First-Principles Thinking in Healthcare Audience Targeting

The SpaceX Lesson

Elon Musk didn't build SpaceX by copying NASA. He used first-principles thinking.

Instead of asking, "How are rockets built today?" he asked, "What is a rocket actually made of?"

When he broke it down, he realized something simple: the materials were cheap. The process was expensive. So he rebuilt the process from scratch.

That is first-principles thinking.

Healthcare Audience Targeting Has the Same Problem

Most vendors copy the same playbook:

• Predictive models
• Propensity scores
• Health inferences

That is reasoning by analogy.

A Different Approach

I took a different approach. I asked one question:

"What is the best way to build an audience for specialty and rare disease?"

That question does not assume models are required. It does not assume inference is necessary. It starts with the hardest use case.

That mindset led to a very different method.

What We Discovered

The most accurate approach also turned out to be the most privacy-safe.

When you strip away assumptions and start from fundamentals, you often find that the constraints you thought were limitations are actually opportunities. Privacy requirements aren't obstacles to accuracy—they can guide you toward better methods.

By not assuming we needed models or inferences, we built something that works without them. And that makes all the difference in today's regulatory environment.