Healthcare & Biotech — What's Going On (April 2026)

The Short Version

You'll often hear healthcare is worth $1.5 trillion or more, but that number is almost meaningless for a solo founder. The part of the market a solo founder with no sales team could actually reach is probably $8–15 billion — not $1.5 trillion. The rest is hospitals paying $85 million to install software like Epic, drug companies running research on their own custom systems, and the government paying for Medicare and Medicaid. None of that is something you can sell into.

The real opportunity is in independent doctors' offices, small clinics, and specialty practices — plus everything around running them (billing, paperwork, scheduling, following the rules). That part of the market is big enough, made up of enough small separate businesses, and underserved enough for one person to build something real — but only if you pick the right specific niche.

How Big Is This, Really?

The entire US healthcare system spends about $5.3 trillion a year (2024, according to the government's CMS agency) — but that's healthcare services like doctor visits and hospital stays, not software.

Healthcare software specifically is a much smaller slice: about $25 billion worldwide in 2024, expected to grow to $75 billion by 2030 (growing about 20% bigger every year). Just in the US, healthcare software is about $13 billion in 2025, headed to about $35 billion by 2035 (growing about 11% a year).

Sources:

• NHE Fact Sheet — CMS (2024 data)
• Healthcare SaaS Market Report — Grand View Research (2024)
• Healthcare SaaS Market — Dimension Market Research via GlobeNewswire (2024)

Who Actually Pays for This, and Can You Sell to Them?

Different parts of healthcare spend money very differently, and only some of them are places a solo founder can actually sell to:

The big picture: according to Grand View Research, doctors' offices and clinics made up 78.64% of all healthcare-software money spent in 2025. Within that group, the part you can actually reach is independent doctors, therapists, physical therapists, dentists, and vets — not hospital systems, which are a completely different kind of business to sell to.

At small, independent practices, the people who actually buy software are: the owner, the doctor, the nurse practitioner, or the office manager. These are people who can just put it on a credit card — you don't need to convince a whole purchasing committee, as long as it costs under about $500 a month.

Where's the Growth Actually Coming From?

The industry-wide "14% a year" growth number you might see combines a lot of very different things: healthcare services, drug companies, biotech research, and software, all lumped together. Healthcare software specifically is actually growing faster than that — more like 18–20% a year. Here's where that growth is really happening:

Most of the growth is NOT something a solo founder can reach:

• Hospitals buying AI tools to help doctors make decisions or speed up billing — sold to big companies
• Drug company research software and gene-science platforms — sold to big companies
• A government rule requiring hospital records to connect to each other (a law called the 21st Century Cures Act) — this money goes to giant companies like Epic and Oracle

Growth a solo founder actually can reach:

1. AI that writes doctors' notes for them — investors poured $800 million into this in 2024 alone. The big, general version of this is already getting crowded (companies like Freed, Abridge, and Nabla dominate it), but specific niches within it — like notes made just for one specialty, or just for therapy sessions — are still open.
2. Software for small doctors' offices — this is the fastest-growing slice of all healthcare software spending, according to MarketsandMarkets. Small practices pay $600 to $6,000 a year for software, and they can't negotiate the price down — they just pay what's listed.
3. Talking to patients and collecting their info digitally — plain administrative software like appointment reminders, digital intake forms, and scheduling made up 53.62% of all healthcare software revenue in 2025. All of this is reachable for a solo founder.
4. Software for specific specialties that got left behind — niche specialties like veterinary medicine, eye doctors, speech therapy, and dietitians are underserved. A lot of them still run old-fashioned desktop software, and no single company has taken over that space yet.

Bottom line: if you subtract out drug-company research and hospital IT spending, the part of healthcare software a solo founder can actually reach is probably growing 12–18% a year — driven by small clinics finally going digital, AI-written notes, and clinics switching from old desktop software to modern cloud tools.

The Real Problems People Have, By Specialty

Mental Health and Therapy

What therapists are angry about:

• SimplePractice, one of the two biggest tools, raised its starter price 69% (from $29 to $49 a month) in March 2025. Therapists were furious, and many started looking for alternatives.
• TherapyNotes, the other big tool, raised its price 17% in December 2025 — two price hikes across the two market leaders in under a year.
• Writing notes after each session is the single biggest time-waster. Therapists report spending over 30 minutes per session writing notes after the client leaves.
• Insurance billing is often broken for small practices — claims get rejected constantly, with no clear reason why.
• SimplePractice doesn't auto-save, so therapists sometimes lose notes they were writing.

