How I Built Resilience: Dr. Iman Abuzeid of Incredible Health

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And thanks. Hey everyone and welcome to How I Built This Resilience Edition. On these episodes, we're talking with entrepreneurs and other business leaders about how they're building resilience into their businesses at this very challenging moment. And today we're going to hear from Dr. Iman Abzaid, the co-founder and CEO of Incredible Health. It's a digital career platform where nurses create profiles and are match with hospitals, making the hiring and onboarding process much quicker and much more efficient. It's currently being used by hundreds of leading hospitals across the Across the country.

So hospitals and health systems they use our platform and our custom matching technology to hire Permanent nurses. in what is fifteen days or less right now. Usually the industry average is ninety days. Now the reason the average is so high at ninety days is because we are experiencing a massive nursing shortage. Even before the pandemic, the shortage was pretty bad.

And it's now become even worse. So the few unique things about our platform and the way it works is that the hospitals apply to the nurses instead of the other way around. Uh and so by flipping it around like that, it's a magical experience for the nurses. They create a profile, they sit back and relax, and they hear from different employers, and they get to choose which interviews to accept or decline. And we also use our software and automation to screen the nurses as well as to custom match uh nurses to the right employers, too. So it's sort of like a job site, but of course the nurses are not applying for jobs, just putting up a profile.

It's sort of like LinkedIn meets match dot com in a s in a way, I guess, right? And hospitals. Right. I mean chief nursing officers refer to us as the match dot com of hospitals and nurses all the time. So yeah. So how does hospitals applying For nurses instead of the other way around help The shortage issue for For both sides.

Our demand for healthcare as a country keeps going up. You know, our population is aging, uh, of course, pandemics don't help, and we just simply don't have enough workers in the system. Like by twenty twenty four, we're going to be one million nurses short. And that shortage just keeps getting worse and worse. Now, what's happening inside a hospital or a health system is the way they hire really hasn't changed since the early nineties, right? Like It's post a job and hope something happens. Unfortunately, like that process and that kind of outdated technology is not uh sufficient to operate in such a competitive talent market like this. That's why by adding the you know, changing the model so they're applying to the nurses, adding the screen, adding the custom matching has really accelerated the hiring, and why we're used at over two hundred and fifty hospitals and health systems across the country today.

My um uh stepsister is a nurse and w th this shortage crisis that you mentioned is obviously a an acute crisis Be before I we talk more about, you know, how Incredible health is kind of streamlining this process, let's just talk for a moment about this crisis um in nursing. I mean, I know maybe people watching don't know, you are a doctor by training your m you're an M D and also an MBA. How do we even begin to change this

presumably you have to attract m more people to the nursing profession. How do you do that? Yeah, that's a great question. Yes, we have to as a country have to solve the underlying supply. And we ні to not only attract more people to the nursing професі. Uh but even for the nurses that are graduating we need to expand the amount of training that we have for them as well.

Um because there's bottlenecks in in both places. There's a few ways to do that. So one is really, I guess, promoting the profession as a fantastic profession. Look at the end of the day, yes, nurs are. They do work a lot. You know, sometimes they do feel underappreciated, but this is A relatively high paying profession after uh you complete your education.

It seems to me that we should pay or subsidize. Their education. That that becoming a nurse should essentially be free. I I hundred percent agree. So for Incredible Health specifically, you know, we provide free continuing education to every single nurse in the country. Continuing education is needed to renew and activate their licenses, and they usually have to pay out of pocket for it, you know, just on continuing education, which is You know, those are courses that you do after you become a nurse.

uh you know, we figured this is crazy. Let's just give it give it away for free. Uh it's accredited in all 50 states, and they can just simply get it done inside the incredible help application. So there needs to be more programs like this across the board. that essentially make the education and the training of nurses cheaper and cheaper and ideally free. I just cannot believe that you've packed so much into your life already. You you have a an a medical degree and an MBA. Did you by the way, did you ever practice I actually did not. So I I finished medical school and I always wanted to make an impact kind of on a on a more system level. And don't get me wrong, look, one on one patient care is amazing. Uh but it's not very scalable.

