Iman Abouzeid

From 2 founders and an idea to a $50M Series A

Iman Abouzeid describes raising Incredible Health's initial $2M seed (75-100 meetings, just two co-founders and an idea) and, two years later, a $50M Series A.

“2 years ago, when it was just Rome and I, we were raising our seed round, just raising the initial $2 million. And at that time, honestly, it was just 2 co-founders and an idea. Probably had to go through through 75 to 100 meetings. And where are we now? We just raised a $50 million Series A.”

Healthcare is the largest labor sector in the US — and the most short-staffed

Iman Abouzeid notes that healthcare employs the most workers of any sector in America yet suffers the worst shortages, because demand keeps rising while the workforce can't keep up. Incredible Health cuts permanent nurse hiring from 90+ days to under 30.

“The reason that matters is the healthcare industry employs the most number of workers in America today. It is the largest labor sector in the country, but it also suffers from the biggest shortages. Our demand for healthcare as a country keeps going up, but we don't have enough workers in the system, and so it's becoming harder and harder to hire.”

What an MBA actually buys: brand, network, knowledge

Iman Abouzeid argues the MBA isn't the only path, but it delivers three concrete things: a brand/stamp that opens doors with VCs and hospitals, a network that got her into Silicon Valley, and useful baseline knowledge (negotiation, finance, ops).

“So first, it's the brand and the stamp, all right? So when you are going into a venture capital firm or a hospital, or you're trying to convince someone to join your team, having that stamp and that brand helps. I mean, at the end of the day, look, we're still in a world where brands and stamps matter. Where you went to school, where you worked, still makes a difference. The second thing I got out of it was a network”

Steal thisEvaluate any credential by what it actually buys you: brand/stamp, network access, or transferable skills — not the title alone.

2,000 paths to the starting line, one path to success

Shaan reframes Iman's '2,000 paths' point: there are countless ways to reach the starting line of entrepreneurship, but only one way to actually succeed — start something, get a customer, make the operations work, then make money.

“The way I would say it is 2,000 different paths to the starting line. To get success is really only one way to do it in entrepreneurship, which is to start something and start trying to get a customer and then start, once you get a bunch of customers to get your operations to work. And then once you get that going, make some money.”

Steal thisStop optimizing the prep work — get to the starting line and start chasing your first customer.

'There has to be a better way' is the nugget of a business idea

Iman found Incredible Health by noticing that her doctor relatives complained of understaffing while Rome's nurse relatives took 2-3 months to land a job. The mismatch in a high-demand group's terrible job search experience signaled the opportunity.

“And so we looked into it, started doing the market research, started doing the customer research, and we realized what a big problem this is, how inefficient the entire process is. How is it that a group in such high demand has such a terrible job search experience? Why it takes them 2, 3 months to get their next job? And like, we're like, this doesn't make any sense. And then that's when we're like, okay, there has to be a better way.”

Steal thisWhen you catch yourself thinking 'there has to be a better way,' treat it as the seed of a business and dig into the root cause.

Recruiting agencies charge $20K-$30K+ per nurse hire

Iman explains why hospital hiring is broken: tools haven't changed since the '80s, job boards flood recruiters with unscreened applicants (each filling ~100 jobs at once), and traditional agencies charge $20,000-$30,000 or more per hire.

“And then the traditional recruiting agencies, they're also using humans to source and to screen. And as a result, you know, they're very expensive. They're charging $20,000, $30,000 or more per hire. And so that's not cost-effective for a hospital.”

Hospitals run on 3% margins with 50% of costs going to labor

Iman breaks down hospital economics: the average hospital runs on a 3% margin (1% if poorly run, 5% if excellent), and about 50% of operating cost goes to labor — making it more brutal than a restaurant.

“And hospitals specifically usually run on very thin margins. 3% is the average. Wow. Relatively poorly run hospitals, 1% or less. A very well-run hospital might be 5% margins. They're— 50% of their operating cost goes to labor.”

The idea checklist: hair-on-fire, huge market, 10x better

Iman's criteria before committing a decade to an idea: it must solve a hair-on-fire problem, be a huge market (so 1-2% share is enough), and your unique insight must be at least 10x better — not an incremental improvement.

“It should be ideally a huge market because if you just capture 1% of it, 2% of it, then you're fine. Right. The third piece is whatever you come up with, your unique insight needs to be at least 10 times better than what's already out there. Okay, like it needs to be faster, better, cheaper, whatever, whatever it is, but at least 10 times better. It can't just be some small incremental improvement.”

Steal thisVet every idea against four filters: hair-on-fire problem, huge market, 10x-better insight, and founder-market fit.

