What does it actually mean when a clinician "works in product" at a healthcare startup? Product is where a lot of clinicians land once they are inside a startup, and it can mean a lot of different jobs: content and claims review, evidence checks, running a medical advisory team, sitting with designers, and translating between the clinical team and the engineers.

Host Helen Tanner talks with Caitlyn Tivy, PT, DPT, a pelvic and women's health physical therapist who went from telehealth care delivery inside a large startup to helping build a new product line, and who now works as a fractional clinical leader across several health tech companies at once. Caitlyn breaks down biotech vs. medtech vs. health tech, why the line between a wellness product and a regulated product shapes everything a clinician can say, and how one advisor's offhand comment became a feature that was never on the roadmap.

She also explains the difference between slowing down for safety (the job) and slowing down for logistics, and why she will not budge on clinical advisors being paid for their expertise.

In this episode:

• What product work can mean for a clinician, and the range of jobs behind the title
• Biotech vs. medtech vs. health tech, explained in plain language
• Why the wellness vs. regulated product line matters for every claim a product makes
• What a fractional head of clinical affairs actually does week to week
• How to hold patient safety first while staying useful on the engineers' timeline
• How clinical input turned into a new feature that was never on the roadmap
• Why unpaid clinical advisors are slow advisors, and why that is a structural problem
• Three things that make clinicians successful in product roles, including upskilling as "CME by another name"

Resources mentioned:

• In Women's Health (formerly FemHealth Insights), founded by Jodi Neuhauser: https://www.inwomenshealth.com/
• Health Tech Nerds: https://www.healthtechnerds.com/
• TechSpeak for Entrepreneurs, AI Agents course with Nelly Yusupova: https://www.techspeakforentrepreneurs.com/ai-agents-6-week-live-training/
• LinkedIn Learning: https://www.linkedin.com/learning/
• Figma: https://www.figma.com/
• Women's Health Innovation Summit (WHIS): https://www.whisusa.com/
• Women's Health Horizons: https://whhwomenshealthhorizons.com/
• HLTH: https://hlth.com/
• That's Gynomite! podcast: https://thatsgynomite.com/

Connect with Caitlyn Tivy:

• C Tivy Consulting: https://www.ctivyconsulting.com/
• LinkedIn: https://www.linkedin.com/in/caitlyn-tivy-dpt/

Get the free Field Guide: The Early Hires Clinician Startup Field Guide, 10 Things Every Clinician Should Know Before and After Joining a Startup, is free when you sign up at https://www.theearlyhires.com/. You will also be signed up for The Early Hires monthly newsletter.

Connect with The Early Hires:

• Website: https://www.theearlyhires.com/
• The Early Hires on LinkedIn: https://www.linkedin.com/company/the-early-hires/
• The Early Hires on Instagram: https://www.instagram.com/theearlyhires/
• Helen Tanner on LinkedIn: https://www.linkedin.com/in/helenltanner/

Please rate and share the podcast so more clinicians can find this show: https://podcasts.apple.com/us/podcast/the-early-hires-clinicians-in-startups/id1882293752

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What do clinician leaders in healthcare startups need to navigate once the offer is signed? In part two of this solo mini series, host and startup leader Helen Tanner walks through the five things that matter after you join: the first weeks, the first six months, and the first year inside a healthcare startup.

She explains how to figure out whether you were hired to build or to learn, how to size clinical infrastructure to the company's stage instead of rebuilding your old health system, why your license is a separate entity from the company and how to protect it, how to navigate the built-in tension between the mission and the money, and why maintaining your professional identity outside the company is the smartest career protection there is.

For each of the five topics, Helen shares a practical next step, a question to ask, or a resource to use.

Together with part one, this completes the full list: 10 Things Every Clinician Should Know Before and After Joining a Startup.

Get the complete list in The Early Hires Clinician Startup Field Guide, free when you sign up at www.theearlyhires.com. You will also be signed up for The Early Hires monthly newsletter, with insights, updates, and best practices for leading inside healthcare startups.

