Most physicians are trained to be excellent within a system someone else designed: the hospital's workflow, the device manufacturer's software, the insurance system's rules. There's good reason for that — medicine is not a place to improvise carelessly. But it also means that when a physician notices a real gap, the default response is to work around it quietly, one patient conversation at a time, rather than to build something that closes it for good.
The gap I kept running into was specific: patients leaving a device check with more data captured about their heart than at almost any other point in modern medicine, and less understanding of what that data meant than they'd had walking in. "Looks good, nothing to worry about" is not an answer to what is my device seeing and reporting about my heart, right now — it's a way of not answering it. I could keep having that better conversation one patient at a time, which is worthwhile but doesn't reach anyone outside my own practice. Or I could try to build something that closes the gap for people I'll never personally treat.
That's the actual origin of The Generator, and of thinking about ventures at all. It isn't a pivot away from clinical medicine — I still practice, still see patients, still find that work as absorbing as ever. It's an extension of the same instinct that made me an engineer before I was a physician: when you can see exactly where a system is failing, the most useful response is usually to fix the specific thing, not to write a memo about it.
I don't think every physician needs to found a company. But I do think medicine loses something valuable when the physicians closest to a problem never get involved in solving it structurally — when the only people building the tools patients use are people who've never sat across from one.
← Back to Ideas