Ben shares the three core skills every builder needs: a clear, long-term vision; the discipline to take one step at a time; and the flexibility to adapt when reality diverges from the plan. He talks candidly about how he coaches his team to reframe setbacks as progress, and why letting go of "pride of ownership" is essential to building the right culture.

Ben then dives deep into Everbright Health, an AI-enabled MSO on a mission to bring advanced mental health interventions — specifically TMS and Spravato — into everyday clinical practice. With over 7 million people eligible for these FDA-approved treatments and fewer than 500,000 receiving them last year, Ben explains how they are working to fill the gap. Everbright's model embeds directly into independent mental health practices, using AI to identify eligible patients from complex EHR data and providing the turnkey infrastructure providers need to offer these life-changing treatments.

Ben also reflects on lessons learned from bootstrapping, PE-backed turnarounds, and scaling Strive Health, and why getting back to business basics can be the best move a founder can make.

Practice with Joy pairs nurse practitioners with an AI-powered operating system called JOI. The platform handles the administrative weight so NPs can focus on patients. It also helps them capture value-based reimbursement, which matters when NPs are reimbursed at 85% of what MDs earn for the same work.

Chris and Erin get into the real mechanics: how the platform works, where AI belongs in the clinical workflow (and where it doesn't), and why health systems move at the speed of trust. They also talk about Joy's current focus, East Coast markets and rural Midwest communities, where primary care access is nearly nonexistent.

For founders building in healthcare, Chris's closing advice is simple: stay flexible, but don't lose your North Star.

What happens when a healthcare policy veteran interviews thousands of stakeholders and keeps hearing the same problem? She builds a company to solve it.

Carol Robinson spent years in Oregon state government shaping health IT infrastructure before launching Cedar Bridge Group, a consulting firm that brought her face-to-face with one of healthcare's most persistent — and overlooked — problems: patient consent. Specifically, the near-impossible challenge of getting sensitive behavioral health and mental health data to flow safely between providers who need it most.

In this episode, Carol shares the origin story of Midato Health and its flagship product, ShareApprove, a consent management platform designed to put patients back in the driver's seat of their own health data. We dig into what it actually takes to build a compliant, scalable software product in healthcare, why data privacy is getting more complicated (not less), and why Carol believes patients deserve to be more than "the football" in the healthcare team sport.

In this episode:

• How Carol went from state government to startup founder
• The real barriers blocking integrated behavioral and primary care
• How ShareApprove works, and why scalability was everything
• Navigating data privacy in a landscape of rising bad actors
• The financial reality of building healthcare-grade software from scratch

In this episode of No Operating Manual, host Erin O'Brien sits down with Michelle Yu, co-founder and CEO of Josie, a company that partners with organizations to support working parents through parental leave coaching and return-to-work transitions. Named after Michelle's daughter, Josie was born out of Michelle's own raw and honest reckoning with what it meant to return to the road — pumping breast milk in airport bathrooms, feeling resentful, watching talented colleagues quietly exit careers they'd spent years building.

Michelle and Erin discuss the real cost of treating parental leave as a logistical formality rather than a strategic imperative. They explore why the healthcare industry, which sets the clinical standards for parental leave, so often fails its own employees, and what the difference looks like between a lactation room stocked with snacks and a hospital OB-GYN pumping in a bathroom between patients.

They also get into the founder journey itself: the pivot from polished consultant to vulnerable storyteller, the slow build of confidence that no pitch deck can fast-track, and why Michelle believes the best founders are the ones building something they can't imagine not doing.

In this episode:

• The parental leave data that should alarm every HR leader
• How Josie's B2B model evolved through listening to customers
• Why clinical settings lag behind corporate in supporting new parents
• The guilt, the joy, and the identity shift of returning to work
• What it means to lead with lived experience as your credibility
  

Sources:

https://pubmed.ncbi.nlm.nih.gov/37096124/

https://www.aamc.org/news/why-women-leave-medicine

https://pmc.ncbi.nlm.nih.gov/articles/PMC6889631/

https://www.forbes.com/sites/michelletravis/2025/11/12/which-large-us-companies-scored-best-on-paid-parental-leave-in-2025/

In this episode, Derek walks Erin through the real cost of a broken referral process. It's not just the frustration of patients who can't find an in-network specialist or wait months for an appointment, but the downstream clinical and financial consequences when people give up entirely. We're talking tens of thousands of dollars in avoidable costs, and health trajectories that get knocked permanently off course.

