A Navy veteran turned physician wants to close the dangerous gap between doctor visits, and he’s using the same systems thinking that once put satellites in orbit.
Most adults see their primary care physician every three to four months, and that’s if they make the appointment. At four visits a year and roughly fifteen minutes per encounter, a doctor spends about one hour a year with that patient.
A year has 8,760 hours
“So, a lot can happen during the interval,” says Dr. Craig Coleman, a 35-year Navy veteran, family medicine physician and founder of Coleman Health Services. “I’m not seeing that patient.”
For high-risk patients 65 and older, the people most likely to be managing diabetes, heart failure or high blood pressure, that gap can be the difference between a quick adjustment and a trip to the emergency room. Craig has built his company around a simple idea: if doctors can’t see patients more often, someone needs to watch the space in between.
Craig describes each office visit as a dot on a timeline. Right now, those dots sit about three months apart.
“If the dots are three months, you don’t know what happens in between,” he says. “Does it go like a sine wave in between? Does it go down in between?”
The obvious fix would be more frequent appointments. But the doctors aren’t there. Projections point to a shortage of tens of thousands of primary care physicians in the coming years, as new medical graduates gravitate toward higher-paying specialties, and experienced primary care doctors burn out and leave.
Meanwhile, the patients aren’t getting healthier. And every time a patient deteriorates to the point of an emergency visit, Craig says, something is lost that doesn’t come back. For many high-risk older adults, a serious deterioration or hospitalization can result in a loss of functional baseline that can be difficult to fully regain.
From Enlisted Sailor to Satellites to Medicine
Craig’s path to that insight was anything but direct.
He enlisted in the Navy in 1984 and rose to E-6 before earning a commission through the enlisted commissioning program. He served as a Surface Warfare Officer, then earned a master’s degree in aerospace engineering at the Naval Postgraduate School in Monterey. From there, he spent about a decade at the National Reconnaissance Office as a program manager, building satellites.
Then came a hard-to-fill assignment: eight months in Iraq alongside General Stanley McChrystal’s unit, at a time Craig describes as “the wild west over there.”
That deployment opened an unlikely door. Craig wanted to go to medical school, but at nearly 40 he was past the age limit. Before he left, an admiral made him a promise: if he made it back, age wouldn’t stop him.
He made it back. The age requirement was waived; he received a military medical scholarship, and he started medical school at 40. He finished his career as a Navy physician, retiring in 2019 after 35 years of service, by a route he says no one had taken before.
To Craig, the jump from engineering to medicine wasn’t a jump at all.
“It’s the same thing. Problem solving,” he says. “In engineering, we call it the solution set. In medicine, we call it a differential diagnosis. That is all of the possibilities that this thing could be.”
His mother saw it coming early. As a boy, Craig took apart the family’s TV remotes and laid every piece out on the table. Putting them back together came later and cost him a few spankings. But the lesson stuck: nothing is just one thing. Everything is a system made of parts.
That systems lens is what Craig brings to healthcare. When he looks at the problem, he isn’t looking only at a doctor and a patient. He’s looking at the insurers, the hospitals, the pharmaceutical industry, and everyone else in the ecosystem, and asking how to cut the waste out of it all.
“How do we Six Sigma the entire system?” he asks. “Take away the slack. Take away the fat.”
He’s candid that not everyone will welcome that. One of his company’s goals is reducing avoidable emergency room visits, and those visits are revenue for someone.
“Somebody’s benefiting from the inefficiency,” he says. “So, you’re going to step on some toes.”
For patients, that inefficiency costs real money. Craig recalls a friend who recently waited six hours in an ER for a problem that wasn’t an emergency. The likely bill: around $1,000 for care that might have cost $150 in a doctor’s office. People end up there, he notes, because they can’t get in to see their regular doctor.
Craig’s answer is a care model designed to add more dots to the timeline without asking already-stretched physicians for more. His wife, a nurse, is part of the process.
The dashboard tracks changes from a patient’s baseline and categorizes emerging signals so clinicians can apply the appropriate level of attention.
Patients today generate more health data than ever: continuous glucose monitors, wearables, remote patient monitoring devices. The problem, Craig says, is that not enough people can make sense of it.
Craig is equally blunt about why existing tools haven’t closed the gap. Many practices point to their patient portals. But patients still say they can’t reach their doctor.
“We still have people, 80 years old, 75 years old, who still remember when the doctor would come to your house,” he says. “We’re telling these people to go to the portal.” To many of them, the message they hear is that the doctor doesn’t care.
In 2016, while stationed in Bahrain, he and two other family medicine physicians tried an early version of this outreach with about 50 patients whose diabetes or high blood pressure was poorly controlled. Over six months, he reports, the group’s A1C dropped by about two points and systolic blood pressure fell by roughly ten percent.
He is careful to call it what it was: an unofficial study. But he believes it showed something important.
Asked what he would do with unlimited money, Craig doesn’t hesitate: hire more doctors and bring patients in more often. But he falls back on a lesson from the military.
“You go to war with the army you have,” he says. With the army healthcare has today, the job is to get earlier visibility into what’s happening with patients, so the system pays upstream instead of downstream.
“Upstream is cheaper, less stress on the system. And downstream is the opposite.”
And as taxpayers who fund Medicare and Medicaid, and as policyholders paying rising premiums, Craig points out, everyone has a stake in getting it right.
He has been bootstrapping Coleman Health Services, drawing on the runway that came with starting a business after already becoming a doctor. But he says the mission matters more than the credit.
“I’m okay if the solution doesn’t come from me,” he says. “If somebody took this idea and said, We can do this at scale, I would be happy with that. I would love to see it just implemented. Period.”
