Two ways in, one destination. Where I am now, and how each route keeps founding live.
01
Where I am now
Applying on two tracks. Consulting — healthcare strategy / CDD: Carnall Farrar (October cohort, warmest access), PMSI Strategy (re-approach), Mansfield Advisors, Candesic. Commercial — founding-GTM / first commercial hire at seed–Series B health-tech startups. The commercial track is both a bridge (income and immersion before a consulting start) and a backup (if consulting doesn't land this cycle). Underneath both, continuously, the technical co-founder search.
02
The map
Two ways in, one destination. The heavier-ruled boxes are the founding outcomes; every other branch keeps founding live rather than closing it. The dashed link is the bridge/backup relationship between the tracks I'm running right now.
03
Operating principles
Time-box the experiment. If I enter consulting, it's a diagnostic with a readout date (~24 months), not an open-ended stay. Institutional gravity turns two years into five by inertia — decide by preference, not default.
Name the exits in advance. Partner track · corporate strategy (e.g. Palantir health) · senior operator · found. Revisit them deliberately at the readout date.
Build relationships as people, not engagements. Medical directors, clinical leads, service managers only become a network if I tend them after the project ends. This is the asset with the longest half-life — and the one consulting won't hand me automatically.
Pick relationship-rewarding buyers. Favour B2B / B2B2C into NHS & ICS, employers, insurers, pharma — where credibility compounds — over pure D2C, where capital and brand win and clinical relationships don't.
Keep the co-founder search always-on. No technical co-founder in a reasonable window means I'm the clinical/commercial founder of someone else's company, not a solo CEO. Decide that consciously.
Gate founding on evidence, not enthusiasm. Threshold to raise: at least one signed design partner plus a defensible evidence plan. Regulation is necessary, not sufficient — the moat is the specific thing I build.
Stay falsification-first. Run the kill signals below against whichever path I'm on, honestly and on a schedule.
04
Kill signals — what would change my mind
Consulting — 12+ months in, staffed only on short CDD sprints, no provider-side immersion, no durable operator relationships: the "relationships + map" rationale isn't accruing. Re-evaluate the firm or the path.
Commercial — title inflation without real ownership of clearance, evidence or buyer relationships: the role isn't building the assets. Move.
Founding — the wedge relies on cheap-to-replicate software with no regulatory, data or workflow moat: the defensibility thesis fails. Kill the idea, not the domain.
Domain — nothing seen so far falsifies health as the 10–15 year area. The open question is always the vehicle, never the domain. If that ever inverts, this whole document is up for review.