I have a hard time looking at anything, a process, a tool, a habit, a system, and accepting that it's finished. Someone hands me something that already works, and my first instinct isn't gratitude that it works. It's a question: what would make this better?
That's not restlessness for its own sake. It's a pattern I've noticed in myself across every part of my life, personal habits, health, work, the way I practice medicine, the way I've built companies, and once I saw the pattern clearly, I realized it's the actual throughline connecting everything I've done.
Where it started: a screw that already worked
Pedicle screws have been a standard part of spine surgery for decades. The design was established, the surgery worked, and by any reasonable standard, the tool was fine as it was.
But "fine" isn't the same as "as good as it could be." In the operating room, I kept noticing small frictions, moments where the existing hardware made a routine step slower or more awkward than it needed to be, especially as more procedures moved toward minimally invasive approaches that demanded more precision through smaller openings. Nobody had asked me to redesign anything. The tools worked. But I couldn't stop turning the problem over.
That instinct led to two U.S. patents, a poly-axial pedicle screw assembly and a related lock screw system, both aimed at the same goal: making an already-functional tool meaningfully easier to use in minimally invasive surgery. Not a reinvention. A refinement. The kind of change that looks small on paper and shows up as real time saved and real precision gained in an actual operating room.
The same instinct, a different scale
Years later, I noticed myself doing the exact same thing with entire healthcare organizations, just at a much larger scale. I'd look at a clinic that was functioning fine, patients were being seen, bills were being paid, and I'd still see the gaps. Where communication broke down between departments. Where a process existed because it always had, not because anyone had asked whether it still made sense. Where growth was about to expose a weakness nobody had bothered to fix while things were still small.
Building physician-led healthcare platforms was never about the idea being new. Primary care, imaging, surgery, and rehab connected under one roof isn't a novel concept. What mattered was refusing to accept the version of that idea that already existed elsewhere, the ones with the weak governance, the vague incentives, the systems that worked until they didn't. Same instinct as the screw. Look at what's already there. Ask what's actually broken, even when nobody's complaining yet. Fix that, specifically, instead of starting over from scratch.
Then I turned it on myself
The most recent place this pattern has shown up is in how I think about my own health. For a long time, like most people, I treated my body as something to maintain, not something to actively improve. Eat reasonably. Exercise when there's time. Handle problems as they come up.
At some point I asked myself the same question I'd been asking about screws and clinics for twenty years: is this actually as good as it could be, or have I just stopped looking? That question is most of what sits behind the writing I do now on longevity and performance. Sleep isn't just something you get enough of or don't, it's a system you can actually audit and improve. The same is true for nutrition, training, recovery, stress. None of it is ever finished. There's always another layer to look at.
The question I keep asking, in an operating room, in a boardroom, or in my own life, is never "does this work." It's "is this actually as good as it could be."
What makes this different from just being restless
I want to be honest about the distinction, because restlessness by itself isn't a virtue. Plenty of people chase change for the sake of change and end up with something worse than what they started with. The difference, I think, is that this instinct only works when it's paired with actual discipline: you have to be able to name specifically what isn't working, not just feel generally dissatisfied. You have to measure whether your change actually helped, not just assume it did because it was new. And you have to know when something genuinely doesn't need touching, so you're not creating complexity for its own sake.
A patent that makes a screw easier to place in surgery is a specific, measurable improvement. A healthcare platform with clear governance and aligned incentives is a specific, structural fix, not just a bigger version of what existed before. A training and nutrition plan built around actual lab work and body composition data is a specific adjustment, not a vague resolution to "be healthier." The instinct to keep improving only works when it's this concrete.
Where this leaves me now
I don't think I'll ever fully turn this off, and at this point I don't want to. It's the same question in every room I walk into, whether that room is an operating suite, a company I'm building, or just my own life: what here could be meaningfully better, and what's actually standing in the way of that?
Most of what I've built, the patents, the platforms, the way I think about my own health now, came from refusing to accept that something already good enough was actually finished. I'd rather keep asking the question than stop and assume I've arrived.