Things like software and technology are highly scalable. You can literally transform an entire industry. Um the genesis of of incredible health came from my background, right? So I am an MD. I have a lot of hospital uh friends and family members that are doctors as well, who are often complaining about understaffing. At the same time, my co founder, who's a software engineer from MIT, uh Rome Portlock. His sisters are nurses. And they were saying, Hey, I'm experienced and I'm qualified, and it still takes me two, three months to get my next job. I apply to ten, fifteen places, I often don't hear back. This is a very common experience for nurses, by the way, even today. And so we just figured there just has to be an easier way to solve this problem. So essentially the problem you identified was this kind of

The process, right, of hiring nurses was broken. Which doesn't make sense, right? Because you would think uh you know, with a shortage and hospitals needing nurses, they would bring'em on, but hospitals are also big bureaucracies with lots of different challenges. So I guess it does make sense. You identified this problem. which was the hiring the onboarding process and

you decided to figure out how to streamline it and That was the genesis of Incredible health. That's right. And it's now expanded beyond just the place where a nurse

uh finds a job it's the place where he or she manages their career Uh, I mentioned continuing education earlier. We also have free salary estimators. We have a couple more services that are launching at the end of this year as well. That's exclusively for nurses. You know, so it's it's really become the place where, you know, you can manage your entire career on Incredible Health. Well. I'm wondering Iman, how does the business model work? Do hospitals subscribe, pay a subscription fee to the site, or do they pay You know, every time

They hire somebody, you get a fee, sort of like Zoc Doc's model. Yeah, it's designed as a subscription and within that, you know, the hospitals are are picking are selecting different tiers that are based on volume. But it's of course a hundred percent free for the nurses. when nurses go and work at hospitals, do they tend to stay at the same hospital for a long time or is there high turnover? Are they moving around to different hospitals? Yeah, so for our platform specifically, we only do permanent workers, right? We don't do any contract workers. Now look nursing in general

is known for high turnover, right? So usually t it's it's Uh seventeen percent is a national uh an annual t turnover right now. Um and so retention is also a hot topic and a very important topic for these for these employers as well. Um, and we'll try to do whatever they can to to keep their nurses. So let's go back to the the beginning of this year.

At what point did you realize That this pandemic was going to be a major problem and that the service you offer was was potentially going to be in high demand. I

figure this out put this all together probably in January, early February, and that was because I was on Twitter. Um and honestly the most amount of information was coming from epidemiologists and MDs and public health experts around the world. 'Cause we weren't getting real time data here in the US. So tw Twitter was actually the my source. For figuring this out.

I know you've got a team of about thirty people. You're based in San Francisco, right? We are headquartered in San Francisco, but o our team is in different parts of the country. So when you realize that this was potentially gonna be a huge issue Did you see an i an immediate spike in in demand for your services? We did certainly by April.

Uh, there was a spike in demand for specific types of nurses. If you were an ICU nurse or an E D nurse. Like the hiring for that like increased like by three X on our platform, like right away. And we saw a drop for some of the other specialties because you know surgeries were getting canceled. But since then, since July, August. the the demand for every single role has dramatically increased. Because not only are hospitals operating at full capacity, they're also dealing with this pandemic. So how did you start to position your

your company and your business to meet that demand. So there were a few things that we did. We we we a few months ago we launched uh what we call the pandemic hiring suite, right? And what that is, is uh a range of features and tools that even more dramatically accelerates the hiring. Um and really helps the hospitals reduce costs because they had gone through some very severe financial hardship, right? So uh a couple of the things that we did was we added in automated interview scheduling, remote interviewing, because that's just what you have to do during a pandemic, um, in app chat. Um you know, enhanced our matching algorithms. All of these with a goal of accelerating the hiring even further. So we got it down to twelve days now. And on average we save every hospital that we work with at least two million dollars uh because they dramatically try to reduce uh their travel nurse costs as well as their overtime and HR costs.

So essentially last year or the year before, if you were a nurse using your platform You would have done an in person interview at least one. You would have traveled to the hospital. And that of course has has gone away. That's gone.

So that's not even a feature anymore. Now everything is happening virtually. Correct. And that has accelerated the process. So now it it's meant that the average hiring period is just twelve days from the time that somebody identifies a nurse they want to the time that nurse is offered a job.

From the time the nurse accepts the offer. Yeah. How are the interviews happening? Do they go through your an interface on your site or or is it just like a Zoom call? Yeah, the first set of interviews are all uh facilitated through our software and our site.

Um and we have automated interview scheduling built in that requires like zero integration with hospital IT teams. So that it was very rapidly adopted by both both the recruiters and the nurses. Did you build that this year? Ah yeah? At the beginning of this year. I mean it was in our roadmap, we just have to accelerate it.

Because of the pandemic. How did you ramp that up so quickly? Um it's just a case of prioritization with when it comes to product roadmaps, right? Like you you just kinda shift things around and you prioritize uh what your customers most urgently need uh right away. half our team is software engineers and so we are able to ship product honestly ship code every single day and uh do product launches every single quarter.

