Growth that compounds gross margin instead of eroding it, R&D spend that goes further, and teams built to execute across countries and cultures, with AI compounding the work throughout.
A 30-minute call to get a first read on where the margin and the velocity are leaking, and a proposal for a 2–4 week problem-framing engagement.
Scale is a discipline, not a spend. More output per dollar and per person, teams that ship without waiting on a center, a business that gets stronger as it grows, not just bigger.
Growth is easy to buy and hard to keep — revenue up while margin quietly bleeds, headcount up while velocity drops. I work inside the team to scale revenue, patients, and usage while gross margin moves the right way, turn around the R&D engine, and build the org to sustain it — with AI compounding the work at every step.
Scale revenue, patients, and usage while gross margin moves the right direction, not the wrong one — diagnosing where margin leaks and where it compounds as you grow, with new lines that reach break-even fast.
Cut R&D spend without cutting velocity — more output per dollar, with AI compounding the work across the build.
Hire and restructure teams that ship into autonomous units, across countries and cultures — the org and cadence to sustain the scale.
I’ve scaled revenue and patients many times over while pulling gross margin up, not down — and cut R&D spend without losing a step. The trap is treating growth as something you buy: more headcount, more spend, more surface. It compounds cost faster than value.
I treat scale as a discipline. Find where the unit economics leak, fix the R&D engine so it produces more per dollar, and build an org of autonomous teams that ship without waiting on a center. AI runs through all of it, compounding the work, not padding the org chart.
More learnings from my decades in tech and digital health on Substack →
Real gross-margin and growth stories: margin doubled (R&D cut ~40% at the same time), a virtual-care line grown to national reach, and a platform built from zero.
As SVP Product & Technology (CPTO) at Form Health (obesity and cardiometabolic care): scaled ARR and patients 15× in two years and doubled gross margin above benchmark, while reorganizing product/design/eng/data 3×+ into four autonomous units and leading the B2C→B2B2C pivot.
As VP Product & Engineering at Sana Benefits (self-funded insurance for SMBs): grew 50%+ while doubling gross margin above benchmark and reducing R&D spend ~40% — and launched Sana Care, a new virtual primary-care line that hit break-even and 1,000 patients within four months.
At a Fortune-10 health plan I took Virtual Visits from proof-of-concept to a standalone business — shipping an end-to-end Virtual Care Hub to ~40M members across Optum Care and partners, on a member experience reaching ~4M monthly active users. Scale at the largest end of the market.
Early product hire at a benefits-administration platform: 0→USD 40M+ ARR on a platform supporting USD 1B+/yr in healthcare spend, 30→500+ employees, 0→60+ employer clients, 0→250k members — the same scale-with-discipline playbook, from zero.
Most engagements start with a 2–4 week problem-framing sprint, priced by role and cadence, not hours. The phases overlap.
Unit economics and R&D spend under the hood. Where margin bleeds, where velocity is lost, where AI can compound the work.
Fix the unit economics and the R&D engine. Margin moving the right way, output per dollar up, AI woven across the build.
The org and hiring to sustain the scale. Autonomous units that ship, across countries and cultures, after I’m gone.
See the one-page capabilities summary →