What If Your Doctor Only Has 11 Minutes to Figure Out What Is Wrong With You

The average family with a child who has a rare disease in the United States spends about seven years bouncing between specialists before they get a real diagnosis. Not weeks. Years. And during those years, the disease keeps getting worse.

In this episode, I sat down with Joshua Resnikov from Sunstone Health. Joshua is a biomedical engineer who worked at the Wyss Institute at Harvard and helped build a company called Emulate Bio, but his story here is personal. About a year and a half into his second son's life, the boy started running 105-degree fevers every month. That began what Joshua now calls the diagnostic odyssey, and it took years of ER visits, referrals, and dead ends before they got close to a real answer. His son turned out to be one of roughly 500 children in the country with a specific hyperinflammatory condition.

That experience is what Sunstone Health is built on.

Joshua walked me through why this is so common, and the answer is not that doctors are bad at their jobs. The economics of the system give a doctor about 11 minutes with each patient. If what you have in front of them is not obviously solvable in that window, the safest move for their schedule is to refer you to someone else. You then wait six or nine months for the specialty appointment, and repeat. Nobody in the chain is doing anything malicious. The incentives are just pointed in the wrong direction.

He was also clear about where the money actually flows. Hospitals and doctors get paid to run tests and deliver services. Insurance is paid to approve fewer of them. So the system optimizes for the cheapest next step, not the fastest correct answer. Joshua put it well: insurance can save 80 dollars today by picking the cheaper test, and in an actuarial spreadsheet that is a win, even if it costs the patient six more years of pain.

What Sunstone does is interesting because it does not try to rebuild the system. It routes around it. They identify high-complexity patients very early, move them straight to whole-genome sequencing, and return specialist-level guidance to the family in about 12 weeks. Not seven years. Twelve weeks.

The business model is the piece I want other operators to pay attention to. Sunstone does not sell to insurers. They sell to self-funded employers as a benefit. When an employer runs their own health plan, they carry the real cost of a long, unresolved diagnosis, including specialist referrals, ER visits, missed work from the parent, and sometimes disability accommodations. Getting the right answer fast saves the plan real money. That financial alignment is what finally lets a patient-first approach actually scale.

There is a broader lesson here for anyone trying to fix a broken system. You do not always need to take on the whole machine. Sometimes you just need to find the one stakeholder whose incentives already match what the customer needs, and build the product for them. For Sunstone that stakeholder is the self-funded employer. For a lot of small business automations I build, it is the owner who actually feels the cost of a slow process. Once you find the aligned buyer, the rest of the work gets easier.

At the end of the day, this conversation was a good reminder that the most expensive part of healthcare is often not a treatment. It is time. Seven years of the wrong care is more expensive than 12 weeks of the right diagnosis. And the companies that are going to actually improve this space are the ones that understand the incentive structure and find a way to bend it toward the patient without waiting for the whole system to change first.