So when you release that, that's a pretty, you know, sophisticated feature, right, on your site, where you can now interface and do an interview through the site. When it was initially released, was it Perfect? Has it been improved upon? Was it a little glitchy at first? Yeah, of course it it was not perfect. You know. The the the priority was to release it fast. uh even if it was imperfect and then we dramatic you know, rapidly improved it over time.

Do you think that that you could have done something like that so quickly. Without the urgency of the pandemic. Honestly Ah, yes, because one of the values of our companies is speed.

I just believe one of the only competitive advantages you have as a startup is you can operate and you can execute far faster than any of your incumbents and anyone else. So we generally move as quickly as humanly possible. And so the improvements to our platform are rapid, uh, even before the pandemic. Tell me about your workforce. I mean, you're based in San Francisco, but you've got a distributed workforce or pre pandemic where most people coming into an office in San Francisco? Yeah, so half our team is in San Francisco and we do have an office here in San Francisco, but half the team are in other parts of the US. That's been really helpful because we do serve clients, you know, all over the country. And of course, at the moment we're fall fully remote.

We are going to keep our office, so we're pr likely uh going to do this hybrid model. So people will kind of work from home or come in a couple days a week depending on how how it works for them. You know, you said half of your workforce are are engineers, so Presumably they are

kind of self sufficient. But what about the rest of the team? I mean, you are the CEO of the company and you know, even the best of employees are It's a challenge this year, right? Th there are lots of challenges that people are dealing with, whether it's um family issues or just, you know, loneliness and isolation

uh morale. Um, how are you How have you been handling those challenges with your team? You're right, I mean it's it's been a very challenging year. Um mentally, right? Uh we had done a quick survey of our team and it was like fifty percent were experiencing some kind of s symptoms of anxiety or depression. And I think that's pretty common across the board, across the country. Um, so there were a few things that we did. So the first thing is just in the acknowledgement and communication of the problem. Everything from just like, hey, like we understand everyone's going through a tough time right now, and just saying that explicitly and saying that we understand. And then also for certain groups of employees, like

You know, the parents with the young kids. Right. Or the the person in an apartment with three other roommates. I mean, they were under even additional strain. Um and and saying that, hey, it's okay if we're on a Zoom call that your you know, your kid shows up, right? That's perfectly acceptable. The second thing we did is just really invest more time on just improving the setup, right? So uh everyone got to work from home like stipend to set up their office space at home. Um For some employees, they did have to like scale back a little bit in terms of their hours and switch from full time to part time, which is completely understandable.

And then the third major thing that we did is just kind of dramatically improve our communication and our interaction as a team in in a remote setting. Yeah. So whether it be like our weekly hangouts, our coffees that are we do every Friday, um, our game, you know, game afternoons, you know, just Adding more of these uh intentional uh communication uh touch points was was really helpful as well. When we come back in just a moment, Iman describes the biggest changes she's seen in the healthcare industry during this unprecedented year. Stay with us. I'm Guy Raz, and you're listening to How I Built This Resilience Edition. From NPR.

And one more thing, the New York Times bestselling book, How I Built This, is now available. It's a great read and a great gift for anyone looking for ideas, inspiration, wisdom, and encouragement. to have the courage to put out an idea into the world. It's filled with tons of stories you haven't heard. About how some of the greatest entrepreneurs you know and respect

Started out at the very bottom. Check out how I built this the book. Available wherever you buy your books. Hey, welcome back to How I Built This Resilience Edition, and I'm talking with Dr. Imon Abuze, the co-founder and CEO of Incredible Health. And she says the healthcare industry has had to adapt very quickly to meet the increased demand for services during the pandemic.

The biggest change I've seen is the rapid decision making and rapid adoption of whatever solution there is, right? So You know, historically the healthcare industry has just been known for lots of red tape, bureaucracy, like it can't get anything done fast. And this year just like really dramatically changed all of that. Whether it's the adoption of um telemedicine, adoption of uh you know operational um uh infrastructure like Incredible Health, um and others like it was

The the speed in which they started to move and operate and make decisions has been we've never seen anything like this before. I've had two consultations with my doctor this year. Um for minor things, you know, like a skin issue and I got a COVID test just out of safety a couple months ago. Um, you know, the doctor that I used to go see, she uh was just a remote

Call. And as you know, CMS is now reimbursing doctors for consultations with Medicare patients, which is a new feature this year. Um

Do you think telemedicine now is here to stay and will actually be the predominant form of Medical care in the future? I think it is here to stay. At the end of the day the health healthcare industry as a whole needs to really focus on customer service, which is like basically the

patient experience or you know many phrases for that. And if patients are adopting uh telemedicine and you're going to get reimbursed for it, like as you just described. then there is no reason why it would not be fully adopted. Now there's a few you know Are they need to get figured out. Uh, you know, there are entire communities in the US that don't have access to these devices and don't have internet access and so on. So it's not a solution for everyone and every single location and every person. Um, but it the adoption of it, the dramatic adoption of it is here to stay. Anyone who's been to a hospital for any reason

uh knows that you interface mostly with nurses, and nurses are the people who make your experience Better. Um There's a a bunch of questions coming in. I'm gonna ask this is more of a comment from Patty McLaughlin. Um, she she says that she is a registered nurse.

