The 3 Mindset Shifts Every Clinical Product Manager Needs
Lessons from Lorenzo Espinosa on building digital health products at scale
This is Clinical Product Thinking đ§ , your weekly newsletter featuring practical tips, frameworks and strategies from the frontlines of clinical product.
Good afternoon friends, this is issue No. 022. This week weâre discussing why good organisational structure alone isnât enough and what actually makes clinical product effective
Last week, we looked at the TechâProductâMedical (TPM) model that worked at Ada Health, based on my conversation with Lorenzo Espinosa.
The structure matters. But structure alone doesnât make it work.
Part of what determined whether TPM accelerated delivery or collapsed into friction came down to how clinical product managers showed up inside it.
In particular, three mindset shifts consistently separated clinical product managers (CPMs) who became trusted partners from those who didnât.
1. From âclinical inputâ to true partnership
The Tech-Product-Medical model only works well when clinical product stops operating as an external checkpoint and starts acting as a partner in product development.
At Ada, the clinical product managers who had the most impact didnât sit at armâs length.
They got close to:
the product manager,
the problem being solved,
and the decisions being made as the work took shape.
That proximity mattered.
It meant clinical product wasnât reacting to designs or solutions after they were formed. It was shaping the direction early, while options were still open and trade-offs were still cheap.
The mindset shift here is subtle but important:
Not âI represent clinical safety.â
But âIâm jointly responsible for helping this team make a good product decision.â
When clinical product shows up this way, it stops feeling like a gate at the end of the process and starts feeling like part of the engine.
2. From âcanât be doneâ to pragmatic option-building
One of the biggest unlocks Lorenzo described was pragmatism as a muscle.
Early on, clinical feedback often landed as a hard stop:
âThis isnât safe.â
âThis doesnât comply.â
âWe canât release this yet.â
Those concerns were usually valid.
But framed that way, they stalled momentum.
Over time, the most effective CPMs shifted from acting as gatekeepers to acting as option-creators.
Instead of:
âNo, this canât be done.â
They moved towards:
âYes, thatâs a real risk, but what if we approached it this way instead?â
That might mean:
sequencing delivery differently,
narrowing scope,
reframing what âminimum clinically viableâ really means,
or proposing an alternative path that reduced risk without killing progress.
The mindset shift here isnât about lowering standards.
Itâs about helping the team move forward safely, rather than blocking movement entirely.
In TPM teams, progress comes from people who can hold safety and momentum at the same time.
3. From âclinical correctnessâ to commercial awareness
The third shift is the one many CPMs find most uncomfortable, but itâs also the one that builds the most trust.
At Ada, CPMs who understood the commercial context of decisions had far more influence.
They knew:
what the product was sold for,
who was paying,
which clients were at risk,
and what would happen if a feature slipped or failed.
That knowledge changed the conversation.
It meant clinical product could:
prioritise risks in context,
help teams make trade-offs consciously,
and step into client conversations as a reassuring, credible clinical voice when needed.
The mindset shift is this:
Clinical doesnât exist in a vacuum.
It exists inside a business that has customers, contracts, and consequences.
CPMs who grasp that become far more effective.
How these mindsets actually develop
What struck me most in this conversation is that none of these mindset shifts come from formal âclinical product trainingâ.
In reality, there isnât a single, established pathway for learning this work yet.
These skills are built through exposure, by seeing how product decisions get made under uncertainty, by working closely with product teams and by developing judgment over time.
What actually builds them is:
spending time with product managers,
learning how product decisions are made under uncertainty,
understanding how the business really works,
and seeing clinical product as part of the system, not outside it.
Equally, Lorenzo made a strong point about the other side of the partnership.
Product managers coming from a traditional product management model often underestimate how much clinical product can amplify their impact, not slow it down.
When that partnership clicks, output doesnât just improve incrementally.
It compounds.
The real takeaway
The TPM model doesnât succeed because it balances disciplines.
It succeeds when the people inside it adopt the right mental posture:
partnership over policing,
pragmatism over purity,
context over isolation.
Thatâs where clinical product stops being perceived as friction and starts being experienced as force-multiplying.
Clinical Product Career Coaching đââď¸
Opening up 4 spaces for clinicians looking to break into or progress within clinical product in 2026. For those who know their experience is valuable, but arenât sure what actually counts or how to demonstrate product thinking that gets offers.
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Hiring Spotlight đ
Raj Kohli, co-founder and CEO of HealthTech-1, is hiring a Clinical Product Manager. I caught up with Raj about the role and the teamâs direction. HealthTech-1 is doing incredible work in primary care, and this position would suit a mid-level CPM with a strong regulatory mindset and Clinical Safety Officer (CSO) experience. đ Apply here.
Thatâs the public post for this week. See you next time! đ
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Written by Dr.Louise Rix, Head of Clinical Product, doctor and ex-VC. Passionate about all things healthcare, healthtech and clinical product (âŚobviously). Based in London. You can find me on Linkedin.
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How Ada Operationalised Clinical Product Without Stalling Delivery
To support the Tech-Product-Medical model, teams used multiple frameworks throughout the product development process:
