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In November, I had the pleasure of sitting down with Zach Ziegler, co-founder and CTO of OpenEvidence, at our GV AI Builders event for a truly candid and honest conversation in front of dozens of entrepreneurs at different stages of the founder journey. We discussed the emotional toll of building an early-stage founder, Zach’s prediction for the next big AI inflection point (hint: agents that operate in the world), and how they manage rapid change by focusing on product value regardless of the underlying LLM engine. OpenEvidence is an incredible example of AI’s power to solve mission-critical problems, having grown from 10 million to nearly 18 million clinical consultations per month in just the last few months. More than 40% of U.S. physicians now use the platform for clinical decision support. What’s truly astonishing is how Zach and the team achieved this trajectory, especially within the famously challenging healthcare sector.