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

    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

    37 min
  2. Why Has to Be Greater Than How: Hafeezah Muhammad on Building Backpack Healthcare

    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.

    19 min
  3. The Builder's Mindset: Ben Kuhn's lessons from Strive to Everbright Health

    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.

    30 min
  4. Chris Bane on Why Nurse Practitioners are the Future of Healthcare

    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.

    25 min
  5. The Consent Conundrum: How Carol Robinson Is Giving Patients Control of Their Health Data

    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

    29 min
  6. The Parental Leave Problem Healthcare Can't Ignore | Michelle Yu of Josie

    Apr 20

    The Parental Leave Problem Healthcare Can't Ignore | Michelle Yu of Josie

    What happens to working healthcare parents — and their careers — before, during, and after parental leave? It's a question Michelle Yu couldn't stop asking, even after more than a decade at the top of healthcare consulting. 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 leaderHow Josie's B2B model evolved through listening to customersWhy clinical settings lag behind corporate in supporting new parentsThe guilt, the joy, and the identity shift of returning to workWhat 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/

    32 min
  7. Lost in Referral: How AI Is Fixing Specialty Care Referrals with Derek Baird

    Apr 14

    Lost in Referral: How AI Is Fixing Specialty Care Referrals with Derek Baird

    Derek Baird has been watching the specialty care referral system fail patients for over two decades. As an EMR product manager at 23, he first learned how referrals actually worked. Not much has changed since. Today, as co-founder and CEO of Switchboard Health, he's doing something about it. 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.

    30 min
  8. The System Is the Starting Point: Kristin Kelly on Building Healthcare Companies That Last

    Apr 7

    The System Is the Starting Point: Kristin Kelly on Building Healthcare Companies That Last

    Kristin Kelly has built healthcare companies, worked inside government, and now helps other founders do the same. In this episode, the Founder and CEO of Voyageur Health Advisory joins Erin O'Brien to share what it really takes to grow in a system that doesn't bend easily — from her time standing up Minnesota's ACA marketplace and scaling Bright Health, to the hard truths she now brings to the startups she advises. They get into what founders consistently misread about government, payment models, and go-to-market timing — and why enduring healthcare companies are built on alignment, not just ambition.

    15 min
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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
    2K
  • Episodes
    18
  • Rating
    Clean
  • Copyright
    © 2026 Erin O'Brien
  • Show Website
    No Operating Manual