In this episode:

• How to know whether your job is to build the first version or learn the existing machine
• Why matching your speed to the company's stage protects your runway and your credibility
• The clinical infrastructure floor no company should operate without, for care delivery and for product companies
• How to protect your license when the company's risk tolerance is not yours
• What tail coverage is and why one question about it can be worth tens of thousands of dollars
• How to hold the safety baseline when mission and money pull in different directions
• Five ways to keep your career bigger than any one company

Resources mentioned:

• The Early Hires Clinician Startup Field Guide: 10 Things Every Clinician Should Know Before and After Joining a Startup, free at https://www.theearlyhires.com/
• Part one of this series, Five Things Every Clinician Should Know Before Joining a Healthcare Startup: https://www.theearlyhires.com/post/five-things-every-clinician-should-know-before-joining-a-healthcare-startup-with-helen-tanner-pa-c
• Dig Your Well Before You Are Thirsty by Harvey Mackay

Connect with The Early Hires:

• Website: https://www.theearlyhires.com/
• The Early Hires on LinkedIn: https://www.linkedin.com/company/the-early-hires/
• The Early Hires on Instagram: https://www.instagram.com/theearlyhires/
• Helen Tanner on LinkedIn: https://www.linkedin.com/in/helenltanner/

Please rate and share the podcast so more clinicians can find this show: https://podcasts.apple.com/us/podcast/the-early-hires-clinicians-in-startups/id1882293752

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Before You Sign: 5 Things Clinician Leaders Need to Know

In part one of this two-part solo mini-series, host and startup leader Helen Tanner walks through the five things every clinician leader should work through before signing an offer. 

She explains why startup stage matters, why you need to understand who owns and governs the company, how to become equity literate, why your clinical credentials don't automatically translate in startup environments, and how to define the clinical versus administrative split before it defines your role.

For each of the five topics, Helen shares a practical next step, a question to ask during the interview process, or a resource to help you make a more informed decision. You will also find a free downloadable question guide linked in the show notes to help you evaluate startup opportunities with confidence.

Stay tuned as the part 2 of this episode, Helen explores the five things every clinician leader should expect once they're on the inside of a startup.

Must-Hear Insights and Key Moments

• Revenue model dictates whether clinical or administrative work dominates depends less on the offer letter and more on how the company earns money.
• Four equity numbers matter: Options granted, total shares, strike price, and valuation are the minimum data to demand before signing.
• Stock options look like wealth but the denominator of total shares tells the real story.
• The same title means radically different responsibilities at seed versus Series B, and misalignment burns clinicians fast.
• Clinical versus administrative expectations shift constantly in startups; formal review dates protect against misalignment.
• Many postings are written by non‑clinicians; red flags in scope and reporting lines can define your first six months.

Mentioned in the episode:

• Get the Before You Sign guide, the questions to ask before you accept a startup offer or at www.theearlyhires.com

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Hannah Lowe, NP, RD, CDCES, is a nurse practitioner, registered dietitian, and Certified Diabetes Care and Education Specialist whose career spans both frontline clinical care and digital health startups. After joining one startup as its first nurse practitioner and growing into the Director of Advanced Practice role, she stepped into a clinical leadership position at another company just before it was acquired by a larger healthcare organization.

In this conversation, Hannah and Helen reflect on two very different startup endings: walking away from a company she helped build and leading a team through the uncertainty of an acquisition. She shares what those transitions felt like from the inside, how she supported her team when answers were limited, and why career resilience comes from more than your job title. 

Along the way, she offers thoughtful perspectives on networking, maintaining clinical expertise, and building a career that can adapt to change. This episode offers practical insights into leading with confidence when the future is uncertain.

Must-Hear Insights and Key Moments

• Startup careers require embracing uncertainty while staying grounded in transferable clinical skills.
• Clinicians can build startup leadership paths by expanding beyond patient care into cross-functional collaboration.
• Early startup roles often evolve faster than job descriptions, creating opportunities to discover new strengths.
• Formal titles matter when clinicians take on leadership responsibilities because they validate expanded scope and career growth.
• Acquisition transitions require rebuilding trust as teams adjust to new structures, processes, and expectations.
• Small startup cultures often shift toward more established systems after acquisition, requiring new leadership approaches
• Networking should happen continuously before uncertainty appears, not only when career changes become urgent.

About Hannah

Hannah Lowe, DNP, FNP‑C, RDN, CDCES, is a nurse practitioner, registered dietitian, and certified diabetes care and education specialist whose career bridges direct patient care and the unpredictable world of healthcare startups. 

