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 — unit economics that hold as you grow.
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, 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 →
Not a growth theory. Four companies scaled with discipline: two with gross margin doubled — one of them with R&D spend 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 →