At the Google-backed tech company, physicians and engineers work side by side to improve workflow in oncology clinics—and help fix America’s broken health care system.

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Software Engineering Manager Kevin Hobson had only recently started his new job at the New York medical software company Flatiron Health when, in January 2016, his bosses flew him down to Florida. The trip wasn’t a mere perk: Hobson’s mission was to spend a day shadowing several medical professionals in an oncology clinic, Florida Cancer Specialists & Research Institute, in West Palm Beach. One of those professionals was Dr. Bobby Green, Flatiron’s SVP and a practicing oncologist at the Florida clinic.

About halfway through the day, Hobson recalls, he was shadowing Green. “Bobby was trying to tell me a story about the patient we were about to go see,” Hobson recalls. The doctor was sharing a detail that wasn’t critical to the patient’s well-being, but that he nevertheless wanted Hobson to know. But after a few moments of rummaging around files on his laptop, Green couldn’t find the information and decided to move on. “Eventually he just said, ‘Ah, whatever, it’s fine,’” Hobson says.

But it wasn’t fine to Hobson. “Basically, I thought to myself, ‘That’s crazy!’ He should have been able to type whatever he was thinking and get the right thing.”

A doctor thinks one way; a software engineer, another.

The idea that there are two core ways of thinking, both of which deserve equal status, is the central philosophy at Flatiron Health, which makes software to improve the workflow in cancer clinics and aggregates anonymized data from that software to share with pharmaceutical companies and research institutes. The interaction between engineers and physicians is not a unique notion for medical startups, but few adhere to it as the law of the land like Flatiron does.

It’s an entirely different style of working for the engineering talent, who often hail from top consumer-facing tech companies. For Keith Cowing, Flatiron’s director of product management, the environment requires a bit of humility. Cowing formerly worked at LinkedIn and Twitter, where top coders enjoy godlike status. So when he came to Flatiron, he had to get used to working on teams with people who brought impressive expertise in an entirely different field. “A product manager is used to being the quarterback, the decision maker,” Cowing says. “And on clinical teams, a doctor is used to being the quarterback, too. So you’ve gotta bring both of these sides together and check your ego at the door.”

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