Lay of The Land

Akram Boutros — Founder and CEO of Nexus Bedside. Akram brings more than 30 years of experience as a healthcare leader, executive, and clinician. He previously served as CEO of The MetroHealth System in Cleveland from 2013 to 2022, where he led a team of more than 6,000 employees and 3,500 medical staff, overseeing a nearly billion-dollar revenue operation and the complete transformation of the MetroHealth campus and care model. Prior to that, Akram held senior leadership roles at multiple health systems across the country, and he began his career as a physician, earning his Doctor of Medicine from SUNY Downstate Health Sciences. Akram is also a serial entrepreneur. In 2025, he raised a few million dollars of seed capital to found Nexus Bedside—a company reimagining inpatient nursing staffing and working to fundamentally improve outcomes for patients, nurses, and health systems overall. In this conversation, Akram and I unpack his full journey and perspective on healthcare and entrepreneurship—from immigrating to the U.S. and becoming a physician, to his decade leading MetroHealth, to navigating a public and controversial departure from the public health system, and ultimately experiencing the healthcare system as a patient himself. We explore how these experiences shaped his decision to start and build Nexus Bedside, his philosophy on leadership, lessons learned as an entrepreneur, the massive opportunity for AI in healthcare, and what he believes the future of inpatient care and nursing should be. Please enjoy this awesome conversation with Akram. 00:00:00 - Introduction00:03:40 - The Journey of Akram Boutros, MD00:08:45 - Formative Experiences and Lessons Learned00:13:57 - The Complexity of Running a Health System00:19:08 - Defining the Ideal Health System00:25:42 - The Birth of Nexus Bedside: A New Approach to Nursing00:30:54 - Optimizing Patient Care Through Technology00:35:40 - Business Model and Client Success00:42:10 - Entrepreneurial Lessons in Healthcare00:46:44 - Building Nexus in Cleveland00:52:12 - Reflections on the Journey ----- LINKS:https://www.linkedin.com/in/akramboutrosmd/ https://nexus-rn.com/ ----- SPONSORS: Roundstone Insurance Roundstone Insurance is proud to sponsor Lay of The Land. Founder and CEO, Michael Schroeder, has committed full-year support for the podcast, recognizing its alignment with the company’s passion for entrepreneurship, innovation, and community leadership.Headquartered in Rocky River, Ohio, Roundstone was founded in 2005 with a vision to deliver better healthcare outcomes at a more affordable cost. To bring that vision to life, the company pioneered the group medical captive model — a self-funded health insurance solution that provides small and mid-sized businesses with greater control and significant savings. Over the past two decades, Roundstone has grown rapidly, creating nearly 200 jobs in Northeast Ohio. The company works closely with employers and benefits advisors to navigate the complexities of commercial health insurance and build custom plans that prioritize employee well-being over shareholder returns. By focusing on aligned incentives and better health outcomes, Roundstone is helping businesses save thousands in Per Employee Per Year healthcare costs. Roundstone Insurance — Built for entrepreneurs. Backed by innovation. Committed to Cleveland. Cerity PartnersCerity Partners, a full-service investment and wealth management firm serving high-net-worth individuals, entrepreneurs, and business owners, is proud to sponsor Lay of The Land. The firm has local roots in Cleveland and across Ohio, and like this podcast, Cerity Partners advisors specialize in serving the interests of local entrepreneurs and business leaders. They understand how to manage the total picture of wealth, both personal and professional. Cerity Partners has a unified team of specialists who collaborate on almost every aspect of a client’s financial life, including business ownership. The firm’s national presence means it can offer the resources and specialized knowledge of the largest institutions with the independence and service of a neighbor. The Cerity Partners Cleveland team understands the complexity that comes with wealth, and they adhere to fiduciary standards. Discover the financial lay of your land. Learn more at ceritypartners.com/NPR or call 216-464-6266. ----- Stay up to date by signing up for Lay of The Land's weekly newsletter — sign up here: https://layoftheland.ck.page/5f0c1e28fa Connect with Jeffrey Stern on LinkedIn — https://www.linkedin.com/in/jeffreypstern/ Follow Lay of The Land on X @podlayoftheland https://www.jeffreys.page/