Inside the AI Startup Tackling the U.S. Radiologist Shortage - Rustin Rassoli

What kind of founder decides to build a full radiology practice, an AI research lab, and a software company - all at once?On this episode of the 1st10 Podcast, Boris Epstein sits down with Rustin Rassoli, founder of Epsilon Labs to talk about why solving the U.S. radiology crisis requires breaking the rules of traditional healthcare tech. Rustin recounts his early entrepreneurial experiments, the lessons learned at Atomic VC, and the childhood experiences that exposed him to the failures and bottlenecks inside medical imaging. He details how Epsilon manages a daily throughput of 500+ patients, why existing AI models fail at medical imaging, and what it really takes to build a hybrid org where radiologists, ML researchers, and world-class engineers operate as one unit. Rustin’s unconventional path led him from drop-shipping at age 10, to cold-DMing his way into venture studios, to tackling one of healthcare's most critical problems. And he’s now betting that his integrated 3-in-1 approach might be the only viable path to solving a medical crisis accelerating toward disaster.Inside you’ll find answers to some fascinating questions, such as:Why a "normal" AI startup approach simply cannot solve one of healthcare's fastest-accelerating failures. How a childhood insight inside an imaging center quietly shaped a multi-layered startup strategy years later. What happens when engineers and radiologists attempt to collaborate without speaking the same language. Which single overlooked bottleneck has the potential to determine whether AI can meaningfully affect patient outcomes at scale. Why Rustin believes a tectonic shift is coming for AI startups - and why most won't survive it. Specifically, don’t miss the part where Rustin shares candid views on the current AI bubble. Spoiler alert, he isn’t very happy with Silicon Valley and its ‘throw-cash-at-everything’ VC culture!Chapters00:00 Introductions02:16 An Unexpected Origin Story05:18 Learning the Hard Way in Zero-to-One Land08:31 "Getting the First Job" Might Be the Wrong Goal12:15 The Radiology Crisis Is Impossible to Ignore17:14 What Happens When Demand Explodes and Supply Collapses20:41 Solving This Problem Requires Building a 3-in-123:07 The Strange Dance Between Radiologists and AI Engineers27:52 "Just Make the Model Better" Isn't How AI Works31:46 Medical AI Accuracy & Hidden Technical Battles35:56 Building a Team for an "Impossible" Mission38:47 A Brutal Reality of the AI Talent War41:53 Predictions for 2026 (HINT: The Bubble Must Burst!)Quotes:"I want my tombstone to say, 'This guy solved the radiology shortage and did some other kind of impactful things with medical imaging.'" (16:43) "I think engineers don't fully appreciate how nuanced radiology is and the fact that it's not binary. And a Radiologist A can be very kind of differently opinionated on something than Radiologist B." (28:08) "99% of what's being created today is not very valuable to the world." (39:25) Follow:Spotify: https://podcasters.spotify.com/pod/show/1st10podcast Amazon: https://music.amazon.com/podcasts/7e8ec9af-f38c-4cd9-8c68-1c1dd4516b 27/1st10-podcastApple: https://podcasts.apple.com/us/podcast/1st10-podcast/id1760411207 Podcast: https://www.1st10.com/podcast YouTube: https://www.youtube.com/@1st10podcast Links:Music by Roman Senyk from PixabayProducer: Shrikant Joshi