Purpose vs. Profit in HealthTech.
When compromise kills trust and how to design models where safety saves
This is Clinical Product Thinking 🧠, a weekly newsletter featuring practical tips, frameworks and strategies from the frontlines of clinical product.
Welcome, friends, this is issue No. 031 of Clinical Product Thinking. This week we’re diving into business models in healthtech and how to reject false trade-offs.
Healthtech founders love to talk about purpose. Investors love to talk about profit. And somewhere in the middle, most companies get stuck.
To dig into this, I sat down with Kevin McDonnell, an operator who’s scaled clinical services to millions in revenue and advised boards wrestling with this exact tension.
Here’s what he said.
The False Trade-Off
Kevin puts it bluntly:
“Too many founders treat purpose and profit as separate lanes. Some obsess over outcomes and impact but ignore the need for a sustainable engine. Others chase revenue so hard they erode clinical trust. Both approaches fail.”
The best businesses reject the trade-off. They build models where clinical outcomes and commercial success reinforce each other.
👉 Practical steps for CPMs/founders:
Map your current initiatives: which are primarily “purpose-driven” vs “profit-driven.” Where are they reinforcing each other (green zone) vs in conflict (red zone)?
Pressure-test your product: can you clearly articulate how better outcomes = better business performance?
Run a “dual lens” review of new ideas: what’s the clinical case and what’s the commercial case? If you can’t articulate both in one sentence, pause.
When Compromise Kills Trust
I asked Kevin about the hardest trade-offs he faced when running a clinical services business.
His answer: speed and scale.
Do you hire more clinicians to maintain service levels, or stretch the team and risk patient dissatisfaction?
Do you take low-margin contracts to keep the doors open, knowing you can’t invest properly in quality?
Kevin’s lesson:
“Some compromises kill trust. And trust once lost is almost impossible to regain.”
👉 Practical steps:
Create a “red lines” list of compromises you will not make (e.g. minimum staffing ratios, clinical governance guardrails).
Build a “trust recovery” playbook: how will you handle it if something goes wrong? Communicate openly, fix fast and log lessons learned.
Stress test your processes: if you had to double volumes tomorrow, would safety break?
Designing Models Where Safety Saves
Clinical excellence on its own won’t pay the bills. Kevin argued you need a business model where safer care directly reduces cost.
Fewer readmissions → saved bed days
Fewer unnecessary scans → saved spend
Longer time at home → freed up system capacity
And then? Quantify it. With real-world evidence, not just trial data.
Kevin pointed to Cera, which uses AI to predict risk in home care. They claim £100m+ in NHS savings while scaling to millions of visits. That’s what it looks like when clinical and commercial reinforce each other.
👉 Practical steps:
Identify 2–3 safety metrics that naturally translate into cost savings (e.g. readmissions, ED attendances avoided).
Build those into your KPI dashboard alongside financial metrics.
Partner with your finance or ops team to quantify savings in real money terms (£/bed days).
Turn your “safety saves” stories into case studies, both for clinicians and investors.
Metrics That Actually Matter
Vanity metrics are tempting: downloads, pipeline size, number of pilots. Kevin calls them “hollow.”
What matters instead:
Adoption: Are clinicians actually using it?
Utilisation: Are patients sticking with it?
Impact: Are you shortening stays, reducing costs, preventing escalation?
And don’t forget the commercial backbone, metrics like:
Net revenue retention
Margin per contract
Pilots that don’t convert? Contracts that never scale? That’s not a business.
👉 Practical steps:
Replace vanity metrics in your OKRs with metrics such as adoption, utilisation, impact and NRR.
Run a quarterly “metric audit”: are we tracking things that actually drive decisions, or just what’s easy to measure?
For pilots: set explicit conversion criteria before you start (e.g. “will only proceed if X% adoption within 3 months”).
One Metric to Rule Them All
The hardest part of alignment, Kevin said, is language.
Clinicians talk safety.
Product talks features.
Investors talk revenue.
They’re all chasing outcomes, but with different vocabularies.
Kevin’s fix: one shared metric that everyone can rally behind.
“Take reduced bed days. Clinicians see safer care. Product sees adoption. Investors see cost savings that convert into revenue. Alignment happens when you stop letting each group keep their own scoreboard.”
👉 Practical steps:
Facilitate a cross-functional session (clinical, product, commercial, investors) to agree on one shared anchor metric.
Translate that metric into each group’s language. (e.g. “reduced bed days” = safer care for clinicians, freed capacity for ops, £ savings for investors).
Put that shared metric at the top of your OKRs.
The Guiding Question
At the board level, founder level and advisor level, Kevin always comes back to the same question:
👉 Does clinical value drive commercial value?
If yes, double down. If not, you might be in the wrong market or have the wrong model.
Because at the end of the day, a healthtech business is still a business.
The takeaway?
Stop pitting purpose and profit against each other. The companies that will win are building models where one fuels the other.
Join Us at HLTH Europe 🇪🇺
Danielle Brightman and I are running a panel event on clinical product with two incredible guest speakers. If you don’t know about HLTH, it’s the health tech conference you absolutely cannot miss.
👉 Register your interest for the panel here.
🎟️ Get your HLTH ticket here. (Use code: HE26PP_CPT250 for €250 off your ticket!)
Clinical Product Drinks ✨
Last week we held Clinical Product Drinks #002 and it was such a fantastic crowd. 30+ clinical product leaders and managers all passionate about building the future of healthcare. 👉 For future events subscribe here.
That’s all for this week. See you next time! 👋
🤝 Work with me | 📅 Attend an event | | ✍️ Send a message
Written by Dr.Louise Rix, Head of Clinical Product, doctor and ex-VC. Passionate about all things healthcare, healthtech and clinical product (…obviously). Based in London. You can find me on Linkedin.
Made with 💜 for better, safer HealthTech.
We’ve found that purpose and profit only feel in tension when the model isn’t designed properly, because in healthcare if trust breaks, everything else tends to follow.
Hey — I came across your writing and really liked how you think.
I’m exploring something similar from a different angle — writing about human behavior through a system design lens (like debugging internal patterns).
Just started publishing on Substack. If you ever get a moment to read, I’d genuinely value your perspective.
Also happy to support your work — feels like there’s an interesting overlap here.