Shiv Rao

CEO of Abridge and a practicing cardiologist at the University of Pittsburgh Medical Center (UPMC).

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Key positions and views

The U.S. healthcare system is facing an existential staffing crisis, with a significant percentage of doctors and nurses intending to leave the profession due to burnout and administrative burden.

AI's most immediate and impactful application in healthcare is to automate clinical documentation, thereby directly addressing the root causes of clinician burnout and improving retention.

A focused enterprise strategy targeting large, academic health systems is the most effective path to drive adoption, establish a new standard of care, and build a defensible market position.

The current U.S. healthcare reimbursement model, which compensates based on documentation rather than care delivery, makes accurate and efficient note-generation a critical economic function for health systems.

While AI will profoundly augment clinicians by automating administrative tasks and providing decision support, it will not fully automate or replace doctors and nurses within the next decade.

Podcast consensus on Rao

Points of consensus

▶Shiv Rao consistently frames the problem of clinician burnout as a critical, system-level crisis, citing statistics that large percentages of doctors and nurses intend to leave the profession.Mar 2026

▶Abridge is presented as a company experiencing rapid growth and significant market adoption, evidenced by its deployment in over 110 health systems, processing millions of conversations, and securing major customers like Kaiser Permanente.Mar 2026

▶The core value proposition of Abridge's technology is its demonstrated ability to reduce clinician burnout and cognitive load, with specific metrics cited, such as a 50% reduction in burnout and a 60% reduction in cognitive burden.Mar 2026

▶Abridge's primary competitor in the enterprise health system market is Microsoft, and Abridge positions itself as a superior solution in head-to-head comparisons.Mar 2026

Points of debate

▶The claim that Abridge has 'never lost a head-to-head' sales competition against Microsoft is a strong, self-reported assertion that lacks external verification and may represent a selective timeframe or definition of a 'loss'.

▶The high-impact metrics cited (e.g., 50% burnout reduction from a Stanford survey) are presented without full context on methodology or sample size, making their generalizability across all 110+ health systems debatable.

▶Rao's prediction that doctors and nurses will not be fully automated in the next 10 years represents one viewpoint in the broader AI community, where opinions on the timeline for AGI and job displacement vary widely.Mar 2026

▶The assertion that every clinical note is a bill because physicians are compensated for documented care, not delivered care, is a strong characterization of the US healthcare system that may oversimplify complex reimbursement models, though it effectively highlights the importance of documentation.Mar 2026

Key themes

▶The Clinician Burnout Crisis as a Market Opportunity

Rao consistently frames the dire state of the healthcare workforce as the central problem his company solves. He cites high-level statistics on doctors (40%) and nurses (27%) considering leaving their professions to establish the urgency and scale of the burnout crisis, positioning Abridge not just as an efficiency tool but as a critical intervention for system stability.

This problem-framing allows Abridge to sell to health system executives on the basis of talent retention and cost avoidance (citing a nearly $1M cost to hire a new clinician), which is a more compelling ROI than simple workflow efficiency.

▶Enterprise Focus and Competitive PositioningMar 2026

Abridge has made a strategic choice to target large health systems and academic medical centers, deliberately avoiding smaller practices. This has pitted the company directly against Microsoft, which Rao identifies as the primary competitor in head-to-head deals. Rao expresses extreme confidence in this matchup, claiming Abridge has never lost such a competition.

By focusing on and claiming dominance in the enterprise segment against a tech giant, Rao is building a narrative of being the best-in-class, specialized solution, which can create a powerful brand halo and attract further large-scale clients.

▶The Data Flywheel and Proprietary AIMar 2026

Rao emphasizes Abridge's sophisticated, in-house technology stack, including proprietary speech recognition models tailored for healthcare. He describes a powerful data flywheel where clinician edits on generated notes are used for preference tuning and reinforcement learning, continuously improving the models. This is complemented by advanced capabilities like processing multilingual conversations in real-time.

The focus on a proprietary data and model improvement loop is a key strategic defense against larger competitors with more general AI capabilities, suggesting Abridge's competitive moat is its specialized, self-improving dataset.

▶Vision for End-to-End Clinical Workflow AutomationMar 2026

Rao's vision for Abridge extends far beyond transcription and note generation. The company's roadmap includes automating the extraction and placement of medical orders and billing codes directly from conversations. The ultimate goal is to provide real-time clinical decision support, such as identifying patients eligible for clinical trials during their appointment.

This forward-looking roadmap indicates an ambition to move from a system of record to a system of intelligence, fundamentally embedding Abridge into the core clinical and financial operations of a health system and significantly increasing its strategic value.

Source episodes

Sentiment over time

Not enough data for timeline

Changes over time

Initial Deployments

Abridge secured its initial successful deployments at large academic health systems, including the University of Kansas Health System, Emory University, and Yale University, validating its enterprise-focused strategy.

2023

Rao cites articles from JAMA and the American Journal of General Internal Medicine published this year to quantify the severity of the clinician burnout crisis, grounding his company's mission in recent, high-profile data.

Recent Years

Abridge established Microsoft as its primary competitor in the enterprise space and, according to Rao, has maintained an undefeated record in head-to-head sales competitions during this period.

Pre-Podcast Period

Abridge achieved significant scale, crossing the threshold of $500 million in total funding and expanding its footprint to over 110 health systems.

Podcast Appearance

Rao discusses Abridge's current scale of processing millions of conversations every few days and outlines the company's future roadmap towards real-time clinical decision support and workflow automation.

Suggested prompts

How does Abridge's proprietary, healthcare-specific AI model and data flywheel provide a sustainable competitive advantage against larger, more generalized models from competitors like Microsoft? &nearr;What are the primary risks to Abridge's growth trajectory, considering its reliance on large health system contracts and the bold claim of never losing a head-to-head deal? &nearr;How will the planned transition from documentation automation to real-time clinical decision support and order entry change Abridge's product, regulatory, and business model? &nearr;Given the claim that 80% of raised capital is invested in R&D, how does this allocation reflect Shiv Rao's long-term vision for the company versus near-term sales and marketing pressures? &nearr;

Key concepts

Clinician Burnout 1 ep AI in Healthcare 1 ep Enterprise Go-to-Market Strategy 1 ep Market Adoption & Scale 1 ep Healthcare Economics 1 ep Abridge Technology Stack 1 ep Venture Capital & Funding 1 ep Competitive Landscape 1 ep Multilingual AI Processing 1 ep

Notable quotes

“two out of five doctors don't want to be doctors in the next two to three years.”

Shiv Rao · No Priors Ep. 108 | With Abridge Founder and CEO Shiv Rao, MD

“we're live, we're doing millions of conversations, like every couple of days, like it's real scale.”

Shiv Rao · No Priors Ep. 108 | With Abridge Founder and CEO Shiv Rao, MD

“So far, we've never lost a head-to-head in these last few years of doing this.”

Shiv Rao · No Priors Ep. 108 | With Abridge Founder and CEO Shiv Rao, MD

“what if I had the superhero power and in the moment, at the point of care, I was being told by a technology at the right time, like, hey, Shiv, this patient in front of you has inclusion and exclusion criteria for something that could save their life?”

Shiv Rao · No Priors Ep. 108 | With Abridge Founder and CEO Shiv Rao, MD

Report last updated: Apr 21, 2026

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