YouSaid · the spoken record

Shiv Rao

lines on the record: 79
first: 2026-05-16
most recent: 2026-05-16
sittings or episodes: 1
sources: podcast

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“No, you don't. Not in our case. You're going to get to that zero to one. You're going to get to that first product in all the ways, like people in the health systems, in the clinics, and listening to the doctors and the nurses and figuring it out. But that's not for deployed motion. That's just like figuring out how to build a product that fits. But if your first product is something that is everywhere, you know, if you've attacked a workflow that can scale, then you're sort of set. It's a classic motion of we picked a first product that we knew was everywhere in healthcare. Every single doctor practically speaking has to speak to a patient. Great, that's our signal. We're going to attach ourselves to that spoken signal and create value. Great. What's our first bit of value? It's a note. Got it. Do they hate notes? Yep, they hate notes. We can automate them. Great. We created notes. Now let's go scale notes. Then it was like, what's next? They hate placing those orders. They have to hit all kinds of drop-down menus and like figure out what the right order is.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“It's not easy. It's not easy to go into one of these enterprises and figure stuff out, to get access to the data, to clean the data, to organize the data, to be able to integrate into specific workflows, to do it in a compliant way, to check off all the boxes. It's not sock too. It's high trust. It's like all the cyber stuff. It's being able to know that behavioral health information from a psychological encounter, for example, that data should be treated very differently than data that's coming from an internal medicine primary care physician's encounter, there's just so much to it, and it takes a lot of effort to build a machine that's scalable.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, it is. When you saw the announcements from OpenAI and Anthropic about forward deployed engineers and these partnerships with big private equity groups to go help their portfolios, if that wasn't a sign that there is absolutely an incredible opportunity for the foreseeable future for vertical AI, I don't know what is.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“I think when it gets in the way of our ability to create more impact, to raise more money, to impact more users, I don't think it necessarily has to do with anything around IPOing. One of our investors is Henry Kravis. And I remember sitting down with him in the first meeting. And one of his questions was, do you want to go public? And I remember starting to like clumsily navigate an answer on the fly. And he interrupted me and said, no, you don't. Like, you don't need to. Why are you even thinking about it? Like the right answer was, no, I don't need to. I have a mission. And to serve that mission, I will do what it takes. And if I can do it in the private markets, I'll raise money there if I need to go public to do that. Then I will go public.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“I don't care now, but I also know that my future self might care more now. That attitude is like again, I think like just putting the user first in our specific space given our product and where it sits in workflow has allowed us to sort of build at a layer of the stack that gives us agency on the P&L that we wouldn't have otherwise. And that's awesome, but that's not what we're optimizing for right now, obviously.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“It's dynamic. I think inside the company, we just always remind ourselves that the only thing that matters is the end user. We just have to have the best product and whatever it's going to take. There cannot be any pride of ownership here. It's just about what gives us the best user experience. Now that has ended up serving us really, really well because especially of the last weeks, there's been a lot of angst about perhaps cost going up in the coming weeks and months and what's that going to do.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Diagnosis that ends up informing billing in their own reimbursement. These are high stakes workflows. You need to be fast. And so that's where things started. But then quality is a part of it too.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, number one, it starts with the end user. Milliseconds matter when you're in workflow. These are doctors who are, they have no patience for new technology. Our refrain inside the company is reduce, reduce, reduce from a product and user experience standpoint. It's like we want to be good air conditioning where when it's set right, we're in the background. You're just focusing on everything that's more important. And to get to that, though, you really need to think about being in workflow. The thinking machine stuff that just came out is really fascinating. It's like it's an agent that's in the moment with you, right? But that kind of experience, you need insane performance and latency. And that's something that we weren't able to achieve in an easy, elegant way with Frontier model. So for certain use cases, there was really no choice. It started with the end user. We're like, okay, to deliver this kind of value, this specific type of value in workflow so that before the patient leaves the room, the doctor is okaying an order or putting in the right visit.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Challenge inside this new product that we're delivering for nurses. But then there are certain challenges in your product suite that you're never going to be perfect on. But every week, every month, you want to be able to look back and say you're less than perfect than you were before. And it's going to matter. It needs to matter to the market. If the market cares about you always improving on something that you don't think you'll ever be perfect on and healthcare is a lot of use cases like this, it makes more sense to ride the frontier wave.