Uh, she went through a refresher course at the age of sixty three, but nobody would hire her. Uh, and she believes it's blatant age discrimination. Um You know, she says she had great references and did really well in her refresher course. She got certified in B L S and A C L S I don't know what those mean, but you do. Uh fine colors. Um

And w apparently we're getting a lot of nurses responding to that comment on Facebook who are saying, Yeah, same experience. First of all, do you think that is a common experience? And then the second question I I would have is if there's a shortage in nurses now, Wouldn't hospitals want to hire somebody like Patty at age sixty three? Yeah, so unfortunately it is a common experience. Not only um

Do do older nurs get hired less? Even if you took a gap from the workforce, right, like you had to raise your kids or You know, just have to take a few years off. That also reduces your h hiring

you know, chances and opportunities. And you're right, that is really unfortunate because like there is a dramatic shortage. And we need we need uh every able body we can get. You know, a lot of that has to do with just The existing I don't know, bias, right? That just exists among employers today. And that's ac across all industries, not just healthcare. And so this is one of the t a really important topic because it's something that we track really carefully because we're a software platform, we have so much data on this. Like I'll I'll give you another example of a human bias that's been introduced. Or that we noticed.

We notice that nurses that lived further away from a facility. uh were less likely to get interview requests on the platform, even though they wanted to, you know, live in wherever it was LA or Dallas or whatever it was. And uh what we did is we just removed the current location of the nurse. Right. And we just saw that human bias just

Remove. It's gone. You know, hiring in general Іно, ви тер'залота преconceived notions and biases and so on that just have to constantly be addressed. uh in order for it to get better. And the the great thing about a software platform is it can h really highlight this data at scale. And so we can have more informed discussions about it. Could you also remove age?

From the site. The tough thing with age is that you know work experience of course is required. And so Absolutely, age is not part of the nurse profile, but work experience is. And so sometimes um You know, employers can tell from that.

I mean, I would rather have a sixty three year old nurse than a nurse just out of nursing school. Not to say that a nurse out of nursing school isn't great, but I mean a sixty three year old nurse or sixty five year old nurse is coming with decades of experience. I mean, to to me it would seem like a no brainer that you would want somebody with that experience at a hospital. And y you do, look, and that's not to say that older nurs don't get hired. Look, there is a huge cohort of nurses that is approaching retirement, which is gonna be another at another strain when they do retire. So regardless of what age you're at, like nurses are needed. Whether you're a new graduate, ten years experience, thirty years experience, like You need it. Yeah. Here's a question from Mark Monroe. It's more asking you to put on your your entrepreneurs hat for a moment. Um he writes as someone who's built a hiring platform.

I'm wondering what your Iman, what your best interview practices are. Oh, that's that's a great question. Um so W well, there's interview practices for nurses specifically, and there's interview practices for uh technology workers. And so I'll just answer it in two different ways. So Um In terms of interview practices when we're hiring for our team

The most critical thing is to get phrases like cultural fit. And like my gut feeling. These kinds of phrases need to just be removed from any high process. Totally. That's just They're nonsense. They're complete nonsense, right? So what I what we've done is like really have improved on this and like got really diligent with our hiring process. So every single interviewer has specific questions that they must ask. Like literally there's a guide and they have to follow the guide, right? Um, the way the rubrics that the interviewers fill out afterwards are very um regimented. We do training for the interviewers as well. And then we think through a hiring process is not just like asking behavioral questions, but you have to ask case studies or you have to do a presentation to kinda test like a range of different skills. Now for nurses specifically.

I I don't think nurses should assume because they're very experienced that they know how to interview. And we've just seen it time and time again that uh You know, very experienced nurses can sometimes bomb interviews. And so we have put together pretty detailed interview preparation and guides that are available on our site and free to everyone and that have like the do's and don'ts. for nurse interviewing. Everything from like, you know, don't bash your former employer, uh, don't say you're looking for the job because of money. You should be saying it's because it's about patient care. And you know, just things like that. You just need to present yourself in an extremely professional way.

