prepares doctors for entrepreneurship
• Why AI and data literacy matter for physicians—without needing a tech background
• How to start advisory work without getting taken advantage of
• The role of incubators and health system innovation programs
• Practical ways physicians can explore non-clinical impact while staying grounded

This episode is especially relevant for physicians who feel ready for more impact, creativity, or system-level influence—but want to move intentionally.

Chapters:

00:00 – Why Physicians Belong in Innovation

00:53 – Academic Medicine vs Private Practice Reality

02:59 – Becoming CEO in January 2020

03:43 – Pivoting During COVID

04:55 – Why an MBA (and Why MIT)

06:05 – AI Isn’t Magic—It’s Math

08:25 – Moving Into Health System Innovation

10:45 – The Hidden Value of Physicians in Startups

13:00 – How to Start Advisory Work

17:59 – Avoiding Exploitation in Business

21:56 – Defining and Pricing Your Value

25:23 – Incubators, Accelerators & Health System Opportunities

29:13 – Final Advice for Physicians Exploring What’s Next

🔗 Connect with Dr. Jennifer Miles-Thomas: www.linkedin.com/in/jennifermiles-thomas

Transcript

Alison Curfman (00:00.942)
Hi everyone, welcome back to Startup Physicians. This is your host, Dr. Alison Curfman, and I am joined today by Dr. Jennifer Miles-Thomas. Thank you, Jennifer, for coming on the show today.

Jennifer Miles-Thomas (00:11.525)
Thank you. Thank you very much for the opportunity.

Alison Curfman (00:14.497)
So we met at a conference that I've talked about before. It's called the Health Conference, HLTH, and a lovely colleague of ours arranged a breakfast for some physician innovators, and we just had such a nice time. And Jennifer, I loved hearing about your story and all the different work that you've been involved in from being in...

going from private practice to more academic practice, but also doing a lot of work with startups and venture and incubators. So I would love if you could share a little bit with us about your journey and how you got started.

Jennifer Miles-Thomas (00:53.809)
Sure, I would love to. I'll start kind of in the beginning, but as a surgeon, I am pretty efficient. So it's gonna be a long story. So I started, so I trained at Hopkins and in Hopkins, the mentality really is like, you are always gonna be an academic, right? You're going there because you wanna be a chair of her department. But while I was there, I was thinking, hmm, there has to be more, have to be different models to practice. So I first joined a smaller health system.

spent about five years there. And as everyone knows, when you finish residency, you think you know everything. And then you start practicing, you're like, learning curve, all of these things I had no clue about, right? And a lot of it's the business of medicine or just literally how to work together in teams. And so after about five years where I was, I was like, this doesn't seem like the right fit. These aren't my people. And I mean, I'm five years out, didn't really know what that meant, but I just knew it wasn't comfortable.

So then I joined a private group, and this is one of the largest private urology groups in the country. So pretty diverse patient population covered a big swath of the East Coast, and I learned a lot there. I learned a lot about working with people who are now like your equals. I learned about how to actually put things like ideas in place, because in private practice,

You can build whatever you want, but it has to make money, right? Because otherwise it comes out of your pocket at the end of the day. So understanding how to do performance, understanding really about marketing, how to figure out who your avatar is, all of those things that we think about with startups now, I had to learn about in order to build new products for our patients. And while I was there, as I was building things, I moved onto the board and then I was voted to be the CEO. That was...

That was an awakening because of course I said I should have played the lottery instead because it was January 1st of 2020. Right? So I'm the brand new CEO running this like huge company, making these decisions, just surviving day by day. Because honestly, when you come in, there's not really, it's not like open this folder first and here are the five things you're doing. It's more of, Hey, we have these emergencies. This is going on. And yes, your patient is also calling.

Alison Curfman (02:59.763)
wow.

Jennifer Miles-Thomas (03:18.949)
So it's quickly trying to get up to speed figuring out how to run a business, understanding the legalities of you signing documents, taking loans, all of those types of things. And then the world shuts down. during.

