What It Looks Like to Join a Series A Healthcare Startup as One of the First Clinical Hires with Andrew Shiflett

From Primary Care to Startup Leadership: Why Clinicians Matter Most in Early Chaos 

Andrew Shiflett, PA-C, brings more than a decade of experience in complex primary care and was one of the first clinical hires at a Series A mobile primary care startup. Joining within the first months of the company’s life, Andrew stepped into patient homes without playbooks. He had no formal title, but a role as the clinician others trusted to navigate uncertainty and advocate for their needs.

In this conversation, Andrew reflects on leaving a stable practice for the unpredictability of startup life, weighing risk against opportunity while raising a young family. He shares candid stories of knocking on doors with nothing but a stethoscope and a printed schedule, building trust with patients in underserved communities, and learning to translate clinical realities into business language.

Helen and Andrew revisit pivotal moments, including advocating against a productivity-based compensation model that threatened clinician retention and patient outcomes. The importance of clinician voices in shaping startup culture, the responsibility of early hires to smooth the path, and the leadership that emerges when clinicians step into uncharted territory.

This episode is for clinicians considering the leap into startups, leaders building early teams, and anyone curious about how frontline expertise drives innovation.

Must-Hear Insights and Key Moments

• Andrew was one of the earliest clinical hires at a Series A mobile primary care startup, stepping into patient homes without established systems. 
• Leaving a secure practice in Richmond for startup chaos, he weighed risk against stability while raising a young family.
• Clinician leadership emerged without a formal title, as colleagues relied on him to navigate uncertainty and raise concerns to leadership 
• Knocking on doors with no playbook showed the realities of startup medicine and the physical demands of home‑based care.
• Dog years of startup life meant each month felt like a year in traditional practice.
• Trust before titles became the foundation for patient care and clinician advocacy in early chaos.
• Partnering with Helen Tanner, he pushed back against productivity‑based compensation models that threatened retention and outcomes.
• Building the plane while flying captured the challenge of asking patients to trust a system still being created 
• From Series A chaos to a $13B Series E Medicare Advantage startup, Andrew’s journey shows how clinicians shape healthcare innovation.

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