She has lived through two very different endings: choosing to leave one company she helped build, and stepping into another as a clinical leader while an acquisition was already underway. In both, she carried the responsibility of guiding clinicians and patients through change, balancing honesty about uncertainty with steadiness for her team

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What Gets You Promoted: A Health Tech SVP on Leadership, Red Flags, and the Leaders Who Rise - with Laura Demuth, MSN, NP-BC

Laura Demuth, MSN, NP-BC, joined Curology, then known as Pocket Derm, as employee number 12 nearly a decade ago. Today, she serves on the executive team as Senior Vice President of People and Patients, helping lead an organization that serves millions of patients while overseeing teams across people operations, patient experience, and clinical functions.

In this episode, Laura shares the leadership lessons she has learned through years of building teams in a high-growth startup. At the center of the conversation is her philosophy of "servant leadership, with an asterisk." She explains why supporting your team should never come at the expense of your own voice as a leader and how that perspective has evolved throughout her career.

Helen and Laura discuss the importance of building trust before difficult conversations, why "clear is kind" has become one of Laura's guiding leadership principles, and the five qualities she believes every leader should develop: trust, humility, accountability, curiosity, and courage. They also explore what distinguishes clinicians who grow into effective leaders, from demonstrating mission alignment and informal leadership to becoming a student of the business and adapting through change.

This episode offers practical insights for leading people, developing culture, and helping others grow without losing yourself in the process.

Must-Hear Insights and Key Moments

• Servant leadership, with an asterisk. Laura explains why the best leaders support their teams without removing themselves from the table.
• Why "clear is kind." Learn how trust makes difficult conversations more effective and why avoiding conflict is not the same as being compassionate.
• The five leadership non-negotiables. Laura shares the values that shape her leadership approach: trust, humility, accountability, curiosity, and courage.
• What separates clinicians who become great leaders. Mission alignment, informal leadership, business curiosity, and adaptability are often stronger predictors than clinical expertise alone.
• Become a student of the business. Understanding finance, operations, product, and strategy helps clinicians become more influential leaders.
• Give away your Legos. Laura explains how letting go of responsibilities creates opportunities for others to grow and allows leaders to scale their impact.

About Laura

Laura Demuth, MSN, NP-BC, is a nurse practitioner and healthcare executive with experience spanning inpatient care, outpatient medicine, and high-growth healthcare startups. She began her clinical career at Albany Medical Center before becoming a nurse practitioner in internal medicine.

She joined early-stage telehealth company Pocket Derm, now Curology, as employee number 12, where she worked across clinical care, recruiting, and team building as the organization scaled. Over time, she moved into senior leadership roles spanning clinical operations, licensing, customer experience, and people functions.

She currently serves as Senior Vice President of People and Patients at Curology and sits on the executive team, supporting both clinician and patient-facing organizations within a large-scale telehealth company.

Curology is a direct-to-consumer telehealth dermatology company on a mission to make effective skincare accessible, connecting patients with licensed medical providers for personalized prescription treatments. Patients complete a quick assessment, receive custom-formulated skincare shipped straight to their door, and get expert care and ongoing follow-up from their dedicated medical provider.

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Clinical Onboarding as Infrastructure in Healthcare Startups  with Anna Ballard, PA-C

Anna Ballard, PA-C builds clinical onboarding and learning systems inside healthcare startups that are scaling quickly. Her work sits at the intersection of training, operations, and clinical quality, where new clinicians must become productive in environments that are still being defined. 

In this conversation, Anna and Helen discuss what it takes to design onboarding without an established system, and playbook. They look at how early-stage teams translate clinical expectations into repeatable systems, why onboarding functions as operational infrastructure, and how time to productivity becomes a defining constraint in scaling care delivery. 

They also discuss the transition clinicians make into operator roles. This includes moving from individual care delivery to shaping workflows, competency expectations, and cross-functional execution with product, engineering, and finance teams. Further looking at competency framework development in high-growth environments, support structures for new graduate clinicians inside startups, and how onboarding design shapes clinician readiness.

This episode is relevant for clinicians working in healthcare startups with early operator roles, onboarding and training, and for leaders building systems from the ground up. 