Alison Curfman (03:31.519)
Especially for surgeries, For like, that was a very bizarre time to be in your first like CEO position of a medical practice of a, I'm assuming it was like a surgery group.

Jennifer Miles-Thomas (03:43.332)
Yes. yeah, it's a urology group. So it was very interesting. But one of the life lessons is the way that the world works is you have to pivot. And I think that's for all of us. And that's like the startup world also. If what you're doing isn't working or not possible, you don't just burn the house down. You figure out what can you do next or how can you do it differently? And what we did is we pivoted

to an ASC and learned how to do surgeries on an outpatient basis because the hospitals were only doing emergent cases. And that kept us very viable. And it's kind of like, honestly, if we look at what CMS is doing in 2026, it's the model that they're following of, hey, move it from the facility into the outpatient world because it's cheaper for the system overall, even though it could be the same exact quality or higher. So while I was CEO, I mean, I guess I wasn't busy enough, i.e. I slept every night.

Basically, I decided to take a new adventure. And for that, I said, well, let me get an MBA because I do know there's multiple different ways to run businesses and there have to be best practices. I don't know if we're always doing the same best practice because it's always great to get inside, like an outside review of what you're doing inside, especially if you've been there for a little while. So I decided to go to MIT, not because of it was MIT. It was I understood that the language and

how healthcare was moving was going to be based upon data. It seems historically as we were training, it's always about, and I don't want to say anecdotes, but you learn the way that your institution always did it. And it was like, this was the Hopkins way. Well, maybe there are other ways that people are doing it. And maybe if we had more data, we'd make some tweaks. And so I said, well, where's the best place to learn about how to use data, how to understand data, how to model data? And that was MIT. So I joined the executive program, which was an

interesting time because literally it was in person. This was not online. So I would fly back and forth from Virginia to Boston every other week for two years. it was, you land at 730, class starts at eight, you were in the Uber and you were logging in as you were running in with your suitcase type of thing. But, well, know what? Like residency was intense. Like we've done hard things. And like I said, in residency, you can't stop the clock.

Alison Curfman (05:52.33)
you

Alison Curfman (05:56.416)
That's intense.

Jennifer Miles-Thomas (06:05.135)
So I knew I could do something for a finite amount of time and get what I needed. But when you're there and when you put yourself in situations where you haven't been before and there aren't people just like you, you learn a lot. You learn a lot about the rest of the world, how other people think differently. And a lot of times in medicine, we are, I'm just gonna see the patient, that's it. I don't have time for anything else. And then when you meet other people, you're like, wait a minute.

These people are, they may work in law, but they're building something in finance. And you realize the world is truly your oyster. You're only limited by what you're willing to do. And so that was also the time where open AI was now becoming public. And it's like, whoa, this whole AI thing. then of course, the first iteration, first versions never as good, but then quickly that snowball was like building. It's like, whoa, you can actually do a lot.

And to understand how the algorithms are written, understanding the different types of neural networks and when you're supposed to do what, and the ways to figure out probabilities, I was like, this is just math. All right, I can do math. So it's not this like woo woo in a black box. It's math algorithms. And it's going to be useful in medicine. Knowing that all of the data that we're collecting on our patient is going to be utilized in some way, either for or against us, right? Because there's a lot of other competing interests. I said,

All right, this is a space that's gonna explode, I have to understand. And so for me, it was a big decision where I really wanted to work with startups, I wanted to work in innovation. Now I had some of the expertise, I traveled to Africa to work with deep tech startups. And I was like, I love this space. I like seeing patients, I love operating, but I wanna try to use most of my brain. And this opportunity here at Northwestern Medicine presented itself saying, hey.

We would love someone working in innovation and help us guide and integrate just how the systems could work. And I felt that my background, definitely knowing the deep dive into private practice and how to run large businesses, and then also hospital system medicine and how to think, it's very different to manage 300 employees than it is 30,000 employees. And just to think systems level, how to implement, how to start new ideas, understand.