Pick the axis you're 10x better on: cost, efficiency, or NPS

To avoid 'everyone loves their baby' bias, Iman defines 10x-better concretely: you must be 10x cheaper, 10x more efficient, or 10x better on NPS/customer experience — and it can come from a different business model, not just better tech.

“Yeah, it's either 10 times cheaper, 10 times more efficient, 10 times better NPS score or customer experience.”

Steal thisName the single axis — cost, efficiency, or experience — where you're measurably 10x better, instead of vaguely 'better.'

The competitor sweet spot: 10 to 30, not 0 and not 500

Iman adds a fourth idea filter on competitors: 500 competitors is too crowded, zero may mean the market doesn't exist, so the ideal is roughly 10-30 — a mix of incumbents, publicly traded players, and a few startups.

“So ideally you don't want 500 competitors. Okay. You also don't want zero because maybe the market doesn't exist. —right. You know, the ideal is, I don't know, 10 to 30. I'm kind— this is a little bit arbitrary— combination of publicly traded companies or like incumbents, maybe a few startups, but that's it.”

Steal thisTreat a handful of existing competitors as validation; worry when there are either none or hundreds.

Pivoting was the highest-stress point — but Slack, Twitter, Instagram all pivoted

Iman calls the pivot to Incredible Health the highest-stress moment of her entrepreneurial journey, but argues pivoting should be acceptable since Slack, Twitter, Twitch, and Instagram were all pivots — you just have to be bold and take the leap.

“This was the highest stress point I've had in my entire entrepreneurial journey. Wow. Pivoting is hard, but the thing is, it should be, should be acceptable. A lot of massive companies today were pivots. Slack, Twitter, Twitch, Twitch, many, many, right? And so Instagram, Instagram, you just have to be bold. Like many things in entrepreneurship, you just have to be brave.”

Language matters — from your company name to the copy in your app

Iman relays the NFX view (via James Currier) that language is load-bearing: the company name, the tiny copy in your app, your outbound emails — it's often the first interaction a customer has with you. They chose 'Incredible Health' because it's unique and sounds big.

“Where language matters. Everything from the name of your company down to like the tiny copy in your app, to your emails that you're sending out, language matters. It is often the first time users or customers, clients interact with you.”

Steal thisSweat the language everywhere — name, microcopy, emails — because it's usually the customer's first touchpoint.

Work backwards from market domination to set your growth rate

Asked why they target 20% month-over-month hire growth, Iman says it's reverse-engineered: that's the growth rate required to take over the entire market in under ~8 years. The right metric (hires) keeps the whole team focused on one lever.

“If we want to take over the entire market in less than, say, 8 years, like, that's the growth rate required.”

Steal thisDefine your end-state goal, then back out the monthly growth rate it mathematically requires.

Cash, skills, or lifestyle — you only optimize one at a time

Iman shares a career framework: in any role you can optimize for only one of cash, skills/learning, or lifestyle, compromising the other two. Want cash → banking/consulting; want skills → startups; want lifestyle → big corporations like Google. Decide which one you're choosing and own the trade-off.

“I think there's only 3 things that you can aim for. Number 1 is cash, number 2 skills and learning, and number 3 is lifestyle. And at any given time in a particular role, you can only optimize for one of those 3 things. You're going to compromise on the other 2. So if you're trying to optimize for cash, especially risk-adjusted, then yeah, go to investment banking, go to management consulting.”

Steal thisBefore taking a role, name which of cash, skills, or lifestyle you're optimizing for — and accept you're sacrificing the other two.

Learn, earn, lifestyle, legacy — switch gears by life stage

Shaan offers his variant of Iman's framework — learn, earn, lifestyle, or legacy. In his 20s he deliberately optimized to learn (treating money-losing startups as 'business school'), then shifted to earning to bank cash that funds the next learning sprint.

“I have a similar framework. You're either trying to learn, earn, lifestyle, or legacy. The last one is legacy, which is— that's around impact, which I think you're also kind of doing right now.”

Steal thisPick one mode per life stage — learn, earn, lifestyle, or legacy — and consciously switch gears as your situation changes.

Build for the healthcare back-office, not patient-facing apps

Iman's pick for an underbuilt opportunity: too many founders chase patient-facing healthcare apps, while the operational back-end stack — compliance, revenue cycle, labor staffing — has far too little innovation.

“I think there's a lot of founders that are working on things that are patient-facing. I don't think there's enough founders working on things that are more around the operations of it. Like there's a whole backend stack to the healthcare industry where there's just not enough innovation. We're tackling one, happens to be labor staffing, right? But there's compliance and revenue cycle and, you know, lots of different areas in the operational stack.”

Steal thisSkip the crowded patient-facing healthcare space and build for the unglamorous back-office: compliance, revenue cycle, staffing.