Every physician remembers the first time they ran a code. The adrenaline. The organized chaos. The moment you reach for the crash cart and trust, without thinking, that everything inside it is where it should be, that the medications aren’t expired, and that the equipment has been checked.

But here’s what most physicians don’t think about: Who’s making sure that crash cart is actually compliant? Who’s tracking whether every piece of equipment across every unit in the hospital is accounted for, up to date, and not subject to an active recall?

For most hospitals, the answer is a patchwork of spreadsheets, manual logs, and overworked staff doing physical checks on a schedule that’s more aspirational than reliable. I know this because I lived it. As an inpatient hospitalist managing thousands of patients a year, I saw the operational gaps behind the clinical curtain every single day. And for years, like most physicians, I assumed somebody in the back office had it under control.

Nobody did. Not really. The national average for daily crash cart audit compliance hovers around 70 to 75 percent. That means on any given day, roughly one in four crash carts in American hospitals may not be fully verified. In a setting where seconds matter and expired medications or missing equipment can mean the difference between life and death, that number should bother every physician who has ever run a code.

How a physician spotted the deal

A few years into my transition from clinical practice to health care venture capital, one of the physicians in my investor network came across a startup through an unexpected channel. He’d been working with a group of entrepreneurs in a completely different industry and heard about a former health IT executive who had built a technology platform for hospital inventory management and regulatory compliance, including crash cart tracking, medical device management, and recall notifications.

The physician recognized it immediately as a health care problem and routed it to me. That’s the kind of thing that happens when you have a network of over 200 physicians who are trained to spot clinical and operational pain points. They see problems everywhere (in their hospitals, in their conversations, in industries adjacent to health care) and they flag them.

Within a day of being introduced to the founder, I knew this was real. Not because the pitch deck was impressive. Because I had lived the problem. I’d seen the manual crash cart checks. I’d watched nurses spend hours on inventory reconciliation that could have been automated. I’d heard about device recalls that reached hospitals weeks after they should have.

17 people said yes

Before I invested a dollar, I took the product concept to 17 frontline health care professionals. Not surveys. Not focus groups. Actual conversations with inpatient physicians, nursing managers, chief nursing officers, and supply chain leaders, the people who would use this product or approve its purchase.

Every single one validated the need. And they didn’t do it politely. They did it with frustration. They described the workarounds they’d built because no good solution existed. They walked me through the hours of manual labor their teams spent on tasks this product could eliminate. One chief nursing officer told me that if this product worked the way it was described, she’d fight to get it into her system.

That was the signal. Not a market research report. Not a total addressable market (TAM) calculation. Seventeen people who live inside the problem telling me, with specificity and emotion, that this needed to exist.

What happened next

We invested early, at a stage when no institutional venture capital firm had seen the deal. The valuation reflected that. We got in before the product had its first paying customer.

Over the next few years, the company landed contracts with multiple integrated delivery networks, large health systems managing dozens of hospitals. I joined the board. And something happened that I didn’t fully anticipate: the same physician network that sourced and validated the deal started driving customer introductions. Physicians in our network connected the founder with hospital technology leaders, supply chain executives, and health system administrators. The network didn’t just fund the company. It became a distribution channel.

Today, the company serves multiple health systems. And that 70 to 75 percent national compliance average? Their technology pushes it to near 100 percent. That’s the kind of measurable, clinical-grade improvement that gets a physician’s attention, not because it’s a clever product feature, but because it directly impacts patient safety. I’m not going to pretend that every investment works out this cleanly. Venture capital is unpredictable, and I’ve made bets that didn’t pan out. But this deal illustrates something I believe deeply: The best health care investments start with someone who has actually experienced the problem.

The lesson behind the crash cart

When I tell this story, physicians ask: “How did you know?”

The honest answer is that I didn’t know. Not with certainty. What I had was proximity to the problem. I’d seen the operational gaps firsthand. I could evaluate the product against my own clinical experience. And I had a network of 200+ physicians who could pressure-test the idea with the same granularity.

This is the part of health care investing that gets overlooked. The most valuable thing in early-stage health care isn’t a sophisticated financial model or a flashy deck. It’s someone who has spent years inside the system and can tell you (immediately, from experience) whether a product solves a real problem or a theoretical one.

Physicians have this instinct. We develop it through thousands of patient encounters, hundreds of workflow frustrations, and years of navigating a system that often feels like it was designed to resist improvement. That instinct is extraordinarily valuable in the investment world. And it is almost entirely absent from the rooms where health care capital allocation decisions are being made.

I didn’t find this deal through an accelerator demo day or a cold pitch. A physician in my network spotted it during a conversation that had nothing to do with health care. He recognized the problem because he’d lived it. I validated it because I’d lived it too. And the physicians who funded it alongside me did so because they understood the clinical pain from the inside.

The crash cart is the most universal symbol of emergency medicine. Every physician has touched one. It took a physician network to spot that the system behind it was broken, and to bet on the team fixing it.

That’s what physician-led investing looks like in practice.

Harsha Moole is an internal medicine-trained physician-scientist with more than 100 peer-reviewed publications, including work featured in the New England Journal of Medicine. After years of clinical practice and gastroenterology outcomes research, he made an unconventional transition from the bedside to the boardroom by founding PhysicianEstate, a health care-focused venture capital firm.

Over the past seven years, Dr. Moole has made 22 early-stage health care investments across digital health, medical devices, biotech, and therapeutics. He has also built a network of more than 200 physicians from institutions such as Johns Hopkins and Stanford who help source opportunities and provide clinical diligence before capital is deployed. His core thesis is that physician-scientists with firsthand clinical experience are uniquely positioned to identify health care investments that generalist investors often miss.

His research background is reflected in his publication record on Google Scholar, and he shares professional updates on LinkedIn.