David
Craig, MD

Most emergency physicians spend their downtime away from medicine. David Craig spends his building software to fix it. At any given point in the week, he might be interpreting FCC telecom regulations, pushing code for an internal analytics tool, negotiating a compliance framework with a healthcare system, or running a resuscitation in a San Francisco ER. This is not multitasking. This is what happens when someone genuinely cannot separate the two things they love.

Craig grew up coding - websites, scripts, tools - before he knew he wanted to become a doctor. The pivot toward medicine came in college, a realization that the problems he wanted to solve lived inside people, not inside machines. But he never set the keyboard down. By the time he finished his emergency medicine residency at Stanford-Kaiser in 2014, he was already talking to Ray Bradford, the founder of a small San Francisco startup called Spruce Health, about building communication infrastructure for a broken system.

The problem Spruce was founded to fix is embarrassingly obvious once you see it. Doctors' offices in the 21st century were still running on infrastructure from the last one: fax machines, paging systems, separate phone trees, unencrypted SMS, paper forms. Patients expected to text their doctors the way they texted anyone else. The technology to do that securely existed. Nobody had put it together for healthcare in a way that passed HIPAA muster and actually worked in practice. Craig joined as Chief Medical Officer and Director of Compliance and started filling in the gaps - not just as a clinician but as someone who could read a telecom regulation and write a database query to test it.

His role at Spruce was described early on as "unusual for a medical director." He handled legal research on novel regulatory questions, wrote analytical tools, built internal technical systems, managed physician networks, and guided the product through compliance certifications that most healthcare startups avoid because they're hard. HITRUST certification. SOC2 Type II audit. These aren't marketing badges - they're the infrastructure requirements that let Spruce into the rooms where large health systems make purchasing decisions.

By December 2021, Craig was CEO. The transition was less a promotion than a recognition of what was already true: he had been running the operational center of the company for years, and the product direction had converged on his specific area of expertise - the intersection of clinical workflow, communication technology, and regulatory compliance. The founder, Ray Bradford, stepped aside, and Spruce entered a new chapter with Craig at the helm.

Under Craig, Spruce expanded from a promising messaging tool into a full communication platform for care teams and patients. Today the platform handles HIPAA-compliant texting, phone calls with voicemail, group messaging, internal clinical notes, secure file sharing, digital payments, e-fax, automated call handling, video visits, clinical questionnaires, and care coordination tools - essentially every channel through which a modern practice communicates, unified under one roof. The platform reached 25,000+ healthcare providers and 5 million+ patient accounts. A partnership with Mass General Brigham and Avo brought clinical AI research into the picture. G2 named Spruce a leader in telemedicine, HIPAA-compliant messaging, and patient engagement - four separate recognition categories in the Winter 2024 awards alone.

The detail that stops people is this: Craig still works weekly shifts in the emergency room. Not occasionally, for optics. Weekly. He describes it as grounding - a way of staying connected to the actual problems clinicians face rather than the abstracted versions that make it into product roadmaps. When you are personally responsible for triaging patients, ordering labs, and communicating across a care team under time pressure, you notice exactly where the communication tools break down.

This is not a common founder behavior. Most startup CEOs talk about "staying close to the customer" and mean a quarterly user interview. Craig means showing up for a shift, using the tools, and bringing what he finds back to work on Monday morning. The phrase "dogfooding your product" takes on a different weight when your product is used in life-or-death situations and you are physically present in those situations.

His trajectory at Stanford is itself worth noting. He did not come for one degree. He came for three - a B.S. and M.S. in biology before the M.D. from Stanford School of Medicine. The MD path, combined with the pre-existing technical background, gave him a kind of interpretive fluency that's rare in both communities. He can read clinical literature and regulatory filings. He can discuss EHR interoperability specs and then turn around and explain payment model incentives to a room of investors. Most people who can do one of these things cannot do the other.

Spruce Health is not a consumer health app. It does not track your steps or remind you to drink water. It is closer to what Twilio is for the internet - a communication layer that sits beneath the care experience, invisible to patients and essential to providers. The integrations with Athenahealth, the public API, the HITRUST certification - these are not features for casual users. They're signals about where Craig is positioning Spruce: as infrastructure, not an interface.

The investors who backed this vision - Cowboy Ventures, Baseline Ventures, Google Ventures (GV), and Kleiner Perkins - represent some of the most credentialed bets in Silicon Valley. Cowboy, Aileen Lee's firm, was early on Twitter and Lyft. GV backed Google's internal healthcare bets. Kleiner Perkins ran healthcare as a specific thesis for a decade. That combination of firms does not write a check into a messaging app. They write it into something they believe could become the default layer for clinical communication across the industry.

Craig's framing of the problem centers on what he calls the "quadruple aim" of healthcare: patient experience, health outcomes, reduced costs, and clinician wellbeing. Each of those four dimensions, he argues, is damaged by broken communication. Patients who can't reach their doctors miss follow-ups. Clinicians drowning in phone tag experience burnout. Costs rise when simple questions require expensive visits. Outcomes suffer when care coordination happens over voicemail and fax. Fix communication, and you nudge all four levers simultaneously.

This is not a new argument. What's different is that Spruce has now built the product that demonstrates it at scale - 25,000 providers, millions of patients, measurable improvements in how care teams collaborate. Craig is methodical about avoiding hype. The company's growth has been steady rather than viral. The product improvements are incremental and compliance-first rather than flashy. That is a deliberate choice from a CEO who knows that the category he's building in requires trust above all else.

The personal dimension of Craig's work - the reason someone with three Stanford degrees and a clinical career keeps working ER shifts - comes back to access. He has said consistently that healthcare should be available to everyone and uncompromising in its quality. Those two things are in tension in the current American system, and he is not naive about that. But communication is a lever that sits upstream of policy, upstream of insurance, upstream of political will. If a patient cannot reach their doctor, no amount of structural reform fixes that interaction. Spruce, at its core, is a bet that better tools create better access, one practice at a time.

There's an anecdote from his Spruce profile that says something about him: when asked which cartoon character he'd want as a colleague, he chose Sebastian the crab from The Little Mermaid - specifically for the chance to be part of "Under the Sea." It is the answer of someone who works very hard and wants, occasionally, to be somewhere warm and musical. That seems right.