It happens in clinics across the country every single day. A doctor spends fifteen minutes explaining carbohydrates and portion control to a patient with prediabetes. The advice is medically sound. But the moment that patient walks out the door and back into a life of double shifts, exhausted evenings, and 10 p.m. frozen meals, the advice quietly evaporates. Dr. Usmani knows that situation very well. Rather than letting it harden into burnout, he used it as a blueprint.
Dr. Usmani is part of a quiet but growing cohort of physicians who refuse to leave health care innovation entirely to software engineers. He balances clinical practice with his role as Medical Director at Pocketpills, a national digital pharmacy, while also running HealthTech Investors, a community helping doctors navigate early-stage startups, and building Manna Health AI, a metabolic coaching platform. None of these projects began because he wanted to be a tech founder. They began because he was tired of watching the same frictions repeat themselves in exam rooms, pharmacies and patient follow-ups that never happened.
I had the chance to speak with Dr. Usmani about what it actually takes for physicians to build in the current era of accessible software development.
Build for reality, not the ideal
When tech companies build health tools, they often design for the perfect patient, someone with high health literacy, infinite motivation and tremendous free time. Usmani knows this type of patient rarely exists. Manna Health AI pairs with a continuous glucose monitor (CGM) for a defined window to capture how a patient's blood sugar actually responds to their diet. Once it gathers that data, it delivers personalized dietary recommendations grounded in how that specific patient actually eats.
Dr. Usmani notes that physicians possess a visceral understanding of the limitations their patients face. This proximity to the struggle ensures that physician-led design is not just more empathetic, but more effective. In the world of software, that empathy can be a competitive advantage.
Treat clinical caution as an advantage
Physicians looking to enter the startup space are often intimidated by the Silicon Valley ethos of "move fast and break things." But in health care, breaking things means harming people. Usmani argues that a physician’s deeply ingrained respect for risk isn't a roadblock to innovation. His work at Pocketpills illustrates the point. The platform succeeded not by cutting corners in the name of convenience but by wrapping medication delivery in genuine clinical oversight, improving safety, adherence and the kind of continuity of care that a traditional pharmacy model struggles to replicate.
In a space where trust is the product, a physician's instinct to prioritize patient safety can be good business logic.
Redefining what disruption looks like
Perhaps the biggest trap for aspiring physician-founders is the belief that their idea needs to instantly revolutionize the health care system to be valid. Usmani’s view is much more grounded. When asked what success looks like for his AI coaching platform, he doesn’t talk about shifting health care funding or economics. He talks about a patient who makes a slightly better decision in the cereal aisle on a chaotic Tuesday evening.
Dr. Usmani believes the people best positioned to build tools that bridge that gap are not distant coders, but the physicians who see the system’s shortcomings firsthand and are motivated enough to fix them.
Editor’s note: The views, perspectives and opinions in this article are solely the author’s and do not necessarily represent those of the AMA.