#277 Shiv Rao: Abridge’s CEO on Skateboarding, “Languishing” Founder Pressure & Reinventing How Doctors Work

This episode is supported by Xero, helping businesses use AI with more control through JAX, its in-platform AI finance partner. Get 90% off your plan for your first 6 months at xero.com/highflyers. 

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Dr. Shiv Rao is the Co-Founder and CEO of Abridge, one of the world’s leading healthcare AI companies, turning clinician-patient conversations into clinical intelligence across 300+ health systems and 100M+ conversations annually. A practising cardiologist, Shiv previously worked across healthcare technology and investing at UPMC before founding Abridge in 2018.

In this rare in-depth conversation, Shiv joins Vidit to unpack his unconventional path: moving from Pittsburgh to India at nine, skateboarding, programming synthesizers, selling records in Japan and nearly quitting medical school before becoming a cardiologist.

He shares how a seemingly perfect career across medicine, technology and investing left him “incredibly restless”, eventually leading to Abridge. But success was far from immediate: Shiv spent nearly four years as a “languishing founder” before generative AI arrived, “the sky just opened up”, and Abridge made its pivotal move into enterprise healthcare.

They also explore why “pressure makes diamonds”, the family sacrifices behind building when “every minute matters”, what changes when a company passes 500 people, why Shiv still practises medicine, and what he’s learned from unlikely influences including Jensen Huang and Rick Rubin.

Please enjoy exploring your curiosity.

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This episode is supported by Xero, helping businesses use AI with more control through JAX, its in-platform AI finance partner. Get 90% off your plan for your first 6 months at xero.com/highflyers. 

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TIMESTAMPS

00:00 Meet Shiv Rao
02:00 Living on planes 
04:55 Xero
07:00 Pittsburgh and India
12:00 Identity, India & belonging
17:00 Skateboarding, music & creativity
19:00 The moment that led Shiv to medicine
23:00 Selling records in Japan
25:00 Nearly quitting medical school
28:00 Medicine’s complicated relationship with technology
30:00 Teaching himself to code & early product-market fit
35:00 Why “pressure makes diamonds”
39:00 Medicine → healthcare investing
44:00 Leaving the “dream job” to build Abridge
48:00 Family sacrifice & the reality of building
50:00 Why “every minute matters” in AI
54:00 Abridge’s years as a “languishing” startup
59:00 When “the sky just opened up”
1:01:00 Abridge’s YOLO move into enterprise
1:03:00 The first customer “Love Stories”
1:10:00 Why enterprise healthcare is so defensible
1:15:00 Building AI that enterprises can’t