How Artificial Intelligence Helped a Man and His Brother Build a $1.8 Billion Company
Imagine building a company projecting $1.8 billion in revenue with just two people on the team.
Sounds like science fiction, right?
But that is exactly what Matthew Gallagher, 41, did when he got his startup off the ground in just two months, with $20,000 in his pocket and over a dozen artificial intelligence tools working for him. From his home in Los Angeles, Gallagher used AI to write the software code that powers the company, produce the website copy, generate images and videos for ads, handle customer service, and even analyze business performance in real time.
Medvi, a telemedicine platform focused on GLP-1 weight loss medications, has become one of the most surprising business stories in recent memory. Not because of the product itself, but because of how it was built and the absurd speed at which it scaled.
In its first month of operation, Medvi landed 300 customers. In the second month, another 1,000 joined. In 2025, the first full year of operation, the company recorded $401 million in sales and accumulated 250,000 customers. And all of this with just one employee besides the founder: his younger brother, Elliot. 🚀
What once seemed like a distant prediction from Sam Altman, CEO of OpenAI, about billion-dollar companies with a single founder, is starting to take shape in the real world. In 2024, Altman said on a podcast that a one-person company worth $1 billion would have been unimaginable without AI, but that it would happen. In an email to The New York Times, Altman said he apparently won a bet he made with fellow tech CEO friends about when such a company would emerge, and that he would like to meet the guy who pulled it off.
And the Medvi story raises a question nobody can ignore: what changes when two people can do what used to require hundreds?
The Journey of a Born Entrepreneur
To understand how Gallagher got here, it helps to go back a bit. He had an itinerant childhood, living in motels and cars for a stretch before settling in Cincinnati at age 12. That is where an uncle gave him a laptop, and he used it to teach himself programming, building a Weird Al Yankovic fan page.
Still a teenager, he started building websites for local businesses. He always had an entrepreneurial spirit, selling candles and samurai swords on eBay. At 18, he sold a web hosting business for $6,000. He briefly attended the University of Cincinnati and Northern Kentucky University but did not graduate from either.
In 2010, he moved to Los Angeles with dreams of becoming an actor. He ended up going back to programming and bouncing between tech jobs. In 2016, he founded Watch Gang, a startup that sold watches through a subscription model. The company had fans, but it never turned a profit, even as Gallagher chased revenue growth and hired 60 people.
That experience with Watch Gang deeply shaped his view of how companies should operate. Having 60 employees did not help the company grow, according to him. It only increased costs and slowed down decision-making because there were more people in the way. That lesson stuck with him and directly influenced how he structured Medvi years later.
When OpenAI launched ChatGPT in 2022, Gallagher started experimenting with AI. Two years later, he met Jiten Chhabra, co-founder of CareValidate, a medical startup out of Atlanta that essentially offers a plug-and-play telemedicine kit. Companies looking to sell prescription medications can use CareValidate’s technology and network of online doctors to set up a business. The software connects patients to doctors and pharmacies, which prescribe, package, and ship the medications.
Gallagher saw the opportunity immediately. He could use AI to handle branding and marketing while platforms like CareValidate and OpenLoop Health took care of doctors, pharmacies, shipping, and compliance. It was the perfect combination. 💡
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How AI Became the Real Engine Behind the Operation
Matthew did not have an army of developers, designers, or product managers. What he had was a clear vision of where he wanted to go and a set of artificial intelligence tools that turned every hour of work into something exponentially more productive.
To build the Medvi website, he used ChatGPT, Claude, and Grok. He created custom tools, including AI agents — bots that execute tasks autonomously — to make his software systems talk to each other. He tested voice tools from ElevenLabs and others to communicate with customers. And he used the image and video generators Midjourney and Runway to create visual content for the website and ads.
