We do not learn everything at school. I did not learn any of it at school.
In fact, I learned it after dropping out of school, helping start a private-pay addiction treatment program (which has expanded a few times in the last 8 years). I realized at the beginning that the tools my co-founder was bringing in from investment banking would not survive contact with reality. And this exactly happened.
He had done months of research for this program, from financial models to staffing planning and projections. All built on what I thought were pure assumptions, but he was trained for it, right? Except almost everything was wrong.
You cannot model your way into a zero-to-one healthcare company.
There are too many moving pieces, complexities, and unknowns in healthcare (particularly in the early stage). Too many of the things function in the shadows where Excel or spreadsheets have no visibility.
Lately, I have been mentoring a Cambridge MBA who is passionate about building something in behavioral health. She is smart and knows exactly what she wants. But helping her made me realise that I did not have the language early in my career: most of the case studies, mental models, and frameworks taught in business school can only be applied to businesses that are big enough to manage from above.
At the beginning of a healthcare business where you are floundering with licensing, staffing, real estate, an EHR nightmare, and culture, none of these frameworks save you at this time.
1. Zero-to-One in Healthcare Happens On-the-Ground, Not on Excel
Creating a clinic from scratch means having a scheduler who answers the phone, a clinician who collaborates with the team, an administrator who handles insurance back-and-forth. The entire idea is to make care easier for people and the culture that supports it.
And guess what?
None of this exists inside an academic case study.
None of these things is covered in classrooms.
But this is everything!
I have spent so much time thinking about
● How to ease scheduling,
● How to reduce duplicate data entry,
● How to rationalize referrals,
● How to make our EHR tolerable,
● How to get elite aligned on documentation,
● How to build a communication system that does not collapse under real-world work pressure,
Than any “entrepreneur” wants to admit.
After all these years I have spent in this field, I can tell you that healthcare is a messy ecosystem filled with friction. Every single system around you pushes complexities downhill to the people who do the work.
Just like students run to get MBA assignment writing services to understand complex theories or frameworks, entrepreneurs must also find practical ways to solve real-world problems. If you do not spend the first few years identifying and fixing these thousands of tiny cuts the system inflicts on patients and providers, you won't make it.
2. Fancy Models Do Not Help You Survive at Surface-Level
When I talk to the Cambridge MBA I am mentoring, the questions she asks are predictable because they are exactly what she was trained to ask for:
● What is the total targetable market?
● What is our competition?
● How big can we scale?
● What is our five-year plan?
● How can we gauge demand for X, Y, and Z?
These questions are good.
But they are just useless at the beginning.
Going zero-to-one is not a finance problem, a capital allocation issue, or a TAM problem.
Zero to one is:
● Understanding how you can sign a lease under your budget,
● Assessing EHRs without losing your mind,
● Grasping licensing bodies that cannot communicate clearly,
● Creating workflows before you even know what you require,
● Finding who do not flame out in a year,
● Haggling contracts when you have zero leverage.
These aspects do not scale up nearly as well, which is why there are fewer chances of seeing it in a case study.
3. Being a non-clinican founders means you learn the hard way
People assume that the tremendously challenging part of being a non-clinician founder is clinical credibility. Yes, it is a part of it. But the real challenge for a non-clinical founder is to be responsible for the outcomes that he does not personally drive.
This experience was somehow the same when I planned to get MBA admission essay writing services years ago because I thought I lacked knowledge. But in reality, I just needed confidence in my work before submitting it to the assessor.
If you do not understand the work, you lose the trust of others and your own.
And without trust, nothing operates.
So, I learned by doing it.
I have:
● Answered the phone,
● Scheduled appointments,
● Handled denials,
● Built insurance,
● Spent time with patients in crisis,
● Rewritten/reapproached workflows with parishioners who were burning out,
● Sorted EHR issues that were causing harm to productivity.
There is no point in leading healthcare if you do not understand the pain points.
And defenders will know whether you get it.
Healthcare providers want to practice well, be paid fairly, and trust the leadership. This only happens when a non-clinician leader is ready to build a space like this for them.
What Should You Take From This?
My approach is not anti-MBA.
It is not anti-education.
It is not “real entrepreneurs do not go to business schools.”
It is actually simpler than all of this:
Business schools teach you how to run a business that already works.
Zero-to-one requires you to build one before it works.
MBA frameworks matter, but later.
Early on, you need to get into the field and be ready to get your hands dirty.
You have to be shaped by your work.
You have to earn the trust of the people who prioritize patient care over profit.
You have to build systems from scratch because no one else has built them for you.
You have to solve problems that do not fit effectively in a case study.
The part of healthcare that matters most, the part that actually helps people, is invisible from the executive suite.
Business schools do not teach that.
The system itself does not teach that.
The only way to solve it is to live it.
And once you do that, you see the whole thing differently.