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“It's a great question. So, I think this is where we're all kind of nobody knows the answer, but you just have to be principled in how you approach this. So there's any number of different problems we solve as a company with our product. Some of those problems, you can kind of imagine ringing the bell relatively easily. Like, okay, if we just help the nurse with this piece of data getting into this discrete field at this time in their workflow, we won the game. It doesn't need to be, there's no like bells and whistles around this. It's like once you do it, you've done it. It's kind of binary. And those sorts of tasks, being able to just crush it with an in-house model, makes total sense for a lot of different reasons. But most importantly for the user, chances are it's going to be faster. You can kind of optimize that model over time from not just a latency perspective, but also from a cost standpoint. Once you've done it too, you can kind of set and forget to some extent, like, okay, let's move on.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“So about 40% of our model outputs inside our product are generated by in-house models. And that varies from month to month. Next month it might be 60% because we've distilled a new open source model and fine-tuned it and gotten some feedback and we are convicted and we've just replaced a frontier model with this new in-house model.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“It's being able to learn from all the users' edits on a daily basis. It's being able to be useful for all the different types of doctors and all the different settings they deliver care and all the different spoken languages they might use with their patients. And so people, I think, in 2023 thought that was like last mile. That's actually most of it. Is that part the model piece is much less. But even on the model side, I think the vertical AI companies that have the most leverage, that have the most upside are the ones that can reach farther down into the stack and own their destiny in a different differentiated way that can kind of control their P&L.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“So, like healthcare, we say this is a vertical AI company, but you think about it healthcare 5.3 trillion dollar market. It's about 18, 19% of US GDP. I don't know if it's vertical AI company. Like we are an AI company in my head, serving one of the biggest opportunities that is out there. In this market, you can go millions of miles deep, especially on the enterprise side of the spectrum of healthcare. You can go millions of miles deep in a regulated industry with proprietary data sets that you can build into very, very specific workflows in a way that's really, really hard to replicate. But being fast, getting scale very, very quickly is crucial because the scale enables you to not just build more products and just get more surface area, but we do a lot of mid-training and post-training in the company on the post training side.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“You are fighting against them, you've already lost. If you haven't figured out how you're going to win with them, how you're going to not just coexist, but actually find ways to collaborate potentially, and if the tailwinds that they create are not yours to leverage, then you're screwed.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Without even knowing it, we were pre selling the market and preparing the market for what we could bring. And then in 2023, when the sky opened, we ran right in.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Getting there as fast as you possibly can. Because obviously you've got huge ambition. You want to create as much impact as you want, as you need to. And so the trap that a lot of, I think, healthcare founders fall into is that they stay down market. They don't figure out, they don't time their YOLO shot to go upmarket at the right moment. And for us, things really worked out. We're incredibly lucky, incredibly privileged, but like things worked out a lot of different things happened in the marketplace at the same time. On the other side of the pandemic, I'd say 40 50% of the doctors in this country were saying that they were burnt out. And there was a study about nurses recently that was published in GEMA that suggested that 30% of nurses in the country didn't want to be nurses in the next 12 months. So there's all this burnout, all this fatigue. There's incredible financial pressures that have only continued since then, coming down from, for example, Medicare cuts. At the same time, there's this new technology. There's AI. We were in that moment where”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“This is where strong ideas held loosely. You know, when you first raise capital, maybe you hear an investor give you advice about starting down market and swimming upstream, disrupting over time, get that PMF, find those fast feedback loops. And it's true to an extent, but you just have to be really careful and mindful because healthcare specifically in the United States, it's not one $5.3 trillion market. It's a bunch of different markets. And depending on who you're trying to serve, you have to be really careful about how you segment. If you're trying to serve clinicians, doctors, there's about a million doctors in the country, maybe 800,000 of them are actually practicing. The vast majority of them are concentrated in large care delivery systems. They're called integrated delivery networks or payer providers. They also have like pay arms insurance arms or their academic medical centers like the Emory's, the Yale's, the UCSFs, and beyond. And so when they're concentrated there, you have to think about”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“No, 100%. It's every single health system right now. There are doctors right now who we've heard who won't sign up to join a healthcare system, a hospital, if they don't have a bridge. It's one of those moments where all of a sudden almost overnight, over the course of like three to four years, something just became table stakes. It's part and parcel with how care is delivered, especially in the outpatient space.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Probably not, you know, like you always want something more. You always want to build something bigger and your ambition, it always gets bigger. You know, maybe it doesn't get bigger. Maybe you just sort of reconcile yourself to a change in scope over time.