No Operating Manual

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.

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 founder * The real barriers blocking integrated behavioral and primary care * How ShareApprove works, and why scalability was everything * Navigating data privacy in a landscape of rising bad actors * The financial reality of building healthcare-grade software from scratch

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 leader * How Josie's B2B model evolved through listening to customers * Why clinical settings lag behind corporate in supporting new parents * The guilt, the joy, and the identity shift of returning to work * What it means to lead with lived experience as your credibility Sources: https://pubmed.ncbi.nlm.nih.gov/37096124/ [https://pubmed.ncbi.nlm.nih.gov/37096124/] https://www.aamc.org/news/why-women-leave-medicine [https://www.aamc.org/news/why-women-leave-medicine] https://pmc.ncbi.nlm.nih.gov/articles/PMC6889631/ [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/ [https://www.forbes.com/sites/michelletravis/2025/11/12/which-large-us-companies-scored-best-on-paid-parental-leave-in-2025/]

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.

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.