Much of the pain of digital health (and sidecar point solutions for enterprises in general) that is often blamed on EHRs is actually a manifestation of the principal agent problem - where one party (the agent) makes decisions on behalf of another party (the principal), but has different interests and incentives. The expectation is that if you build a good product that is attuned to a user and solves their problem, you will be successful. This is largely true in consumer facing software (if you can handle CAC) - the buyer and the user are the same. When it comes to super small businesses, the buying motion of SMBs can resemble a DTC sale, as the buyer and the user may be the same. If they're not, they're usually close enough to have the same or similar interests. This is not the case for larger and larger enterprises. For example, the CEO wants efficient operations and profitability. The doctor wants more time spent with patients and medical decision autonomy. Your choice to sell to large healthcare organizations (or really any enterprise in general) incurs a silent cost. You now are building for two distinct sets of stakeholders with fundamentally different and often opposing needs - the economic buyer who makes the purchase decision and controls the budget, and the end user who has to actually use your product day-to-day. This tension forces you to either compromise your product's user experience to satisfy buyer requirements, or risk failing to gain institutional adoption despite having happy users. Every GTM motion has pros and cons. This is just the reality of the enterprise motion.