Written by: Muthu Alagappan, MD

What do chefs and doctors have in common?

Imagine you are the head chef of a Michelin-starred restaurant hired to cater a dinner for the 100 most important people in the world. You're thrilled—preparing exquisite food is a skill you've perfected over your career. But there's a catch: your restaurant typically serves 20 people at a time, not 100, and you usually have the entire day to prepare, but now you only have two hours. How would you feel? This is the grave reality of medical care today. Physicians, who have honed their craft over tens of thousands of hours, are now faced with the daunting task of seeing far more patients than they were trained to handle, in far less time.

There are many competing goals in healthcare—quality, affordability, safety, and convenience, to name a few. But there's one goal we don't talk about enough: capacity—how much healthcare we can actually provide at once.

Why capacity matters in healthcare

As a doctor myself, I've seen how important capacity really is. It affects everything—how long patients wait to see a doctor (often 30+ days for primary care physicians and months for specialists), how easy it is to get care, and even how good that care is. During COVID-19, we saw what happens when we run out of capacity—we didn't have enough ventilators, hospital beds, or physicians, and people died who didn't have to. Capacity also affects healthcare costs. When capacity is limited, prices increase due to providers having more bargaining power to negotiate higher fees. And it affects quality, too. As you can imagine, it’s difficult to deliver high-quality primary care in rushed 15-minute appointments once or twice a year.

Simply put, capacity matters more than we think.

We can break down capacity into a simple formula:

W represents the size of our clinician workforce, P1 is the number of patients, and P2 is the number of problems those patients have that can be actively managed.

In other words, healthcare capacity increases when we have more clinicians but decreases when the number of patients or the complexity of their health issues grows. Recently, our clinician workforce has remained stagnant, while the population continues to age and develop more chronic conditions—putting even greater strain on our already limited capacity.

Given the importance of capacity, how do we increase it? Many solutions offer some relief—for instance, AI tools that automate prior authorizations or streamline note-taking might increase capacity by 5 or 10%. That's helpful, and we should embrace these tools wholeheartedly. Every bit counts.

But how do we increase our capacity by 5x or 10x? Let’s add a new variable to the capacity formula: (x).

Where x represents the clinical capacity multiplier.

Announcing our mission

At Counsel, our mission is to multiply the world's clinical capacity. We're not trying to replace doctors or substitute them with less-trained practitioners. In fact, quite the opposite—we want to preserve the same high-quality care from real doctors—we just want to deliver much more of it.

For years, the healthcare system has tried to improve capacity by rearranging clinicians in new ways—a practice known as “care model design.” For example, we have experimented with in-home care and team-based care, all of which have worked to varying degrees (depending on how you interpret the data). However, these ideas can only take us so far.

What we truly need is a way to produce high-quality, physician-led care—to offer it on demand, scale it elastically, and multiply it effortlessly. We need "Iron Man" suits for doctors—tools that amplify their strengths, minimize their limitations, and exponentially increase their capacity. At Counsel, this is exactly what we're building: a software platform combined with a new care paradigm where AI agents and human physicians work together seamlessly to deliver the best asynchronous medical advice.

For many of us, this is the most important work we could be doing. We've all seen how much healthcare matters—as caregivers, doctors, and patients who've experienced both good and bad medical care. While we're focused on building an enduring business that will outlast us all, our greater mission is to create a new model of care for the next hundred years. We envision a future where everyone has access to the world’s best doctors, and healthcare capacity is abundant, not scarce. Our hope is that future generations will experience healthcare that feels limitless.

If this mission resonates with you and you're among the best at what you do, we'd love to meet.