Jennifer Miles-Thomas (08:25.794)
all of the implications of even small changes is what I loved. And so then I said, well, I have this inside knowledge. I definitely need to work with people outside because they're not going to know some of the nuances of how to actually get their products in, things that we desperately need. And so that's how I kind of navigated from the beginning into this innovation space.

Alison Curfman (08:48.765)
That's amazing. And I don't want people to be intimidated who are listening, who are like, man, she like, she's got an MBA from MIT and she does, does all this work in Africa with startups and da da da. Like, yeah, I think one of the things we talked about before we started recording was that we all inherently as physicians have a very valuable skillset. And so,

We can absolutely learn from people like you who have found a lot of lessons in the ways to apply those skill sets. And now you're doing that at scale. You're running the innovation at Northwestern. I know we talked a lot about incubators and even your description of the fact that understanding how the healthcare system actually works is something that I think it's a piece of knowledge that I think we.

take for granted, we kind of think everyone knows that, but I've even talked to companies at times where I start to describe something about how the ER runs and they're like, really? I didn't know that. And I'm like, how do they not know that? Yeah, the people come through the triage and then they come to the back and then da-da-da-da, you know? And so just even our knowledge of the system, not even our subject matter, not even your knowledge of the kidneys and the ureters and the bladder.

Jennifer Miles-Thomas (09:49.69)
Yeah.

Jennifer Miles-Thomas (10:01.881)
It's

Alison Curfman (10:05.043)
But your knowledge of how health care works is incredibly valuable because any company that wants to get their product or service into a health care system or a private practice, they're going to want to know what are the barriers, what are the pathways. And so that's really, really valuable. What sort of advice would you have for people who are in a more traditional setting but

yearning for something more, more impact, more creativity, something to do on the side to generate income and are exploring this whole advisory world.

Jennifer Miles-Thomas (10:45.7)
Yeah, think one is to reach out. there's, I mean, with the age of social media, I'm not on TikTok. I think I'm actually banned from TikTok. One of my kids, I think, reported me when I did the first one, but we won't go there. but like on Instagram, on Facebook, there are, mean, there you can follow people to hear what they're doing. You can reach out to people. On Facebook, there are groups where, I mean, just...

physicians who either VC or innovative in even in your specialty people are talking about ideas and I think for us sometimes as physician There's like this immediate barrier of like we don't want to assume that we don't know because honestly in our worlds we're always the expert but to really come in as I would like to learn something different because we are like

We are perpetual learners. That's how our brains work. We want to learn more about different things. And so if you're a little bit vulnerable and just say, wait, hey, I don't understand this. me how did you start? Or hey, can I have a quick call with you? Or hey, you're in this group chat. Or hey, you're in this Slack channel. Can I just join? And then you network and you meet people. I think one of the things that we are all very good at, if we're

in direct patient care, we learn how to establish relationships very, very quickly. These are people we do not know at all. They're coming in. They're sharing their deepest, darkest secrets. And we're making them feel safe, secure. We're having a real conversation with them person to person. And that's a skill set a lot of people don't have, right? We're not all stuck in our basement playing video games, but we've learned to actually have those conversations. And so,

You can do that with other people who aren't your patient. And I think it's really helpful to kind of just reach out. I mean, there are meetups. There are social things that you can do to find these networks, or you can reach out to people on LinkedIn who are already in these networks. Yes, they may have 10,000 followers, but guess what? Hey, I'm also a doc and I'm interested. Hey, are you doing X, Y, or Z? Or, hey, do you have a minute? Most people will actually say yes.

Alison Curfman (12:49.584)
Yeah.

Jennifer Miles-Thomas (13:00.432)
And then you get kind of freaked out because you're like, oh yeah, they said yes. Now I actually have to do something and talk to them. But that's how you start. And at a certain point, you'll be like, yeah, whatever. Rejection is important. You have to be able, because we're all superstars, right? We got here because we did well in the process. We did well in school. We did well in college. We did well in med school. But in the real world, people are going to tell us no, and they're going to reject us. No just means.