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“In some way I feel like we're on this journey that we were meant to be on. We're doing this thing that we're supposed to do. And by we, I mean it's not just the company, but all of our health system partners. It feels like we're a part of a movement that we're trying to create right now. So I can't say that I ever woke up being like, what is going on? But I can say that I've gone to bed at night feeling like this is awesome. You know, this is great and like we have to think about making it even greater. You know, you wake up in the morning and you're not at all satisfied. But at night as one mentor, a cardiology mentor once told me is like try to go to bed with a little bit of perspective and a little bit of gratitude at least knowing full well you're going to wake up with that fire in your belly again”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, the loosely held, there's the tightly held ones, the ones that we would die on the hill on. The loosely held ones that I've like shifted on pretty profoundly over time, I've had loosely held opinions about where the company's limits are like how far we could expand and how quickly we could expand. I think a lot of our priors, all of our priors are getting the data.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“No, but I do think it means you've got to be discerning, but if you're not exposing yourself to certain flavors, then you're just not going to be aware of it. I think the way we translate that in the company, for example, is we should be reading the latest archive papers about some new type of machine learning model that maybe we can leverage. We should be thinking about the latest UI UX patterns out there and where we could take these primitives in our own specific space. We should be just sort of like living at the edge of culture if we also want to create it. And I think also the best companies in some way, shape, or form are creating culture.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“When we created our company values, this is before this whole taste cycle. We created our company values in like maybe the most recent variant in 2021 or 2022. One of them is that you have to taste good things to have good taste. And this idea of taste, I think, makes a ton of sense to us. It's not just judgment, but it's being able to sort of see patterns but put things together in interesting ways that hit different, that feel different, that feel authentic, that really represent a person or people. And I think that's where the really truly magical companies are these days, like where you can kind of feel like the human behind this product and feel like the decisions that they made, the things that they said no to, the strong opinions held tightly that they died on the hill for.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“That would go against me. You know, speaking of Andy, Andy says this thing he's like the biggest coffee snob in the world. And I once asked him about exactly what his rituals are and the temperature and the bean and all that stuff. Just like coffee's coffee, man. I'll have any coffee. And when you ask him about music, he'll say, I like all the sounds. So maybe on some, on some level, you can see the patterns and you can enjoy anything.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“I wouldn't say it was easy, but it wasn't hard at the same time. Now, this was eighteen twenty nineteen, our series seed was like redised five million dollars on a pre of fifteen. So not the world we live in right now.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“I would have died on this hill. I was willing to pivot on the specific product and what specific order we'd put a feature out. I was willing to pivot on go to market. Certainly we learned so much. Healthcare is incredibly complicated. Figuring out go to market is a really big part of how you win. But I wasn't willing to move on the thesis. And for us, the thesis that healthcare is about people and they're having conversations, I think, was just like core to the identity and it would just have to be an entirely new thing. We just sort of shut it down and start something new if there was something else we could get really passionate about.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I think that certain companies, certainly ours, have to have a true north. You live every day in this anticipation that the sky is going to open up because you have this thesis about the market. And you might not necessarily know exactly when it's going to come true, but you know it's going to come true. And when you feel that in your bones, then I think you can draw a lot of resilience. You can sort of figure out that you just need to stay standing. You just need to not die. You just need to sort of like be there when it's happening. And for us, it was absolutely that way. It was this thesis that this idea, this secret hiding in plain sight, that this data set, these conversations, it's the most human signal and it really powers healthcare. You can build a whole new set of rails on top of this signal. And the thinking was, well, at some point in time, the technology is going to be right, but also the market is going to be open.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“Oh, it's a thrill of winning 100%. I love high stakes games going for broke and trying to do something really big, trying to build a new product and trying to bend a new market or create a new one.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source
“You have to taste good things to have good taste. It is critical in vertical AI. Being one of the first. When you saw the announcements from OpenAI and Anthropic about for a deployed engineers and these partnerships with big private equity groups to go help their portfolios, if that wasn't assigned that there is absolutely an incredible opportunity for the foreseeable future for vertical AI, I don't know what is. We're in for a tsunami of healthcare needs and the system is not prepared to deliver it. They did the seed and the A. USV was our business model initially. The more you can feel inevitable, the more you will be.”
2026-05-16 · The Twenty Minute VC · 20VC: Lessons from Jensen Huang on "Founder Mode" | How to Know if OpenAI or Anthropic Will Kill your Company | How USV Liking Music Made Them $1BN on an Investment | The Five Year Desert to Product Market Fit & a $5.3BN Valuation with Shiv Rao @ Abridge · IDENTIFIED FROM THE TRANSCRIPT · source