No Operating Manual

Erin O'Brien
  • 5.0 (1)
  • Entrepreneurship

No Operating Manual is a podcast about building healthcare companies when there’s no clear path and no one tells you what comes next. Each episode features candid conversations with founders and operators working at the earliest stages, where decisions are made with incomplete information and roles are undefined. The focus is on the real work: what you learn, what you have to unlearn, and what it actually takes to make healthcare companies function in the real world.

  1. 3d ago

    Dr. Louis Harrison: The Accidental Founder Fixing the Cancer Consultation

    Dr. Louis Harrison spent decades as a radiation oncologist at Moffitt Cancer Center, Memorial Sloan Kettering, and Beth Israel. Since childhood, he'd known he was a visual learner working in a profession built on words. As cancer care grew more complex, he watched patients leave consultations frightened, overwhelmed, and unable to explain their own diagnosis to their families. So at 65, instead of retiring, he founded MyCareGorithm. In this episode of No Operating Manual, Lou equates how no one gives a business presentation without slides, while doctors still deliver life-altering news with nothing but conversation. He walks through what a consultation looks like with the tool: anatomical graphics showing where the tumor sits, side-by-side treatment comparisons, resource libraries, and a full visual record sent home with the patient. He shares results from ten pilots across six major cancer centers, including a Moffitt pilot where every patient said the tool influenced their decision to stay for care, and 75% said it influenced them greatly. Lou also talks about being a prostate cancer patient himself, and having to go home and explain his own options to his wife and kids. That experience made the product better.  Lou shares the biggest lesson he's learned in health tech: the patient benefits, the doctor uses it, but the institution writes the check, and being clearly good for patients is not enough to close a sale. He shares his advice to founders, the plan to expand into pediatric sports medicine, and why there's a long distance to travel between a good idea and a good business.

    Dr. Louis Harrison: The Accidental Founder Fixing the Cancer Consultation

  2. Jul 13

    If Great Clips Can Do It, Why Can't Healthcare? | Dr. Michael Pitt, Q-rounds

    What do Domino's, Uber, and Great Clips have in common? They all offer something hospitals don't: knowing when to expect what you're waiting for. In this episode, Erin O'Brien sits down with Dr. Michael Pitt, a pediatric hospitalist, professor at the University of Minnesota Medical School, and co-founder and CEO of Q-rounds, to hear how a text message while waiting for a haircut sparked the first virtual rounding queue in healthcare. Mike shares how Q-rounds grew from a $5,000 university grant and a PowerPoint mockup into an EHR-integrated platform used by more than 60,000 families, tripling nurse attendance at rounds and cutting harmful medical errors by nearly 40%. He shares how he had to navigate grief while fundraising, the long 20-meeting hospital sales cycle, learning "entrepreneur speak" as a career academic, and why he once called founding Q-rounds the worst decision he ever made, and now calls it his best. Whether you're a clinician sitting on an idea or a founder deep in the grind, Mike's advice lands: be married to the problem, not your solution, and celebrate the "fully vested" moments along the way.

    If Great Clips Can Do It, Why Can't Healthcare? | Dr. Michael Pitt, Q-rounds

  3. Jun 29

    The Gap Between Prescribed and Taken | Tamar Sapir from Synchronyx

    Tamar Sapir never planned to start a company. As a biochemist, clinical professor, and author of 80+ published papers, her instinct was always to ask questions — not build startups. But the more she studied medication non-adherence, the more she realized no one was solving it in a meaningful way. So she did. In this episode, Tamar walks us through Synchronyx — a platform that turns any medication package into a smart, connected experience using battery-free smart labels. Patients tap their phone, log their dose, and get reminders and support along the way. Care teams get real-time alerts when something goes wrong. We get into why patients really stop taking their medications — and why it's far more systemic than personal. We talk about the 97% compliance rate Synchronx has achieved, what drives it, and why most drop-offs happen in the first month when no one is watching. Tamar also opens up about what she had to unlearn as a scientist turned CEO — including her biggest challenge: letting go of perfectionism and making fast decisions with incomplete information. Five years in, over a million doses tracked, and 40+ health system and pharmacy partners.

