Founder Fridays: Scaling Fast Without Burning Out with Sam Kothari, Everlab and Alex Dam, Notion

Preventative healthcare can scale fast without burning out when leadership pairs rapid execution with uncompromising clinical quality—and builds a tight feedback loop from real patients. Sam Kothari, co-founder and COO of Everlab, frames the core problem as a healthcare system that’s too reactive and too “average” for the individual in front of a clinician. Everlab’s answer is a 12-month, doctor-led journey that combines personalized risk profiling, ongoing testing, and a centralized “super app” view of family history, genetics, imaging, pathology, and medications—so patients can shift key health markers before problems escalate.

Kothari’s path to that mission starts with a consistent search for environments that match four needs: people to learn from, growth and speed, and deep mission alignment. Restaurants and ice cream businesses offered speed and teams, but lacked the growth pace and mission fit of high-growth startups. At Airwallex, he found a closer match on speed, growth, and mission. Everlab is the first place where all four align—especially the mission, which is personal given family history of heart disease, including his father’s quadruple bypass.

The product experience is designed around proactive care rather than one-off checkups. Everlab begins with an onboarding consultation where clinicians build relationships with members, gather family history and genetic profiles, and collect health data into a single app. After onboarding, members complete testing; results flow back into the app, updating risk profiles. From there, patients work with their doctor on concrete next steps aimed at moving the “markers that matter,” turning risk into an actionable plan.

Operationally, Kothari runs the business through daily signal gathering and direct patient contact. An AI agent reviews tickets and member interactions to surface what people are happy about, unhappy about, and what drives perceived value. Each morning he checks those patterns, then calls three to four members per day—mixing satisfied and dissatisfied customers—to understand what went wrong and what could be improved. That combination of automated pattern detection and human listening is presented as a practical way to keep the organization aligned with patient needs.

Decision-making within Everlab’s small co-founding team follows clear “swim lanes” and function-based decision rights, with a culture that supports disagreeing and committing. Healthcare trade-offs are handled with a strict rule: never compromise on quality, even if that means slower timelines or higher costs. Hiring for “radical generalist” ownership of the messy middle emphasizes humility and energy, not just experience—because the intensity is driven by both mission urgency and the responsibility of patient safety.

On AI, Kothari draws a hard boundary: automation can assist workflows, but it can’t replace the human empathy required for conversations where patients learn they have cancer or serious heart disease. The company’s recent fundraising also ties back to operational discipline and tooling; Everlab used Notion for fundraising materials and now uses Notion databases to pipe CRM and support data into queryable dashboards powered by Notion AI. The takeaway for founders is blunt: building is lonely, so create networks outside the company and ask for help early—because many answers already exist beyond one’s own team.

Finally, Kothari’s “start again” lesson is about scaling earlier. In the search for product-market fit, Everlab was cautious about overinvesting; he now believes the company should have expanded more aggressively—moving from “found signals” to “backing ourselves” sooner to reach the same outcomes faster.