Alison Curfman (13:11.239)
you

Jennifer Miles-Thomas (13:28.686)
Not now, not yet, or hey, change your story, pivot a little bit, try it again with another person. These people don't remember you. They don't really care, right? So it's not like a personal like damnification if you got rejected, you just package it a little bit different, pitch it again. And so I think that's taking ourselves out of it and our own like emotional need to be like liked and wanted. Just put it aside and just try something.

Alison Curfman (13:56.357)
I love that. think that strategic networking is something that anyone can be doing at any stage in their career, no matter whether they think they actually want to move forward with starting a business or creating a side gig, or if they're just kind of exploring, it's free. It is very low risk. I like to encourage physicians to start by

identifying the types of problems that they want to solve. Like I think that when you're drawn to something really meaningful, it can help guide your outreach and determining what direction you might be wanting to go instead of just being like, I don't know what I want to do. I, I, cause you might, I don't know, look through LinkedIn job postings or something and just like nothing really feels like it.

hits right, but if you're more targeted and you start to research like what's really important to you, like for me, it was complex care for pediatrics and I had all these ideas and I also had a lot of thoughts on how to reduce unnecessary emergency department utilization because as an ER doctor, I felt like that was just a huge problem in society that people don't have access points. And so I started by identifying

like something that would really make me eager to work on something. There's other problems that people share with me, like other concepts people bring to me. in the back of my mind, like, that doesn't get me excited. I wouldn't really want to work on that, because you have a limited time. But if you start by identifying problems that you're interested in solving and then start doing some research, I think that as soon as people start looking, they start to realize that

there's a lot more going on in their field than they ever were aware of. And they might start to have opinions and ideas on like, they should not be doing that that way. Or, wow, that's a really cool way to do that. I want to connect with them. And LinkedIn is such a great way to connect with people. think you can have a little.

Jennifer Miles-Thomas (15:51.844)
Yeah, agree.

Alison Curfman (16:10.693)
you know, blurb intro of who you are and you can send a message to a founder or a doctor who works at a startup or maybe someone who's on a product team or as a CEO and just express interest in their idea and see if they want to connect. And I think that, like you said, we don't like rejection. We want to be an A plus always accepted. But nobody

Like the worst that happens, they just don't respond. Like it's so low risk. So that's one thing that I feel like everyone can do. They could just like start building that muscle, like start practicing reaching out and being rejected or just ignored or accepted. Yeah. Because I think that the number one thing to help you to move into a new area is the people you surround yourself with.

Jennifer Miles-Thomas (16:47.376)
this reach out.

Jennifer Miles-Thomas (16:50.948)
accepted or not.

Jennifer Miles-Thomas (17:03.118)
Yes, I agree completely. think it's because we've always been trained to work in teams, but we don't think of that outside of medicine. But it's the same. Like you're saying, build a team, build a support system. People who've been there and did that journey already will help you. Like it is people want to help the next person.

Alison Curfman (17:25.379)
And that's my vision is that like I've already walked this road of being a founder and working in venture and being an advisor. And I just see so much need. And so my goal is to try and help create pathways for other physicians to do this as well. one of the things that we were talking about is some qualities that are pretty, common in physicians and in particular, we tend to be.

I don't know if you would say more trusting or more, we're held to a really high standard in ethics and in practice. And I think sometimes we expect that the rest of the world will operate that way too. I don't know what your reaction is to that.

Jennifer Miles-Thomas (17:59.761)
they are.

Jennifer Miles-Thomas (18:11.61)
Yeah.

Yeah, I completely agree. mean, we are trained from the beginning to be very altruistic, right? We're going to forgive lack of sleep or no food in order to do something for someone else with no expectation of direct payment, right? We're doing it because it's the right thing to do. I think there is more of a balance in the outside world. And for me, that was one of the first kind of awakenings of, for some people, you interact with it.

with them, it's just their job, right? They're going to clock in, clock out. This is what they're doing right now. Some people have been in this quote unquote game for a while and they will try to extract things from you. And so again, you need a team of people who have been there before. You need relationships so you can bounce things off of people. I don't think anyone is intrinsically evil. However, it's business. this, when you interact with different

Whether it's pharma, whether it's other type of industry or device companies, like their job is to build something that's going to be sold. You have insight and information that could help them do that. So you have to have that balance of being like who you are, an intrinsically good person who wants to help and change the world with, hey, your resources are worth something. And we're talking monetary something, not just your time. So it's all trying to figure out.

how to give, but make sure you're not abused.

