She was 42, uninsured, and had been avoiding the doctor for three years. By the time she showed up in my hospital, her diabetes was uncontrolled, her blood pressure was dangerously elevated, and she had early signs of kidney disease. Everything about her case was preventable. She knew it. I knew it. And neither of us could do much about the system that made it happen.
I was an inpatient hospitalist at the time, managing thousands of patients a year. She wasn’t unusual. I saw patients like her constantly: people who delayed care because they couldn’t afford it, showed up in crisis, received expensive acute treatment that could have been avoided with a $75 monthly membership to a primary care physician, and then were discharged back into the same gap that brought them in.
That pattern of preventable illness, delayed care, expensive hospitalization, repeat is one of the most wasteful cycles in American health care. And as a physician living inside it every day, I kept asking the same question: why doesn’t someone build a better way to connect these patients with affordable primary care before they end up in my hospital?
Eventually I realized the person asking the question might have to be the one who answers it.
Building the bridge
I founded a health care technology platform that connects uninsured and underinsured patients with direct primary care and concierge physicians, doctors who offer membership-based care at transparent, affordable prices without insurance middlemen. The concept is simple: if a patient can find a direct primary care physician charging $50 to $100 a month for unlimited primary care visits, they can manage chronic conditions before those conditions become emergencies.
The platform has connected over 10,000 patients to affordable care. Independent modeling estimates that this has generated over $120 million in federal health care savings over two years, savings that come from preventing exactly the kind of avoidable hospitalizations I was managing as a hospitalist. At scale, the model projects the potential to serve 3 million patients and generate $1.8 billion in annual federal savings.
The platform has been recognized with three awards, including a state innovation award presented by the governor. It was also selected for a university accelerator program and received a proof-of-concept grant.
I share these numbers not to pitch the platform, but to make a point about what happens when a physician who lives inside a clinical problem decides to build a solution for it. The insight that drove the platform didn’t come from a market report. It came from years of watching the same preventable pattern repeat itself at the bedside. I didn’t need a consultant to tell me the problem was real. I discharged it from my service every week.
How a patient changed my investing thesis
Building that platform taught me something I didn’t expect: the process of identifying a clinical problem, designing a solution, understanding the regulatory and reimbursement landscape, and bringing it to patients is structurally identical to the process of evaluating whether a health care startup is worth investing in.
The questions are the same. Is the clinical problem painful enough that people will change their behavior? Is the solution designed around how the health care system actually works, or how someone wishes it worked? Is there a viable payment pathway, whether that’s insurance reimbursement, employer sponsorship, or patient willingness to pay out of pocket?
After building the platform, I started applying the same framework to other health care companies. Not as a consultant. As an investor. I transitioned from clinical practice to health care venture capital, eventually making over 20 investments across digital health, biotech, devices, and therapeutics, backed by a network of more than 200 physicians.
But the lens I use on every deal traces back to the patients I treated as a hospitalist. When a founder pitches me a product, I don’t start with their total addressable market slide. I start with the patient. Who is this product for? What happens to that patient if this product doesn’t exist? And is the pain point severe enough that someone, the patient, the physician, the hospital, the insurer, will pay to solve it?
If the answer to that last question is uncertain, I don’t invest. I learned that lesson from years of watching patients fall through gaps that nobody was paying to close.
Why this matters for every physician
Every physician reading this has had a version of the experience I described. You’ve treated a patient whose illness was preventable. You’ve felt the frustration of knowing that the system failed them long before they reached your service. You’ve thought, even briefly, “Someone should fix this.”
That instinct, the one that makes you angry at a broken system rather than numb to it, is the single most valuable trait in health care entrepreneurship and health care investing. It’s what separates physicians who see problems from physicians who solve them.
The health care system is a $5.3 trillion industry. Over $140 billion in private capital flows into health care companies every year through venture capital and private equity. That capital determines which solutions get built, which products reach hospitals, and which innovations make it to patients. The vast majority of that capital is being deployed by people who have never treated a patient and have never felt the frustration you feel when you see a preventable case walk through your door.
Physicians don’t just understand health care. They understand it at the level of individual human suffering: the 42-year-old whose diabetes didn’t have to progress, the father whose heart attack didn’t have to happen, the child whose asthma didn’t have to become an emergency. That understanding is not just clinically valuable. It is financially valuable. It is strategically valuable. And it is almost entirely absent from the rooms where health care investment decisions are made.
I didn’t start building and investing because I wanted to leave medicine. I started because medicine showed me problems that couldn’t be solved from inside an exam room. The exam room is where you treat the patient in front of you. Building and investing is how you change the system that failed them before they got there.
If you’ve ever looked at a broken piece of the health care system and thought “Someone should fix this,” you might be closer to your next chapter than you realize.
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.