Must-Hear Insights and Key Moments

• Anna Ballard draws a distinction between medical education and operational readiness in fast-scaling digital health environments.
• Onboarding challenges reflect workflow and systems design decisions rather than gaps in clinician knowledge or performance 
• Training design in startups sits at the intersection of clinical education and operational execution, requiring both clinical and business fluency
• Clinicians in early operator roles benefit from developing communication and influence skills to align clinical priorities with organizational constraints
• New graduate clinicians require structured support models such as transition-to-practice programs and mentorship systems in fast-changing care settings
• Cross-functional collaboration with product, engineering, and finance becomes a core part of clinical leadership in healthcare startups 
• Effective onboarding design prioritizes what clinicians need to do in day-to-day workflows 
• Clinical competency must move from checklist completion to structured, stepwise behaviors that ensure clinicians can consistently deliver quality care under pressure in real startup environments. 

About Anna

Anna Ballard is a PA-C and strategic Clinical Systems Builder with 11 years in clinical practice and 7+ years leading training, quality, and process improvement in growth-stage healthcare organizations. As a former Director of Medical Learning and Development at Curology, she understands both the clinical realities and the L&D systems needed to support scaling teams. 

Through Process to Practice, she partners with Clinical Operations and People leaders at Series A, B, and post-M&A healthcare companies — from telemedicine platforms to care coordination services — to build onboarding, training, and quality systems that reduce time-to-productivity while supporting consistent care delivery and clinician retention. She also coaches internal clinical leaders to become strategic training leaders who can speak the language of business and partner effectively with operations and cross-functional teams.

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How a Founding Dean Is Rethinking Clinical Education at the Edge of Silicon Valley — with Dr. Amy Bronson, Pepperdine University 

Most episodes of The Early Hires feature clinicians who stepped inside a startup. This one takes a different angle. Dr. Amy Bronson is the founding dean of Pepperdine University’s brand-new School of Physician Assistant Studies — designing a clinical program from a blank page, at the edge of Silicon Valley, at the exact moment AI is rewriting what clinical competency means. She and Helen talk about what a clinician actually needs to know for the world they’re entering: how to teach critical thinking and AI literacy as real competencies, why business fundamentals belong in clinical training, and what startup clinical leaders can do on Monday with the new grads they’re hiring. A builder’s view from the architect’s seat.

Dr. Amy Bronson has spent more than fifteen years as a physician assistant specializing in ENT, plastics, and reconstructive surgery. She is also a researcher, TEDx speaker, educator, and multi‑time founding program leader. Today she serves as the founding dean of Pepperdine University’s new Physician Assistant program in Malibu, California, where she is designing curriculum, culture, and competencies from a blank page. 

This episode is for clinicians working inside startups, educators rethinking healthcare training, and leaders preparing teams for a healthcare system that is changing faster than traditional models can support.

Join the AIMed Conference! Code:  ABPA15  (15% off of the conference price)

* Pepperdine University, Master of Science in Physician Assistant Studies (MSPAS) has applied for Accreditation - Provisional from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The MSPAS program anticipates matriculating its first class in September 2027 pending achieving Accreditation - Provisional status at the April 2027 ARC-PA meeting.  Accreditation - Provisional is an accreditation status granted when the plans and resource allocation, if fully implemented as planned, of a proposed program that has not yet enrolled students appear to demonstrate the program's ability to meet the ARC-PA Standards or when a program holding Accreditation-Provisional status appears to demonstrate continued progress in complying with the Standards as it prepares for the graduation of the first class (cohort) of students. If the MSPAS program does not achieve Accreditation - Provisional status, the program will not commence, and students will not matriculate. Accepted students will be refunded for any deposits or tuition paid. Application fees are not refundable.

The MSPAS program at Pepperdine University has been approved by the Western Association of Schools and Colleges (WASC) Senior College & University Commission (WSCUC).

