The most GenX thing I've ever written: The San Francisco healthtech scene and the New York healthtech scene are osten...
The most GenX thing I've ever written: The San Francisco healthtech scene and the New York healthtech scene are ostensibly solving the same problem: applying machine learning to healthcare without making it worse.They could not feel more different.San Francisco healthtech AI is AI brought to you by Sharon Goodwin if she went to work for Google. It is composed, earnest, and values-forward. Decks are immaculate. Mission statements are morally certain. Every product is “reimagining care delivery,” delivered in a calming color palette that implies the model also practices yoga. Models ship with ethics frameworks, trust councils, and a Substack post explaining why this approach is thoughtful and human-first. Scale is assumed. Regulation will be “partnered with.” The future is inevitable (pending approval from Legal).New York healthtech AI is AI brought to you by Hawkeye Pierce and BJ Hunnicutt.This is wartime medicine energy.The system is broken, clinicians are exhausted, insurers are hostile, and if something doesn’t work by Friday, real people get hurt. The demos are rough. The humor is dark. The house built AI is openly described as “good enough for now.” Ethics exist, but as scar tissue, not committees. If something works, it gets used. If it doesn’t, it dies as quietly as a beloved patient.San Francisco designs for the healthcare system we wish we had.New York designs for the one we’re stuck with.The tension is real. SF sometimes underestimates how stubborn institutions can be. NYC sometimes underestimates how much trust and legitimacy matter at scale. One risks building beautiful solutions that struggle to land. The other risks building brutally effective tools that need refinement before they can expand.The most interesting healthtech AI companies, unsurprisingly, tend to steal from both playbooks. They borrow San Francisco’s discipline around infrastructure, safety, and long-term thinking, and New York’s urgency, pragmatism, and refusal to romanticize the problem.In healthcare, the future isn't likely arrive neatly, with a fresh lanyard and domain-specific, structured, and conversational data; it limps in. With messy data. And a sense of humor about it.