What they're stuck doing in spreadsheets: tracking how many sessions a client has left before insurance stops covering them, managing waitlists, and calculating sliding-scale pricing for clients who can't pay full price.

Sources: SimplePractice Price Increase 2025 — SteadyPractice, SimplePractice vs TherapyNotes comparison — Mentalyc

Physical Therapy

What PTs are angry about:

• WebPT, the market leader, has "frequent glitches, system outages," and reviewers say its smart text box sometimes erases everything they typed (per Capterra reviews).
• WebPT starts at $99/month per person — expensive for solo physical therapists who don't have much profit margin.
• It doesn't work offline and needs a strong WiFi connection at all times.
• About 20% of health insurance claims get denied, and practices lose about $50,000 a year from claim mistakes.
• PTs estimate they spend 30–45 minutes a day writing notes beyond the time they actually spend with patients.

What they're stuck doing in spreadsheets: tracking patient progress over time, tracking home exercise plans, tracking where new patients came from, and tracking productivity for billing checks.

Sources: Best AI Scribes for Physical Therapy — Twofold, Physical Therapy Billing Guide — SPRY

Chiropractic

What chiropractors are angry about:

• ChiroTouch locks customers into 12-month contracts and won't let them cancel even in the first week, even if it's clearly not a good fit.
• You can't book multiple family members at once — it's slow and manual.
• The built-in reports can't be customized, and most of them don't match what the practice actually needs.
• Documents take a long time to load.
• Extra features cost more money, even though competitors include them for free.

Pricing: ChiroTouch costs $159 to $650 a month depending on the plan. A competitor called Jane, at $54 a month, is seen as a bargain by comparison.

Sources: ChiroTouch Reviews — G2, ChiroTouch vs Jane — Capterra

Eye Doctors (Optometry)

What they're angry about:

• Eyefinity has "frustrating updates that interrupt workflow," forces constant saving, is slow, and has an outdated mobile app.
• RevolutionEHR's billing tool is described as "very complicated and hard to use."
• Both tools require too many clicks to do simple things — reviewers specifically complain about "inefficient number of clicks, screens, and poor layouts."
• Ordering glasses and lab work through these systems breaks constantly on mid-tier platforms.

Sources: Eyefinity Reviews — EMRSystems, RevolutionEHR Reviews — Capterra

Dental

What dentists are angry about:

• Dentrix "feels like using Windows 95" — the look and feel hasn't meaningfully changed in a decade.
• Even Dentrix's newer cloud version can't show a patient's x-rays while you're charting — a very basic thing to need.
• Eaglesoft is hard to learn, not intuitive, expensive for small practices, and barely works remotely.
• Both major tools have long waits for customer support. Dental practices are known for still running their own physical servers because they don't want to pay for outside tech help.

What they're stuck doing in spreadsheets: checking patients' insurance before appointments, tracking who's due for a cleaning, and tracking referrals to and from specialists.

Sources: Dentrix vs Eaglesoft — SelectHub, Best Dental Software 2025 — DayDream

Veterinary

What vet clinics are angry about:

• IDEXX Cornerstone is "archaic and out of date," freezes constantly, needs a big physical server that crashes, and can't be accessed from home.
• It doesn't even sync well with IDEXX's own lab results, even though it's the same company.
• It costs $420 a month for software that "feels like it's from 2005," plus extra fees for keeping the server running and backed up.
• Customer service takes a long time to respond, and billing mistakes are common.

What they're stuck doing in spreadsheets: tracking when pets are due for vaccines, tracking inventory (especially controlled medications, which the law requires tracking closely), staff schedules, and following up with clients after surgery.

Sources: Cornerstone Vet Software Review — NectarVet, IDEXX Cornerstone Reviews — TrustRadius

Labs (Research and Small Diagnostic Labs)

What lab workers are angry about:

• A 2024 survey found 55% of lab workers avoid using their own lab-management software because it's clunky, and just use spreadsheets instead.
• Benchling is the modern, well-designed option, but it starts around $20,000+ a year (as of 2020 — likely more now), way out of reach for university or small commercial labs.
• QBench costs $275–$425 per person per month, which is still expensive for a 3-person lab.
• Most labs end up using one piece of software to track their data, and a completely separate spreadsheet to track equipment schedules, chemical orders, and sample tracking.

