Rome Portlock was writing code against two clocks. One counted down the six weeks left before NFX Demo Day. The other woke up whenever it pleased. His first child had just been born.
The software on his screen was not the product he and Iman Abuzeid had entered the accelerator to build. That product was Lift League, a customer-retention service for smaller healthcare businesses. It had been discussed, developed and admitted to a program whose conclusion was designed for showing progress to investors. There was only one awkward detail: it was not growing.
Plenty of founders would have spent those remaining weeks decorating the evidence. Portlock and Abuzeid scrapped the concept. Their partnership survived the verdict, and this distinction proved more valuable than the original plan. They had met at AliveCor, where he was a principal platform engineer and she worked in product. Portlock had already formed a view of his prospective cofounder: “I knew [Iman’s] the kind of person that will make things happen and get things done.” Failure had not changed his mind about the person. It had merely changed their assignment.
“I knew [Iman’s] the kind of person that will make things happen and get things done.”Rome Portlock on cofounder Iman Abuzeid
A contradiction at the dinner table
The better idea had been waiting in the family. Portlock’s sister, brother-in-law and sister-in-law were nurses. They described a job search in which an experienced, qualified professional could apply to ten or fifteen hospitals and receive no reply. If a reply came, it could take months. Abuzeid’s relatives and friends in medicine described the opposite end of the same corridor: hospitals struggling to staff their teams.
A shortage on one side and silence on the other is not merely a labor-market problem. It is a design problem with a labor market trapped inside it. The standard application made the worker ask permission to be noticed. Portlock and Abuzeid borrowed a pattern already used in technology recruiting and reversed the approach. Hospitals would apply to the professionals.
A résumé enters a large hospital workflow. The candidate waits for a response.
Matching software surfaces relevant professionals. The hospital makes the first move.
In January 2017, Portlock coded while Abuzeid called hospitals and shaped the business plan. The division of labor was almost comically clean: build the machine, then ask whether anyone would switch it on. Three weeks after launch, their accelerator profile said 28 hospitals had signed up and posted 2,000 nursing jobs. By March, HCA Healthcare was discussing a contract. The first customer check arrived a few weeks later and was framed on the office wall.
Portlock later said he counted the company’s age by the age of his first child. Founding myths generally improve their lighting and remove the laundry. This one gets more credible when the baby remains in the room.
The long apprenticeship in other people’s systems
The six-week build was rapid, but Portlock was not a sudden engineer. He had accumulated fifteen years of software work by the time Incredible Health appeared at Demo Day. After earning a computer science degree from MIT in 2001, he joined eScription, whose technology turned medical dictation into structured work. Then came A9, Amazon’s search subsidiary; Linden Lab, the maker of Second Life; Eventbrite; and AliveCor, the mobile technology company where his path crossed Abuzeid’s.
Read as brand names, the route looks pleasantly eclectic. Read as systems, it is almost orderly. Search must decide what is relevant. A virtual world must coordinate identity, interaction and rules. An events platform must join supply and demand at a particular time and place. A connected device must earn confidence when the stakes are higher than a click. A hiring marketplace needs pieces of all four.
It is also a career spent mostly behind the interface. Portlock worked at eScription from 2002 to 2006, then at A9 until 2007, Linden Lab until 2011 and Eventbrite into 2012. The titles rose from software engineer to senior engineer to principal platform engineer at AliveCor. There is no abrupt leap from school project to chief technology officer, only the patient accumulation of systems that had to operate for people other than their makers.
That background matters because a marketplace has two opportunities to fail at once. The employer can see irrelevant candidates; the professional can receive irrelevant approaches. Either side can decide that the other is wasting its time. Portlock’s task was therefore not simply to put résumés in a database. It was to make the exchange selective enough to be useful and quick enough to alter behavior. The product’s promise, in plain English, was that a hospital would notice the right person before another hospital did.
A former colleague’s public recommendation calls Portlock technically excellent, supportive and unusually good at collaboration. His own hiring language supplies another clue. When recruiting an engineering leader in 2023, he asked for someone excited by a lean senior team, comfortable “close to the code,” attentive to quality and responsible for business outcomes. It reads less like a fashionable leadership manifesto than a description of the job he values.
The value of changing your mind in time
Incredible Health’s origin is often summarized as insight: doctors knew hospitals were understaffed; nurses knew hiring was slow; therefore, build a marketplace. True enough. Yet the useful part is not that the founders saw the contradiction. Their families had been telling them. The useful part is that they were willing to hear it after investing time in something else.
The pivot did not mean starting from zero. Portlock and Abuzeid retained their experience of working together, their knowledge of healthcare businesses and their place inside NFX. They changed the proposition and preserved the assets that still made sense. A pivot is often drawn as a hard angle. In practice, the graceful ones resemble editing: keep the sentence’s strongest words and remove the clause that is lying.
The edited version proved durable. In 2019, Andreessen Horowitz led a $15 million Series A. In August 2022, Incredible Health raised an $80 million Series B at a $1.65 billion valuation. Portlock wrote that revenue had grown 500 percent and that 10,000 nurses were joining the platform each week. The capital financed machine-learning work, more automation and a planned expansion intended to reach 90 percent of the American nursing workforce.
The company now says 1.5 million healthcare professionals and more than 1,500 employers use the network. Its marketplace brings reported hiring time below 20 days, compared with an 86-day national average. It has also added two voice agents: Lyn works on the employer side, while Gale supports professionals with career tasks. The names have the cheery tidiness of a 1960s switchboard. The engineering underneath deals with a messier reality: specialties, credentials, location, timing, interest and trust.
Portlock’s public presence is modest next to the platform’s reach. He posts sparingly. He is more likely to appear in his cofounder’s account of the company than at the center of his own. Even the official biography is concise: MIT, Amazon, Eventbrite, Linden Lab, AliveCor, three nurses in the family, a better way. There are no childhood epiphanies polished for conference stages.
What the quiet founder leaves visible
Quiet, however, is not invisible. Product choices are arguments that have learned to run on servers. Incredible Health’s central argument is that a professional’s time counts, and that software can make a large employer behave with more urgency. Its second argument is that permanent hiring deserves attention in a market often associated with temporary staffing. Its third is an engineer’s familiar objection to waste: two parties should not remain stranded when the information needed to connect them already exists.
There is wit in the reversal. For decades, employers perfected the phrase “we’ll keep your résumé on file,” a sentence with all the romance of a storage cupboard. Portlock helped construct a system in which the cupboard has to make the first move.
His stated horizon has included scaling the company toward an initial public offering. That ambition belongs to the language of startups, but his more revealing aspiration sits in the product itself: faster, more personalized hiring, increasingly automated without losing relevance. The challenge grows as the network does. A match at 28 hospitals is a feature. A match among 1,500 employers and 1.5 million professionals is infrastructure.
The framed first check remains the better emblem than the valuation. It arrived after the failed idea, after the decision to stop defending it, after the newborn nights and the frantic build. It represents a customer paying for the rewrite. The distance from that check to a national platform is considerable. The decisive distance was only six weeks long.