Must-Hear Insights and Key Moments

• Building without a playbook is becoming a core leadership skill in modern healthcare education
• Clinicians do not need to feel fully prepared before stepping into innovation and leadership roles
• Dr. Amy Bronson has served as a founding faculty member, founding program director, and now founding dean building PA programs from the ground up.
• AI literacy is now part of clinical literacy, not a separate technical specialty
• Curiosity and systems thinking help clinicians bridge gaps between healthcare, technology, and business
• The future of medical education depends on embedding AI and systems thinking across curriculum, not isolating it into one course
• Clinical reasoning skills matter more, not less, in an AI-enabled healthcare environment
• Healthcare organizations need clinicians involved early in technology design, governance, and implementation
• New graduates thrive in environments that provide mentorship, support, leadership development, and space to continue learning
• Amy is designing Pepperdine’s first PA program with AI literacy, systems thinking, and clinical reasoning embedded throughout the curriculum

Mentioned in the episode:

• Pepperdine University’s School of Physician Assistant Studies - https://healthscience.pepperdine.edu/school-of-physician-assistant-studies/
• Join the AIMed Conference! Code:  ABPA15  (15% off of the conference price)

About Dr. Amy Bronson

Dr. Amy Bronson, EdD, PA-C with more than fifteen years of clinical experience in ENT, plastics, and reconstructive surgery. Beyond practice, she has built a career as a researcher, TEDx speaker, educator, and multi‑time founding program director. She holds a doctorate in educational leadership and an advanced certification in AI and medicine from the American Board of Artificial Intelligence and Medicine.

Her leadership includes serving as principal investigator on federally funded research totaling more than $2.5 million and directing new PA programs that bridged care gaps in rural Colorado. Today, she is the founding dean of Pepperdine University’s School of Physician Assistant Studies in Malibu, California.

Dr. Amy Bronson’s work centers on designing curriculum, and competencies from a blank page, preparing clinicians for a rapidly evolving healthcare landscape. She emphasizes system literacy and interprofessional collaboration that extends beyond medicine. Her philosophy is rooted in education advocacy and equipping clinicians to thrive in any environment.

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From ER to Space Medicine: How Clinicians Create Systems Where None Exist

Dr. Marsh Cuttino is an emergency physician who turned curiosity into systems impact. Trained at Kennedy Space Center, he raised his hand early and became one of the few clinicians to support shuttle launches and conduct zero‑gravity medical research.

He founded Orbital Medicine to solve problems no one had addressed, including how to treat a collapsed lung in microgravity. His work secured NASA grants and was successfully tested aboard Blue Origin.

Beyond aerospace, he helped build the VCU Emergency Medicine Residency from scratch, proving clinicians can create systems where none exist.

This conversation explores the translation of lessons of clinicians from extreme environments to startup life. Navigating innovation, building from scratch, and raising your hand before you even feel ready.

This episode is for clinicians stepping into early-stage companies who want to understand how to balance strict protocols with startup creativity, how to create opportunity by showing up early, and how to reframe clinical expertise for innovation in healthcare and beyond.

Must-Hear Insights and Key Moments

• Training at NASA and supporting 34 shuttle launches showed how clinicians can step into industries without precedent.
• Founding Orbital Medicine proved that clinicians can design solutions for problems no one has solved, including collapsed lungs in microgravity.
• Emergency medicine built resilience under pressure, a skill that translates directly into startup leadership.
• Navigating strict NASA protocols revealed why systems discipline matters, even when building new ventures from scratch.
• Flight hours in zero gravity highlighted the importance of adaptability and collaboration when others could not continue.
• Building the ER residency at VCU mirrored startup life, showing how clinicians create systems where none exist.
• Learning “engineer speak” demonstrated how clinicians must cross disciplines to lead innovation.
• Raising your hand early created opportunities that shaped his career, reinforcing the value of stepping in before you feel ready.

About Dr. Marsh Cuttino 

Dr. Marsh Cuttino is a Board-Certified Emergency Physician who is experienced in aerospace medicine, disaster, and mass casualty medicine. He has an undergraduate BS degree in Chemistry from James Madison University, attended medical school and an internship in Internal Medicine at Virginia Commonwealth University and completed his Residency in Emergency Medicine at the University of Florida (Jacksonville) in 1998. He was a founding faculty at Virginia Commonwealth University for the start of the Emergency Medicine Residency. He provided bedside clinical training for US Special Operations Medics while at Virginia Commonwealth University. He has lectured extensively on mass casualty medicine and terrorism response for emergency departments. He continues to be a regular reviewer for the Elsevier journal Resuscitation on Emergency Medicine and resuscitation research and Wilderness and Environmental Medicine on parabolic microgravity.

He is the medical advisor to the Commercial Spaceflight Federation on the SARG (Space Applications Research Group) advisory board. He has assisted with the programs for the Next Generation Suborbital Researchers Conference since 2013. In 2020 he began to work for ZeroG corporation as medical advisor and flight coach, providing flight services for the parabolic microgravity flights with a focus on research flights and medical support. 

He also founded Orbital Medicine, a space medicine startup that secured grants with NASA, and successfully tested a novel device to treat collapsed lungs in microgravity aboard Blue Origin.

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From Primary Care to Startup Leadership: Why Clinicians Matter Most in Early Chaos 

Andrew Shiflett, PA-C, brings more than a decade of experience in complex primary care and was one of the first clinical hires at a Series A mobile primary care startup. Joining within the first months of the company’s life, Andrew stepped into patient homes without playbooks. He had no formal title, but a role as the clinician others trusted to navigate uncertainty and advocate for their needs.

In this conversation, Andrew reflects on leaving a stable practice for the unpredictability of startup life, weighing risk against opportunity while raising a young family. He shares candid stories of knocking on doors with nothing but a stethoscope and a printed schedule, building trust with patients in underserved communities, and learning to translate clinical realities into business language.

Helen and Andrew revisit pivotal moments, including advocating against a productivity-based compensation model that threatened clinician retention and patient outcomes. The importance of clinician voices in shaping startup culture, the responsibility of early hires to smooth the path, and the leadership that emerges when clinicians step into uncharted territory.

This episode is for clinicians considering the leap into startups, leaders building early teams, and anyone curious about how frontline expertise drives innovation.

Must-Hear Insights and Key Moments

• Andrew was one of the earliest clinical hires at a Series A mobile primary care startup, stepping into patient homes without established systems. 
• Leaving a secure practice in Richmond for startup chaos, he weighed risk against stability while raising a young family.
• Clinician leadership emerged without a formal title, as colleagues relied on him to navigate uncertainty and raise concerns to leadership 
• Knocking on doors with no playbook showed the realities of startup medicine and the physical demands of home‑based care.
• Dog years of startup life meant each month felt like a year in traditional practice.
• Trust before titles became the foundation for patient care and clinician advocacy in early chaos.
• Partnering with Helen Tanner, he pushed back against productivity‑based compensation models that threatened retention and outcomes.
• Building the plane while flying captured the challenge of asking patients to trust a system still being created 
• From Series A chaos to a $13B Series E Medicare Advantage startup, Andrew’s journey shows how clinicians shape healthcare innovation.

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Leading Without a Playbook: Why Executive Coaching Matters in Early-Stage Startups

Lupe Prado is an executive coach who works with leaders across startups, private equity, and corporate organizations. For over seven years, she has helped high-performing professionals navigate leadership growth, career transitions, and complex workplace dynamics. Lupe built her career in accounting, and financial reporting. After experiencing burnout early in her career, she sought out coaching herself. Ultimately led her to pursue a master’s degree in leadership, and organizational development with concentration in executive coaching and to launch her own coaching practice.

Lupe explores with Helen what executive coaching is behind the scenes, particularly for leaders operating in a fast paced startup environment. She shares the common themes in startup leaders seeking support, including self-doubt, and the loneliness that often accompanies senior roles. They cover the practical approaches leaders use to seek meaningful feedback, and build support systems as responsibility grows.

Lupe explains how leaders can sustain performance by strengthening foundational habits  by developing tools to manage pressure and internal criticism.

For clinicians moving into startup leadership roles, these insights offer a clearer understanding of how coaching can provide perspective, strengthen decision-making, and support leadership development in environments where the structure is still evolving.

About Lupe

Lupe Prado is an executive coach who has worked with leaders across startups, private equity, consulting, and corporate for more than 7 years. Her work focuses on supporting high-performing professionals as they navigate leadership growth, career transitions, and complex environments.

Before becoming a coach, she began her career in accounting and financial reporting. After experiencing burnout early in her career, she sought out coaching herself. It was an experience that led her to pursue a master’s degree in leadership and organizational development with executive coaching.

Lupe now works with leaders across industries, helping build perspective, and navigate the pressures that often accompany senior leadership roles. Her coaching frequently supports startup leaders in a fast-paced environments, where expectations evolve quickly and structures are developing.

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