Osama Hashmi, MD, MPH, is a board-certified dermatologist and cofounder and CEO of Impiricus.
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When I finished my residency and entered clinical practice, my priority was to give my patients the best care possible. However, I quickly realized how many incentives exist among various healthcare stakeholders—and just how misaligned those incentives can be.
Through my own experiences and speaking with my peers, I learned about those competing incentives. A few examples? Pressure from private equity groups that own practices to see more patients, questions from insurance companies about prescribing certain medications and treatments and pharmaceutical companies competing to make their products the preferred choice among physicians. I observed those competing priorities creating gaps, gaps that patients were left to navigate, which could lead to delayed access to treatment and worse outcomes.
There are many aspects of the healthcare industry that I believe need to be addressed to prevent competing incentives from negatively impacting patients. But as a physician who also founded a healthcare technology company that facilitates engagement between pharmaceutical companies and medical providers, I want to focus on the healthcare technology space in this article. I believe that healthcare technology leaders should embrace a physician-first approach in designing and implementing their solutions, especially in the age of AI, where there’s arguably more information overload than ever before.
From my observations, how physicians practice medicine and how patients experience the healthcare system have changed over the years. A physician’s personal narrative published in the AMA Journal of Ethics captures the shift well, in my view. The author, who stated that his “career began in 1977,” explained: “During these early days in my career, I had wonderful relationships with my patients. There was a high level of appreciation and true friendship between us. However, as group practices enlarged and the use of referrals for specialists increased, physician-patient exposure decreased—visits became shorter, and the patient was exposed to different physicians and nurse practitioners.”
The author also made a point about the impact of answering services on the physician-patient dynamic. Specifically, he noted, “The physician has become even more remote from his or her patients with the proliferation of answering services, making the insulating wall between them almost complete.”
That personal narrative was published in 2015. Over a decade later, I believe that those challenges have become even more amplified. Physicians today, especially those new to clinical practice, often face unexpected constraints. Technology can function as another constraint or a supportive tool that helps physicians better serve their patients.
Whether technology ends up constraining or supporting physicians depends on how it’s designed—specifically, whether it focuses on tracking and generating short-term or long-term value and whether it enables physicians to be more patient-centric. For instance, consider a healthcare communication platform that makes it easier for physicians and patients to communicate by sending automated appointment reminders, centralizing messages in one place and flagging urgent patient messages. If the platform gathers data on short-term metrics, such as physicians’ response rates and message volume, it could end up hindering physicians and patients more than helping them. However, if the platform gathers data on long-term metrics such as how communication patterns correlate with patient recovery and satisfaction over time, it could help physicians better serve their patients.
A physician-first approach isn’t about adding features or improving usability. It’s about fundamentally rethinking what healthcare technology is optimizing for.
From my observations, many healthcare platforms today are built to measure activity. Messages sent. Clicks generated. Response rates tracked. But none of those metrics tell you if a physician made a better decision or if a patient got access to the right treatment faster.
A physician-first approach starts with a different question: "Did this create meaningful clinical impact?"
In my view, that shift changes everything.
First, healthcare technology should prioritize outcomes over activity. Instead of tracking short-term engagement, healthcare technology leaders should measure how their solutions influence long-term patient outcomes, physician confidence and quality of care. If a platform cannot connect its performance to real-world impact, it is adding noise, not value.
Second, leaders should replace passive feedback with real conversations. Surveys capture surface-level input. Conversations reveal how physicians actually think, decide and navigate constraints in practice. Designing in isolation leads to tools that interrupt workflows. Designing alongside physicians leads to tools that integrate seamlessly into how care is delivered.
Finally, technology should reduce friction, not introduce it. The goal should not be to give physicians more to manage; it should be to remove administrative burden, streamline decision-making and deliver the right information at the right moment. When technology aligns with clinical workflows instead of competing with them, it becomes an extension of care rather than a barrier to it.
A physician-first approach is not a design principle. It is a commitment to building systems that prioritize relevance, trust and real impact over volume.
Trust is earned through delivering consistent, meaningful value.
As someone who has been on both sides of healthcare technology, I’ve seen how quickly that trust erodes when solutions are built without physicians in mind and how it builds when physicians are treated as true partners.
That's why it's important to involve physicians throughout the product lifecycle, from design to deployment to iteration, and act on their input in ways that improve real-world care.
Healthcare is fundamentally human. Technology should support that reality, not complicate it.
I believe that the companies that earn physician trust will be the ones that deliver support when and where it matters, in ways that fit naturally into clinical practice.
And ultimately, what defines impact is not how much is delivered, but whether what is delivered helps physicians do what they are trained to do: care for patients.
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