Be Willing to Rethink the Model: Tech-Enabled or Tech-Driven?

One of the most important (and most uncomfortable) questions a healthcare founder can ask is this: Are we a services company using tech to scale, or a tech company that’s lightly supported by people? 

The difference might sound subtle. It’s not. 

It’s a strategic fork in the road, and you can’t keep one foot on each path. 

Why This Question Matters 

Too many early-stage companies try to do both. 

They build a tech platform and provide done-for-you services. They pitch SaaS margins but staff like an agency. They price like software but deliver like consultants. 

What happens? They burn out their team, blur their identity in the market, and confuse investors who don’t understand what kind of company they’re betting on. It’s not sustainable. And it’s not scalable. 

So if you’re in this in-between zone, you need to pause and ask: What is our real model today? And what do we want it to be in 18 months? 

Model 1: The People-Powered Services Business with Tech as a Lever 

This model is often where healthcare founders start—especially if they’re subject matter experts. 

The business is grounded in relationships, white-glove service, and domain knowledge. Tech is a lever, but not the center. You win on results, not automation. 

Pros: 

• Easier to get early traction through consulting, relationships, and referrals 

• High client trust and retention when done well 

• Cashflow can start earlier 

Cons: 

• Hard to scale beyond the founder 

• Margins depend on staffing, not software 

• Not a “venture-scale” story without a pivot 

This model works if you want a high-end boutique or a profitable agency with tech-enabled tools. But it requires ruthless clarity on capacity, pricing, and scope. 

Model 2: The Tech-Driven Platform, Supported by People 

This model flips the equation. 

Here, the product is the platform. The core IP is in the code, the UI/UX, the data structure—not in the people. Services (like implementation, education, customer success) exist to drive adoption, but they are not the product. 

Pros: 

• Higher margins once built 

• Easier to scale and sell 

• A cleaner venture narrative if fundraising 

Cons: 

• Longer runway to revenue 

• Requires significant upfront investment in product and engineering 

• Less flexibility with early clients (you’re building for many, not customizing for one)

This model works if you’re building a SaaS company, AI tool, or data platform meant to scale horizontally across payers, providers, or systems. 

But here’s the catch: you can’t bootstrap this model indefinitely with services. At some point, you have to decide to go all-in, and that requires capital, a product roadmap, and clarity of vision. 

Why Founders Get Stuck in the Middle 

Let’s be real. Most of us didn’t start with a five-year roadmap and a clearly defined business model. We started because we saw a problem, and we knew how to solve it. So we consult. We serve. We pilot. 

And suddenly, we’ve built a services company—while pitching ourselves as a product one. 

This in-between zone feels productive, but it’s often the most dangerous place to be. You’re over-delivering on service, undercharging like a startup, and under-investing in product. It’s not a business—it’s a balancing act. 

The sooner you choose a model, the sooner you can build everything else (pricing, org chart, messaging, go-to-market) around it. 

The Real Question: What Kind of Founder Do You Want to Be? 

• Do you love being close to the customer and solving messy, complex problems in real time? → You might thrive in a services business that uses tech to differentiate. 

• Do you light up thinking about scalable systems, recurring revenue, and building a product that runs without you? → You might be a tech founder—and need to start acting like it. 

Neither path is “better.” But each one requires different hires, different capital, and a different kind of focus. 

Final Thought 

Stop trying to build both. Pick the model that fits your strengths, your goals, and the market you want to serve. 

Be honest about where your business is now. Be bold about where it could go. And be willing to rethink the model if you realize you’ve been building in the wrong direction. 

This is the work that unlocks everything else.