Switchboard's approach works directly inside the EMR, identifying the right specialist at the right moment — factoring in location, insurance, wait times, and clinical fit — so that patients leave the exam room with a plan. Derek also reflects on what's changed in healthcare technology since Switchboard launched in 2022, why the pace of change is forcing even young companies to rebuild from scratch, and what he's learned transitioning from advisor and investor to first-time founder. Including what that actually looks like on a Tuesday night in a Starbucks parking lot.

The Genesis of ClearStep

ClearStep was founded in 2018 with a vision to make healthcare easier for patients. According to Adeel, the core mission has remained consistent: helping patients access optimal care seamlessly. He emphasized that although the landscape has evolved, the fundamental issue of navigating healthcare systems has persisted. Adeel noted, "Everyone has known for longer than 2018 that it is too hard to navigate to the truly optimal side of care."

Rapid Response During COVID-19

The COVID-19 pandemic served as a catalyst for ClearStep's growth. Adeel highlighted how the company quickly adapted its existing technology to develop a COVID triage tool within days. This rapid deployment showcased the potential for innovation in healthcare when urgency drives decision-making. However, Adeel cautioned that this swift progress was not sustainable in the long term, as the healthcare industry reverted to its slower procurement processes post-pandemic.

Lessons Learned and Market Dynamics

Adeel discussed the challenges faced in 2022 as healthcare systems began to recover from the pandemic. The funding that had previously supported innovation dried up, leaving many organizations hesitant to invest in new solutions. He observed that understanding the acute problems faced by healthcare systems is crucial for success. Adeel stated, "It is all about solving an acute problem that the customer organization is really feeling now."

User Testing and Decision-Making

One of the most significant insights from ClearStep's research involved user testing. Adeel shared findings indicating that over half of the time, patients' initial decisions regarding their care were incorrect. For instance, patients often underestimated the urgency of their conditions, leading them to choose less appropriate care options. This revelation underscored the importance of ClearStep's role in guiding patients to the right level of care.

Financial Implications of Proper Care Navigation

Adeel elaborated on the financial impact of directing patients to appropriate care settings. Through detailed modeling, ClearStep demonstrated that rerouting low-acuity patients from emergency rooms to primary care not only saves costs but also enhances revenue opportunities for healthcare systems. He explained, "The value of redirecting care more appropriately is really significant." This insight highlights how optimizing care pathways can benefit both patients and providers.

ClearStep's journey offers valuable lessons in navigating the complexities of healthcare. As Adeel Malik articulated, understanding the nuanced needs of patients and healthcare systems is essential for creating effective solutions. The insights gained from the pandemic and ongoing user testing underscore the importance of guiding patients to the right care at the right time, ultimately benefiting the entire healthcare ecosystem.

In this episode, Torrie shares how that experience, along with decades of work in healthcare analytics and policy, shaped her mission to reduce the total cost of care for patients with serious illnesses. From founding her first nonprofit at 15, to launching a venture-backed startup days before COVID, to building TFA Analytics on grants and customer revenue, her journey is a masterclass in purpose-driven entrepreneurship.

We dig into why scheduling is one of the most underestimated forces in patient outcomes, what a truly team-based care model looks like, and why data balanced with compassion is the most powerful tool we have for transforming healthcare.

Nima breaks down the three core failures in social care — fragmentation, missing data, and an inability to scale — and explains why simply hiring more social workers isn't the answer. Instead, Blooming Health uses AI and automation to digitize social care delivery, partnering with community-based organizations to extend their reach and impact.

We also dig into his unconventional go-to-market strategy: building from the ground up by empowering community organizations first, then using that proven network to attract healthcare plans and larger systems.

If you work in healthcare, social services, or tech for good, this episode is packed with hard-won lessons on building at the intersection of all three.