Sources: LIMS Cost Guide — QBench, Benchling vs Labguru vs QBench — QBench Blog

Electronic Health Records, in General

What basically everyone hates (and it's well documented):

• Doctors spend so much time clicking through software that they see fewer patients. One family doctor had to cut from 30 patients a day to 15 because of how much time their software (eClinicalWorks) demanded.
• Constant pop-up warnings train doctors to just click "ignore" automatically, which defeats the whole point of having warnings.
• The software is designed around billing rules, not around what's actually easy for a doctor to use.
• Epic, one of the biggest systems, requires practices to hire full-time staff just to help doctors use it.

Sources: Why Everyone Hates The EMR — Logic Magazine, Death by 1000 Clicks — Fierce Healthcare, Top 10 EHR Disadvantages — Belitsoft

Proof This Can Actually Work

The most encouraging example is Mentalyc: $2.9 million in revenue with just 26 people and only $105,000 in outside funding is about as close to a true bootstrapped healthcare software success as you'll find. That works out to about $111,000 in revenue per employee, with almost no investor money. This is the model to copy.

Freed's story is different: it grew 992% in a year to $13 million, but it had backing from a major investor (Sequoia) fairly early on. Not a bootstrapped story — but proof that AI-written doctor notes is a real, fast-moving market.

Sources: Mentalyc Revenue — GetLatka, Freed $20M ARR — VentureBeat, SimplePractice Revenue — GetLatka, Tebra Revenue & Funding — GetLatka, NexHealth Revenue — GetLatka

What You Could Actually Sell Without Hiring a Sales Team

Who can say "yes" to buying software on their own

Definitely yes (they'll swipe a credit card):

• Solo therapists, counselors, and social workers — they buy monthly on their own card, watch every dollar, and will switch tools to save even $20 a month
• Solo or small-group chiropractors — the owner makes every software decision; budget is $100–$300/month
• Independent eye doctors — about 47,930 in the US, mostly owner-run; budget is $150–$400/month
• Independent vets — the practice owner decides; historically ignored by tech companies, so they'll pay for things that actually work
• Independent physical therapists — 283,667 PTs in the US, about 40% in some kind of private practice, and owners decide for themselves
• Chiropractors — 71,101 in the US, almost all of them owner-run

Probably yes, but slower:

• Dental practices (solo or small group) — the owner decides, but often checks with an office manager first; budget is $300–$600/month
• Medical billing companies — the business owner decides, and they'll pay for anything that saves staff time
• Home health agency owners — more red tape slows down the decision, but new tracking rules (called EVV) are pushing them to buy faster

Basically no, you'll need a sales team:

• Hospital IT departments
• Doctors who are employees, not owners (they don't control what software gets bought)
• University research lab leaders (the university's own purchasing process is slow and usually needs IT approval)
• Drug and biotech companies (security reviews, purchasing committees, trial agreements)

What people will actually pay

Here's something interesting: solo practitioners actually pay about 3 times more per person than big group practices do, because they have no negotiating power and have to cover all their own costs. They're not cheap customers — but they're not stingy either. They'll pay for things that clearly save them time or money.

Sources: EMR Cost by Practice Size — EMRGuides, EHR Pricing Guide — RXNT, Healthcare Software Pricing Models — SoftwareAdvice

Is That "$1.5 Trillion" Number Misleading?

Yes — very misleading. Here's what the US's actual $5.3 trillion in healthcare spending really breaks down to:

That "$1.5 trillion" figure floating around probably lumps together global healthcare and biotech revenue — drug research, medical device sales, hospital income, insurance — none of which turns into software deals a solo founder could actually close.

A more realistic number: there are over 750,000 independent practitioners in the US (therapists, PTs, chiropractors, eye doctors, vets, solo doctors). If you built a tool priced at $50–$200/month and reached them, that's $450 million to $1.8 billion a year in total possible subscription revenue — reachable without ever hiring a salesperson. That's your real market.

Who Else Is Already Building In These Niches

Niche 1: Mental Health and Therapy Practice Management

The opening here: both market leaders raised prices sharply in 2025, and therapists are openly angry and looking to switch. A cheaper, no-contract option with auto-save and reliable video calls is a real opportunity.

Sources: SimplePractice Price Increase — SteadyPractice, SimplePractice Reviews — G2, TherapyNotes vs SimplePractice — Mentalyc

Niche 2: Physical Therapy Practice Management

The opening here: WebPT is expensive and buggy, and Jane isn't specialized for PT billing. A PT-focused tool with clean notes, progress tracking, and reliable insurance billing at $79–$120/month could compete.

