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My biggest takeaways from OnMed CEO Karthik Ganesh:
1. 𝗙𝗶𝘅 𝘁𝗵𝗲 𝗯𝗿𝗼𝗸𝗲𝗻 𝗱𝗼𝗼𝗿 𝗯𝗲𝗳𝗼𝗿𝗲 𝘆𝗼𝘂 𝗿𝗲𝗻𝗼𝘃𝗮𝘁𝗲 𝘁𝗵𝗲 𝗸𝗶𝘁𝗰𝗵𝗲𝗻. Karthik's metaphor is simple: 80% of U.S. counties are care deserts, 120 million Americans have no access to viable care, and 167 million continue to delay care. The healthcare industry keeps optimizing the experience for people already inside the system while the front door is broken for everyone else. OnMed is fixing the door.
2. 𝗔𝗜 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝘀𝘂𝗯𝘃𝗲𝗿𝘁, 𝗻𝗼𝘁 𝗼𝘃𝗲𝗿𝘁. Karthik was openly skeptical of AI in healthcare until about four months ago. What changed his mind was realizing AI doesn't have to replace the human — it can power the human. OnMed's model keeps a real clinician as the last mile. The patient sees a person. Behind the scenes, AI is improving diagnostics, prescribing, and clinical decision-making. Within nine months, 100% of their clinical workflows will be AI-driven. Within twelve months, over 80% of clinical decision-making will use agentic orchestration.
3. 𝗠𝗶𝗻𝗶𝗺𝗮𝗹𝗶𝘀𝗺 𝗶𝘀 𝗮𝗻 𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝗻𝗴 𝘀𝘁𝗿𝗮𝘁𝗲𝗴𝘆, 𝗻𝗼𝘁 𝗮 𝗹𝗶𝗳𝗲𝘀𝘁𝘆𝗹𝗲 𝗰𝗵𝗼𝗶𝗰𝗲. Karthik personally owns 87 things. He keeps his count under 100. That same discipline runs the company. For OnMed to double down on something, something else has to go. They deprioritized multiple initiatives to go all-in on AI. No plan B. His line: "We do few things and we do them brilliantly."
4. 𝗣𝗲𝗿𝗳𝗼𝗿𝗺𝗮𝗻𝗰𝗲 𝗼𝗽𝗲𝗿𝗮𝘁𝗲𝘀 𝗹𝗶𝗸𝗲 𝗴𝗿𝗮𝘃𝗶𝘁𝘆. Karthik referenced a Nick Saban speech that stuck with me. High performers gravitate toward mediocrity when you introduce mediocre performers into the mix. So you build a culture of zero tolerance for anything else and over-communicate the North Star until every person believes in it. He rebuilt his entire management team in two years. His COO has worked with him for 15 years. There is never any daylight on execution speed.
5. 𝗧𝗵𝗲 𝗿𝘂𝗿𝗮𝗹 𝗱𝗲𝗽𝗹𝗼𝘆𝗺𝗲𝗻𝘁 𝗻𝘂𝗺𝗯𝗲𝗿𝘀 𝗮𝗿𝗲 𝘀𝘁𝗮𝗴𝗴𝗲𝗿𝗶𝗻𝗴. In the towns where OnMed has deployed care stations, they've seen 42% of the population on average. The return rate is 38% — higher than virtually any healthcare setting outside of pediatrics. 78% of patients in rural America say OnMed is their medical home. 54% say the alternative was the ER. These aren't product metrics. These are lifelines.
6. 𝗣𝘂𝗿𝗽𝗼𝘀𝗲 𝗼𝘃𝗲𝗿 𝗺𝗶𝘀𝘀𝗶𝗼𝗻. Karthik doesn't say OnMed has a mission. He says they have a purpose. A mission is stakeholder-driven. A purpose is societal. After 26 years in healthcare, he said something I've never heard from anyone in nearly a thousand interviews: "For the first time, my work has met my soul."
Check out our full conversation in episode 529: lnkd.in/dDNZX8GU

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