Alison Curfman (19:43.236)
Yeah, that's where I feel like lot of doctors hesitate and or just never move forward in this space, even if they're interested, is they're worried about getting taken advantage of. And they don't have like a point of reference of what's normal or what's typical. I see some people coming in really rigid and being like, oh, I would never talk to anyone unless they paid me $750 an hour. And I'm like, okay, well, like that.

could be your standard, but you're not gonna get a whole lot of conversations and you're not gonna be able to build relationships that way. Whereas it is something we work a lot on in the trainings that I do is about how you can really have a fast track way to identify what value they're really looking for and whether or not you can fill that need. I tell people, I train them on how to have a 30 minute, I'll have a 30 minute discovery call with anyone that is.

you know, interested in potentially working together, but then that's it. Like we're gonna, we're gonna understand each other and the core of each other's, you know, backgrounds and mission and challenges. And then at the end, I'll ask if they would like a proposal and if they say yes, then we'll move forward. But I, I have talked to doctors who are like, yeah, I like really trying to close this deal with this company. And I've had like seven or eight meetings over two or three months and we're going to meet again. And I'm like,

Why would they close a deal with you? Because you're doing the work for free. You're checking in with them on a monthly or biweekly basis. Don't do that. And sometimes people are just like, I had no idea. I didn't know not to do that. Like you said, we're altruistic. We want to be like, how should we move this forward? OK, let's meet again.

Jennifer Miles-Thomas (21:08.494)
Mm-hmm. You're volunteer.

Alison Curfman (21:28.105)
And so I think that one of the ways we as physicians can really help each other is those of us like you and I who have done a lot of this work can help to provide those points of reference. I am very open about like pricing and different ways to structure deals and how you can avoid being inappropriate in either direction, either letting yourself get taken advantage of or being too demanding and really out of the realm of what is normal.

Jennifer Miles-Thomas (21:56.344)
Right. But I think also like what you said earlier was they don't know your value, right? Because there is a huge spectrum of physicians. Some people are great with ideas, but can't execute. Some people can execute anything, but if you give them something first, if you give them the idea, these companies, these other people, don't know you at all. So it's your job to show what value you could bring. And then

with contracting actually execute that value where you're getting maybe monetary value or access to information or access to potential career pivots and they're getting the data from you that they need in order to build their business.

Alison Curfman (22:40.896)
Yeah. And I think that we're trained in a way that like you go to med school, you know, the next thing you're going to do is residency. And when you're in residency, you know, most of us are like, okay, I'm either going to go get a job or I'm going to do fellowship. So there's like really clear pathways. There's a lot of protocols. There's a lot of this is how you do this. And when it comes to creating value that is so subjective and it's based on what you

Jennifer Miles-Thomas (22:59.353)
Yes.

Alison Curfman (23:11.382)
believe you know how to do, like where you believe you actually have expertise and where you have ideas, understanding someone else's problem. maybe for you, it's a company that's like, we have a product or service that our business model is based on contracting with health systems and it's complicated. And you may see that as a problem and know that you know some stuff that will help them overcome that problem.

So you've identified what value you could contribute. They're not necessarily coming to you and saying, here's exactly what I need and exactly why I think you're the right one. and exactly what the job description is and what I'm, I mean, some places will have something of what they want from an advisor, but a lot of times it's up to you to find and define the value based on what you know about yourself and what you've gathered about the

company and their challenges. And that can feel very different because there's not necessarily a protocol for that.