Ivan, how do you um And I'm sorry, I keep calling you Imon, I should be calling you Doctor Abu Zaid. Oh no, please That's totally fine. How how do you Prevent.

Or um as best you can. Systemic bias in hiring. the nurses come from diverse backgrounds. And there's incredible need, for example Nurses who are bilingual, who speak Spanish, et cetera. But how do you

Build in. Barriers to prevent. The kinds of bias that That happened in the hiring process. Yeah, that's great, great question. I mean, look, there's there's several tactics uh for addressing bias, but the a a a huge one is just acknowledging it and measuring it.

Right. So uh there's a whole set of best practices around um just measuring your entire funnel, how you're sourcing, and like almost like tagging every candidate that's coming through based on some kind of demographic data, right? And then that way you can quickly, based on the data, acknowledge and and and and and realize where the bias is happening. After getting that information, you know, then it's time to implement some best practices to reduce the bias. That could just simply be training that's needed for the interviewers. Um that could be, you know, completely adjusting your sourcing methodology and like attracting candidates from different from different sources. You know, for the Incredible Health specifically, there's a few things that we do. For example, nurses can pick avatars instead of their profile pictures.

Um if they don't want to kinda r reveal how they look. We absolutely do a a random sort in inside the application on the employer side. The nurses are randomly listed, so everyone has equal opportunity to interview requests. Um You know, there's a few other things that we do to kinda constantly reduce uh the bias that can be introduced. I mean, you can imagine working with like um

social scientists, for example, to experiment with, you know Not using names, for example. Because as you know, names are often a source of of bias, right? It's often where the bias begins. W we've tried, you know, removing names, even removing pictures. Uh the number of interview requests you receive drops. Yeah. There's something about software where like it's There's like almost like a human connection that you're trying to enable in inside a software platform. Things like names and pictures enable.

I mean, how do you think that this year has changed your company's Overall strategy. It's changed our strategy in a few ways. So one in terms of just we talked about the product changes, had to dramatically reprioritize and re-configure. things and and and really double down on what what's it gonna take to help hospitals and nurses find each other faster and interview remotely and just um And dramatically reduce the cost for the hospitals too.

The other thing that's changed is just like where we expand geographically. You know when when the pandemic first hit In you know, April. you know, we just have to delay all our New York expansion plans, basically, right? And and as the pandemic has spread throughout the country, we had to adjust where our ex different expansion plans. At this point, hospital and health systems have honestly become quite accustomed to the pandemic and they're very prepared and they have the you know the personal protective equipment and they've they're making uh adjustments needed and they're not

is it just a lot better prepared now, so we haven't we've been able to kinda really roll out our geographic expansion plans as normal. Um, last question for you, Iman. I'm gonna ask you again to put on your entrepreneurs hat. For for someone watching this who's who's looking at you now. An M D. An MBA from Warden. I believe you are the child of immigrants, am I right about that? I am, yeah.

Yes. Um I I think your parents came from Sudan, is that right? That's correct. Yeah. So if somebody somebody looking at you now and you know, looking at at you as somebody who's inspiring them, do you think it it's a good time right now to start a business or maybe to go to business school Or to um you know, to dive into this uncertain World of entrepreneurship. Okay, so obviously I'm heavily biased here, but an opinion I have is the epitome of what you can do with your business career.

is to start a company. And that's just that's not a fact, that's an opinion. The the Excitement the learning the skill development that comes from entrepreneurship. Is is dramatic.

Now, of course, when that comes an intense amount of resilience is needed, and you know, you gotta manage your mental health pretty carefully as well. But um It it's it's the quickest way to learn as much as possible. And sometimes we need to, you know, evaluate the risk and the perceived risk a little more carefully. It's not, you know, there have been a lot of layoffs this year, so like just working a normal job is not necessarily like foolproof either. So Yeah.

I highly recommend it. That's an excerpt from my conversation with Dr. Imam Abu Zaid, the co-founder and CEO of Incredible Health. To see our full interview, you can go to facebook.com slash how I built this, and if you want to see all of our other past live interviews, you can find them there or at youth.com slash npr. And if you want to find out more about the How I Built This Resilience series or other virtual NPR events, you can go to nprpresents.org. This episode was produced by Liz Metzger with help from JC Howard, Will Mitchell, Bruce Grant, Matt Adams, L. Mannion, Gianna Capadona. John Isabella, Julia Carney, Neva Grant, and Jeff Rogers. Our intern is Farrah Safari.

Thanks for listening, stay safe, and happy Thanksgiving. I'm Guy Raz, and you've been listening to How I Built This Resilience Edition? From NPR.

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