Building — Mar 2026
8 min
Medicine taught me to ship differently
What clinical training does to a founder's instincts — for better, and in a few specific ways for worse.
Clinical training installs a particular reflex: before you act, name the worst thing this could be. It is a good reflex for a person holding someone's life and a mixed one for a person holding a roadmap. Half of what I've learned as a founder has been figuring out where that reflex helps.
Where it helps: irreversibility. Medicine gives you a precise sense of which decisions can be walked back and which cannot, and most product decisions are far more reversible than they feel. Where it hurts: medicine trains you to wait for certainty that startups never supply.
Ask which mistakes are recoverable, then move fast in that space.
The synthesis I've landed on is unglamorous. Move quickly wherever a mistake is recoverable within a week. Slow down deliberately, and write things down, wherever it isn't. Most teams do the opposite: they agonise over the reversible and improvise on the permanent.
Notes
Cite as: Vishal Punwani, “Medicine taught me to ship differently”, Mar 2026, vishalpunwani.com/writing/medicine-taught-me-to-ship-differently