Jennifer Miles-Thomas (24:19.119)
Right. It's much more fluid, much more artistic, much more creative. And I think sometimes in medicine, because of these algorithms and these protocols, we are told not to be creative. I mean, because if you're too creative, people die. So we've really erred on the protocol. yeah, this is, you do have to, one, you have to understand yourself, right? What else is going on in your life, your time commitment, because these are, like, people are coming to you as a consultant.

to get the information and the knowledge you know, but you also have to have a balance to make sure that what you're sharing, what you're giving is what you have a deep interest in. Because what's the worst case scenario is to be able to be an advisor. But like you said before, if you have no passion for the problem, it's another job. And do you really want another job? No, you're doing this because you...

you feel like you can make a difference, that you see a problem that you want to help someone solve. So I think it's just a different mindset. You just have to make a little pivot.

Alison Curfman (25:23.871)
Absolutely. And as we're wrapping up, I'd love for you to share a little bit about your work with the incubator programs and what that looks like, because I think a lot of people don't know actually how many resources are available for entrepreneurs and founders and how many support systems are existing in the form of like their nonprofits. these are, these are

programs that are specifically designed and built to help entrepreneurs. And I know you've been working with some.

Jennifer Miles-Thomas (25:57.112)
Yes, I think it's always exciting to kind of discover something that was always there, but you just didn't know about it. And sometimes I say it's not always advertised in the same way, or it's the fact that we all get 50,000 emails a day and we just kind of delete the ones that aren't something that you have to take immediate action on. But yes, most of the health systems, especially the academic ones, do have some type of innovation.

either access, competition, or incubator. And how it usually starts is a lot of the academic centers have a university arm as well as a health system arm. Sometimes they're combined, sometimes they're separate. But let's say both ends, they are looking for ideas. We know that medicine, I mean, it's changed over last 10, 15 years. Now with AI and data, it's going to change even more. But they're looking for people to help

in many aspects with ideas. Some people are creative geniuses, will come up with ideas. Some people understand the systems and can execute. Some people are great at managing teams. They understand the personalities and the psychology about building together and putting the right people in the right room in order to make something happen. So I would ask people just to reach out. A lot of things are actually on the websites for each of the institutions and health systems, but usually they have competitions.

If not every year, it's every other year. And they're reaching out for ideas. Now we're all super busy. I mean, we all have 15 internal jobs, seeing patients, taking care of our families, taking care of ourselves. But a lot of times these incubators or these programs and competitions actually have funds to help. So they have resources, they have people who can mentor you, they have...

resources that maybe will provide some salary support so you can build something. Because the idea is if we can do something better, faster, let's say improve patient care, overall the entire system wins. So they're willing to put resources behind it. But also no one believes that they know everything or that every single person works for their health system that could contribute. So sometimes they partner with other kind of accelerators or incubators. One that Northwestern

Jennifer Miles-Thomas (28:18.955)
recently aligned with is tech stars. And so in the Chicagoland area, if you have a health tech company, you can engage in the competition. And we're basically looking for people who have developed companies that can solve the problems that we have internally. And it's not just, we're going to buy your product. It's more of a partnership. It's more of, hey, we're going to show you behind the curtain and we're going to do a deep dive. We can talk about how we're aligned, how we're separate.

We can mentor you. So yes, you can go and you can build this in other institutions too. The goal is for everyone to win, but you have to see and understand what is actually happening, boots on the ground from the inside and not the outside. So I think there's many avenues just depending on what you would like to do. And like what you said earlier, find your passion, find what you feel that you can contribute to. And then there's going to be an outlet for you.

Alison Curfman (29:13.044)
That is such great advice. am so grateful for your time and sharing your story and your experience. I hope that people walk away from this feeling like they got some really tangible advice on ways they may need to move forward or want to move forward. If anyone's interested in reaching out to Jennifer, we'll put her LinkedIn in the show notes. But thank you again, Jennifer, this really great conversation, and I really appreciate your time.

Jennifer Miles-Thomas (29:40.515)
Well, thank you so much. This was a great conversation and I hope it's helpful to quite a few people. I am completely available. Feel free to reach out anytime.

Alison Curfman (29:49.085)
All right, thank you all for listening. We'll see you next time. Yay.