Sources: WebPT Revenue — Owler/CBInsights, WebPT vs Jane — Capterra, SPRY PT — SPRY

Niche 3: AI That Writes Doctors' Notes

The opening here: the $29–$99/month tier, where Freed competes, is getting crowded. Writing notes for specific specialties still has some room — for example, physical therapy notes or dental note formats. One important warning: veterinary note-writing is NOT wide open. A company called ScribeNote already offers a free tier plus a paid $79/month plan, and markets to 6,000+ veterinarians, alongside several other vet-focused competitors (HappyDoc, VetRec, and others). The $800 million that investors poured into this space mostly went to tools for human doctors — don't assume the vet version is uncontested.

Sources: Freed ARR — Sacra, Abridge ARR — Sacra, AI Medical Scribe Pricing Guide 2025 — Orbdoc

Niche 4: Dental Practice Management

The opening here: both big players are old desktop software owned by dental-supply companies, not software companies. Cloud-based tools focused on one specific job (talking to patients, reminding them of cleanings, checking insurance) can compete well around the edges.

Sources: Dentrix vs Eaglesoft — SelectHub, Best Dental Software 2025 — DayDream

Niche 5: Talking to Patients, Digital Forms, and Scheduling

The opening here: NexHealth is well-funded and dominates dental, but $350/month is a lot for a solo therapist or PT who just wants safe, compliant intake forms and reminders. A focused, affordable tool for non-dental practices (PT, chiropractic, therapy) at $39–$79/month has real room to grow.

Sources: NexHealth Pricing — G2, NexHealth Revenue — GetLatka, HIPAA Form Builders — HIPAAtizer

Niche 6: Software for Small Labs

The opening here: 55% of lab workers avoid using their own lab software because it's clunky (2024 survey). A genuinely simple tool for small research labs — university labs, small commercial testing labs, small biotech startups — priced at $49–$99 per person a month could work. But you'd need to deeply understand how labs actually work (samples, chain-of-custody records, connecting to lab equipment), and the rules around lab accuracy (called CAP and CLIA) raise the bar to get in.

Sources: LIMS Cost Guide — QBench, Benchling Alternatives — QBench, LIMS Lab Management — Third Wave Analytics

Niche 7: Medical Billing for Small Practices

The opening here: Tebra started out as the affordable option (under the name Kareo) but has been raising prices and chasing bigger customers (it raised another $250 million in December 2025 to build enterprise AI tools). That's leaving a gap at the true solo-practice end of medical billing.

Sources: Tebra Revenue/Funding — BusinessWire, Kareo Pricing — SoftwareFinder, TheraNest Pricing — TheMedicalPractice

The Health-Privacy Rules (HIPAA), in Plain English

HIPAA is the US law that protects patient health information. You have to follow it if your software creates, stores, sends, or receives any information tied to a patient — names, appointment times, diagnoses, clinical notes, or billing info. That includes:

• Intake forms that ask about someone's health history
• Scheduling tools that show what kind of appointment someone booked
• Notes or documentation tools
• Billing and insurance-claim software
• Any messaging that mentions a specific patient

You do NOT need to follow HIPAA for:

• Simple wellness apps (step counters, general nutrition tips) that don't collect anyone's specific health records
• Health content or education websites with no personal health records
• Tools for practitioners that never touch a specific patient's data (like a tool that helps a PT design a generic workout plan, not tied to one person)
• Consumer health apps where the only person seeing the data is the person it belongs to

What it actually costs a solo founder to follow HIPAA (2025 estimates):

• Using Amazon Web Services' health-privacy-approved tools, plus signing their standard agreement: free, included in normal AWS pricing
• Extra compliance software (like Aptible or Datica): $12,000–$20,000 a year for a startup-level plan
• A lawyer to draft the agreement you need customers to sign: $2,000–$8,000, one time
• A security test (often required by bigger customers, not always by small ones): $8,000–$20,000
• Realistic minimum for a scrappy solo founder: $3,000–$8,000 in the first year, if you use Amazon or Google's already-approved tools directly and write your own agreement from a template. You don't need to pay for Aptible — it just means more manual paperwork on your end.

Here's the upside: once a practice signs your agreement and builds your tool into how they work every day, it's a hassle for them to switch away. Following HIPAA is annoying to set up, but once you've done it, it actually protects you from casual competitors who don't want to bother.