    The Gap Between Prescribed and Taken | Tamar Sapir from Synchronyx

  4. Jun 15

    The Other 364 Days: How Seth Merritt Is Rebuilding Chronic Care from the Outside In

    Most chronic disease patients see their doctor for 15 minutes, once or twice a year. Seth Merritt, co-founder and CEO of Welby Health, thinks that's absurd. And he's building the infrastructure to fill the other 364 days. In this episode of No Operating Manual, Erin O'Brien sits down with Seth to talk about a truly unlikely origin story: college dropout, aspiring rock musician, healthcare executive, and now startup founder trying to fix part of the American healthcare system. Seth shares how a $50 Facebook ad campaign became proof of concept, why founders should never hand off sales too early, and what he had to unlearn after years inside large health plans before he could build something new. He walks us through the Welby model, a "clinical operating layer" that embeds virtual care teams directly inside physician practices, and explains why the biggest bottleneck in chronic care isn't technology. It's people. You'll also hear Seth's candid take on the hard lessons of hiring for startups (hint: corporate success doesn't always translate), why he believes the healthcare system can't fix itself from the inside. In this episode: Why value-based care often just "shuffles money around" without fixing anythingHow Seth validated his idea with $50 in ads before writing a business planThe "pod" model that makes Welby feel like part of the practiceWhy AI triage is about getting the right patient to the right human at the right timeWhat Seth's boss told him that changed the trajectory of his career

    The Other 364 Days: How Seth Merritt Is Rebuilding Chronic Care from the Outside In

  5. Jun 7

    Why Has to Be Greater Than How: Hafeezah Muhammad on Building Backpack Healthcare

    When Hafeezah Muhammad's son experienced a mental health crisis and she couldn't find care because he was on Medicaid, she didn't just navigate the system — she decided to rebuild it. In this episode, Hafeezah shares how she left a senior executive career to found Backpack Healthcare, a multi-state pediatric mental health clinic that serves children and families who are too often left behind. She opens up about the steep learning curve of going from corporate leader to solo founder, how she's using AI to reduce clinician burnout (not replace therapists), and why she believes the first billion-dollar Medicaid business hasn't been built yet, but will be. A candid conversation about mission-driven entrepreneurship.

    Why Has to Be Greater Than How: Hafeezah Muhammad on Building Backpack Healthcare

  6. May 26

    The Builder's Mindset: Ben Kuhn's lessons from Strive to Everbright Health

    In this episode of No Operating Manual, host Erin O'Brien sits down with Ben Kuhn, serial healthcare entrepreneur and co-founder & CEO of Everbright Health, to explore what it really takes to build innovative companies from scratch. 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.

    The Builder's Mindset: Ben Kuhn's lessons from Strive to Everbright Health

  7. May 17

    Chris Bane on Why Nurse Practitioners are the Future of Healthcare

    According to Chris Bane, 77 million Americans live in primary care shortage areas. A 50,000-physician deficit is projected by 2030. He saw an opening and built Practice with Joy around it. 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.

    Chris Bane on Why Nurse Practitioners are the Future of Healthcare

  8. Apr 28

    The Consent Conundrum: How Carol Robinson Is Giving Patients Control of Their Health Data

    No Operating Manual | Episode featuring Carol Robinson, Founder & CEO of Midato Health 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 founderThe real barriers blocking integrated behavioral and primary careHow ShareApprove works, and why scalability was everythingNavigating data privacy in a landscape of rising bad actorsThe financial reality of building healthcare-grade software from scratch

    The Consent Conundrum: How Carol Robinson Is Giving Patients Control of Their Health Data
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About

No Operating Manual is a podcast about building healthcare companies when there’s no clear path and no one tells you what comes next. Each episode features candid conversations with founders and operators working at the earliest stages, where decisions are made with incomplete information and roles are undefined. The focus is on the real work: what you learn, what you have to unlearn, and what it actually takes to make healthcare companies function in the real world.

Information

  • Creator
    Erin O'Brien
  • Years Active
    2026
  • Episodes
    21
  • Rating
    Clean
  • Copyright
    © 2026 Erin O'Brien
  • Show Website
    No Operating Manual

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