Healthcare is at the end of its MS-DOS era
In 2003, when the New York Times asked Steve Jobs why the iPod became an overnight success, he didn’t talk about its storage capacity, hardware specs, or marketing campaign. He said, simply: “Design.”
“People think it’s this veneer,” he added. “That the designers are handed this box and told, ‘Make it look good!’ That’s not what we think design is. It’s not just what it looks like and feels like. Design is how it works.”
He was talking about music players. But he could’ve been talking about healthcare.
Because today, in 2025, American healthcare is still stuck in its MS-DOS era. The systems might be powerful, but the interface is broken.
You feel it the moment you try to understand your lab results. Instead of something you can scan and absorb, you get a dense, clinical PDF full of acronyms and numbers, usually without any explanation of what they mean or what to do next). No context. No clarity. It’s like receiving an email in binary code and needing a doctor to translate.
Most people don’t go back to their doctor for clarity. According to a new national survey from my firm Cactus, 71% of patients turn to WebMD after a diagnosis. Nearly half now use AI tools like ChatGPT to make sense of their care. One in four say those tools help them understand their health better than their own doctor does.
That’s not just a curiosity. It’s a crisis. A comprehension crisis. One that affects everyone: Patients, providers, and the health systems trying to keep up.
TRUST ISN’T THE ISSUE. COMPREHENSION IS.
Here’s the paradox: 78% of Americans say they trust their doctor. But more than 1 in 4 walk out of appointments more confused than when they walked in.
Why? Because the system still communicates like it’s running on a command line system where users literally need to learn a new language to ask their questions. Your health and care answers are there, but it’s buried in jargon, fragmented across systems, and delivered in ways that overwhelm or alienate.
Patients aren’t given context, only data. No wonder they forget what was said. No wonder they turn to Google. We’ve built a $4.5 trillion industry on clinical excellence but wrapped it in a user experience from the 1980s.
This isn’t just a communication problem. It’s an interface problem. And it’s costing us dearly.
THE COST OF CONFUSION
Poor communication doesn’t just frustrate patients. It drives worse outcomes, higher costs, and missed opportunities for connection and care.
According to Cactus’ survey, 20% of Americans believe miscommunication with a doctor has led to worse health outcomes. That number isn’t theoretical. It shows up in delayed diagnoses, unnecessary ER visits, and care plans that never get follow-through.
Even more concerning, 30% of Americans are currently sitting on a specific, known health concern that they haven’t brought up with a medical professional. The reasons: They don’t know how to start, fear it’s not serious enough, or feel they won’t be understood.
The cost of silence is high.
Yet, many providers are missing the signal patients are sending. Those patients don’t just want better communication; they’re willing to pay for it.
Nearly half of Americans say they’d pay out-of-pocket for more personalized, ongoing care. That’s not just dissatisfaction. It’s demand. It’s a market signal for a better-designed experience—one that prioritizes clarity, empathy, and usability alongside clinical excellence.
TIME TO UPGRADE THE INTERFACE
When I was 11, my family brought home our first Apple computer, the Apple II. It was a revelation. Not because the machine was so advanced, but because for the first time, I could use it without a teacher guiding me. I designed a birthday banner. I clicked instead of typed. The same underlying machine had become exponentially more useful, simply because it was designed with the user in mind.
Now imagine if your next doctor’s visit was designed that way.
Instead of cryptic PDFs, your lab results live on an interactive health dashboard. Biomarkers are plotted on a bell curve that shows what’s optimal and where you stand. Explanations are written in plain language. Click a number and you get verified insights from your care team. Time spent with clinicians is engrossing and educational. Time spent with digital tools is satisfying and motivating.
That’s not a future fantasy. It’s possible right now. But only if we bring design to the table earlier and stop treating it as cosmetic.
DESIGN ISN’T DECORATION. IT’S INFRASTRUCTURE.
In healthcare, communication isn’t a soft skill. It’s a system function. When patients don’t understand, outcomes suffer. When doctors can’t easily share information or collaborate across teams, outcomes suffer. That isn’t a design detail. It’s a product flaw.
In most industries, design is how people get from input to impact. It’s how they navigate complexity, make decisions, and take action. From airports to financial apps, good design anticipates human needs. It removes friction. It builds trust.
Healthcare deserves the same standard.
Instead of treating design as something to layer on at the end, we need to treat comprehension as infrastructure. We need systems that explain, not just record. Tools that coordinate, not just collect. Interfaces that feel intuitive and human, even in high-stakes, high-stress moments.
What patients are asking for isn’t unreasonable. They want care that feels clear. Tools that help them follow through and communication that builds confidence.
Design can deliver that. But only if we prioritize understanding as a core part of the system, not an afterthought.
Noah Waxman is CEO and cofounder at Cactus.
