ProKidney's CEO observes that over a 10-year period, the only significant change he saw in dialysis clinics was the addition of flat-screen TVs. This starkly illustrates the profound lack of clinical and technological innovation in a massive, life-sustaining industry, highlighting a huge opportunity for disruption.

The next evolution in personalized medicine will be interoperability between personal and clinical AIs. A patient's AI, rich with daily context, will interface with their doctor's AI, trained on clinical data, to create a shared understanding before the human consultation begins.

ProKidney's significant funding from co-founder Pablo Legorreta and investor Carlos Slim was driven by their direct family experiences with kidney disease. This shows that for high-risk, long-term biotech ventures, a deep personal connection to the mission can be a more powerful motivator for investors than purely financial interest.

Patients with complex illnesses often become "medical nomads," shuffling between specialists who only view problems through their narrow training lens. Effective treatment requires a coordinated, team-based approach, which is largely absent in private practice, leaving patients to manage their own care.

Of the 30+ million Americans with chronic kidney disease (CKD), most are unaware they have it. The greatest societal impact would come not from a new therapy, but from widespread screening and education, as existing drugs and lifestyle changes can help patients in the early stages before they need advanced care.

In regulated spaces like healthcare, product managers must move beyond surface-level collaboration. They need to develop deep domain knowledge and partner with clinicians who are embedded in the product process, co-writing requirements and ideating on solutions, not just acting as consultants.

The field of ophthalmology is particularly well-suited for a hub-and-spoke model because it utilizes a wide range of treatment modalities (small molecules, biologics, devices, gene therapy). This allows a central hub to leverage shared expertise in areas like ocular delivery and regulatory pathways across multiple, diverse spokes.

Kindbody's rapid, venture-backed expansion mirrored a tech startup's trajectory. However, this 'Silicon Valley style' disruption in a sensitive medical field like fertility care ultimately led to significant patient disillusionment, revealing a fundamental clash between a speed-focused business model and the requirements of trust-based medicine.

ProKidney's CEO, a nephrologist, attributes his entry into the field not to a pre-existing passion, but to the direct influence of a strong-willed mentor who "twisted his arm." This highlights how personal relationships, rather than pure academic interest, can define a career trajectory in specialized medicine.