Sources: HIPAA for SaaS Startups — Security Compliance Guide, HIPAA Compliance for SaaS — HIPAA Journal, AWS HIPAA Compliance, HIPAA Compliant Form Builders — HIPAAtizer

What You Could Actually Build

BEST BET — Write specialty-specific doctors' notes (pick your specialty carefully)

• The general note-writing market (Freed, Abridge, Nuance) is heating up fast with investor money
• Writing notes for one specific specialty can still work where the big tools are weak — physical therapy progress notes, specific therapy note formats, or chiropractic adjustment records. Don't try veterinary notes — ScribeNote and others already serve thousands of vets there, with a free tier and a $79/month paid plan
• Mentalyc is the model to follow: $2.9 million in revenue with almost no outside funding, by going deep on one specialty (therapy notes)
• A note-writing tool for a non-vet specialty, or a PT-specific progress tracker with AI-drafted notes, may still face less competition than a general medical note-writer — but check this carefully before building
• Price point: $49–$99/month, aimed at people who can decide to buy it themselves
• You'll need to follow HIPAA for human-patient notes; veterinary practices generally don't need to

BEST BET — Digital intake forms and patient messaging for non-dental clinics

• NexHealth owns the dental market ($350/month, $177 million raised) but doesn't serve physical therapy, chiropractic, eye doctors, or therapy practices well
• These practitioners need: digital intake forms, appointment reminders, and follow-up messages
• The current options are either too expensive (NexHealth), too generic (JotForm at $99/month with health-privacy compliance as an expensive add-on), or too basic
• Price point: $39–$79/month — about 5 times cheaper than NexHealth
• No need to build a full records system — this can be a standalone tool that connects to Jane, WebPT, or SimplePractice
• You'll need to follow HIPAA

BEST BET — Software for veterinary clinics

• Vet software is dominated by old, on-site desktop programs (IDEXX Cornerstone: "archaic," $420/month, crashes, no remote access)
• About 35,000 independent vet clinics exist in the US, almost all owner-run, and they decide their own software purchases
• Specific unsolved problems: tracking controlled medications the way the law requires (most clinics still do this on spreadsheets), reminding pet owners about vaccines, and giving clients online access to records and refill requests
• No well-funded, modern, cloud-based challenger has broken through yet
• Price point: $99–$199/month — clinics are already paying $420/month for a worse product
• HIPAA does not apply to vet clinics (pets aren't covered under that law), though some states have their own, much lighter privacy rules for vets

PROBABLY NOT WORTH IT — Building a full doctor's-office records system

• Building a complete records and practice-management system from scratch takes 3–5 years, requires connecting to national health-data standards, government certification, and a real sales team. Not something one person can pull off.

PROBABLY NOT WORTH IT — Hospital IT tools

• Long purchasing cycles, security reviews, compliance requirements, and sales processes that take 12–18 months. Not a solo project.

PROBABLY NOT WORTH IT — Drug company or biotech enterprise software

• Same problems as hospital IT: you'd need an actual sales team and a long sales process.

PROBABLY NOT WORTH IT — Competing head-on with Freed on general AI notes at $99/month

• Too crowded, too much investor money already in the space. Freed has $34 million in funding and 26,000 users — you'd be walking into the middle of the market with no advantage.

The State of Each Market Right Now

• Overcrowded with investor money: AI note-writing for general medicine. Don't compete here head-on.
• Growing and reachable: specialty tools for physical therapy/chiropractic/etc., patient communication for non-dental practices, and veterinary software.
• Established, but people are actively switching: mental health practice management — SimplePractice and TherapyNotes both just raised prices, and practitioners are actively looking for something else right now.

How Many Potential Customers Are Out There (US, 2024)

Source: National Center for Health Workforce Analysis — HRSA November 2024, BLS Healthcare Practitioners 2023

How Fresh Is This Data?

• Market size numbers (healthcare software, specific specialties): from 2024–2025 reports. Reasonably current.
• Competitor revenue numbers (from GetLatka, Sacra): from 2023–2025. Roughly accurate, but these companies self-report their own numbers, so treat them as directionally correct rather than exact.
• Complaints from Reddit and practitioners: gathered from 2024–2025 discussions. These kinds of complaints are usually structural and unlikely to change much in 6 months.
• Practitioner counts: from a November 2024 government report — the most current available.
• Health-privacy compliance cost estimates: from 2025. Roughly accurate, but your actual cost depends heavily on how much of the work you do yourself.

The AI note-writing numbers (for Freed and Abridge) are from early-to-mid 2025, and that market moves fast — assume those numbers have already changed.