What happens when a practicing physician builds a $700M healthcare startup?
In this episode of Founders & Empanadas, Joshua sits down with Dr. Alexi Nazem: Co-founder & former CEO of Nomad Health, Assistant Professor at Weill Cornell, and now a General Partner at AlleyCorp.
Alexi shares his journey from hospitalist to founder, how he scaled one of the fastest-growing staffing platforms in the world, and why being transparent (not invincible) is the most powerful leadership strategy during chaos.
We unpack:
This one’s a clinic on founder psychology, systems thinking, and scaling through uncertainty.
🎧 Highlights
00:00 – Intro + empanadas
01:00 – From physician to founder: the notebook that started it all
05:00 – Nomad’s origin story + early clinical pain points
07:30 – Solving the chicken-and-egg problem in marketplaces
10:00 – Why Nomad focused on clinicians first
13:00 – W2 vs. 1099: regulatory complexity as a moat
16:00 – Building a credentialing engine from scratch
18:00 – Why “let humans do what only humans can do” became a guiding principle
20:00 – Using AI to match clinicians to jobs with precision
21:45 – How Nomad automated away credentialing drudgery
24:00 – March 2020: Nomad pivots into PPE and COVID test logistics
26:00 – From survival to 10x growth: scaling Nomad under pressure
27:15 – Lessons from rapid growth: don’t trade tech for headcount
29:00 – Crisis leadership: be honest, be clear, and co-create solutions
31:00 – What medicine taught Alexi about leadership and scaling
34:00 – What doesn’t translate from medicine to startups
35:00 – Stepping down as CEO + the emotional side of transition
38:00 – Why he joined AlleyCorp to keep building and backing big ideas
39:30 – What startup founders get wrong about leadership style
41:00 – Final thoughts on kindness, team dynamics, and long-term impact
42:30 – Where to find Alexi online
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