From day one, the strategy was simple: automate everything that could be automated and focus human energy only on what truly required judgment and creativity. AI tools generated the platform code, others handled patient support, and still others optimized marketing campaigns in real time, adjusting budgets, copy, and targeting without constant manual intervention.
What stands out about this model is not just the operational efficiency, but the speed at which decisions were made and implemented. At a traditional company, a change to the customer service workflow would go through meetings, approvals, testing, and feedback cycles that could drag on for weeks. At Medvi, it happened in hours. Artificial intelligence did not just replace labor — it compressed the time between idea and execution in a way that redefines what it means to be agile in today’s market.
Gallagher even created an AI clone of his own voice to manage his personal life. He used the clone to make calls and schedule appointments, freeing up more time to work on Medvi. He basically works on the company every waking moment he is not sleeping, showering, or spending time with his two kids.
That layer of personal automation was just as important as any other in making sure the startup grew without losing direction. As Kobie Fuller, an investor at Upfront Ventures who advised Gallagher, noted, not everyone can build a company like this powered by AI. Gallagher has the rare combination of knowing marketing and mastering cutting-edge AI tools, which functions as a superpower right now. 🤖
Stumbles, Hallucinating Chatbots, and Sprinting Home
It was not all smooth sailing, of course. The initial Medvi website featured smiling model photos that looked AI-generated and before-and-after weight loss photos pulled from the internet with altered faces. Some ads had that unmistakable look of carelessly generated AI content. A scrolling ticker with logos from major media outlets gave the impression that Medvi had been featured on Bloomberg and The New York Times, when in reality it had only advertised on those platforms.
The customer service chatbot also had issues. Sometimes it made up prices for medications, and Gallagher honored those fictitious prices. Other times, the bot hallucinated and told people Medvi sold hair loss medications when that was not true at the time.
In a fun test, Gallagher asked the customer service system for lasagna recipes, and the bot happily provided them. It took a while to fine-tune the AI to stop going off-script and focus only on what mattered for the business.
If any customer wanted to talk to a real person, the chatbot had been trained to transfer the call directly to Gallagher’s personal cell phone. This resulted in over a thousand customer service calls landing in his pocket. To manage that volume, he integrated programs from OpenLoop and CareValidate that took over answering the calls.
There was also an episode last March that perfectly illustrates the risks of running with such a lean team. Gallagher made a small change to the Medvi website and went out for a walk. In the middle of the trail, he got a call from one of his media agencies asking if it was not strange that there had been no orders in the past hour. He realized the update had broken something on the site. With nobody else to fix it, he sprinted home. The downtime cost roughly 200 potential customers.
As the operation grew, Gallagher gradually moved from makeshift solutions to more professional structures. He swapped LegalZoom for a real law firm. He replaced AI accounting tools with an accounting firm. He hired media agencies to help buy ads and attract customers at a larger scale.
Telemedicine as Fertile Ground for Rapid Growth
Choosing telemedicine as the vertical was no accident. The digital health market has exploded in recent years, especially after the pandemic, and the GLP-1 weight loss medication segment gained massive traction with the popularity of compounds like semaglutide and tirzepatide. Americans wanted cheap GLP-1s delivered to their door without having to visit a doctor’s office. Medvi started charging from $179 for the first month of medication, in line with competitors.
Gallagher was entering an established market. For nearly a decade, companies like Hims and Hers Health, Ro, and others have been selling medications for erectile dysfunction and hair loss online, using doctor networks to prescribe. Hims, which went public in 2021, has 2,442 employees and generated $2.4 billion in revenue last year. Both Hims and Ro had already expanded into GLP-1 medications, but Gallagher believed he could do the same thing faster and more efficiently with AI and on-demand doctor platforms.
The telemedicine model fits perfectly with an operation powered by artificial intelligence because much of the patient journey can be structured, standardized, and automated. Scheduling, medical history intake, results delivery, follow-up reminders, and even parts of post-consultation support are processes that AI can manage with high quality and virtually unlimited scale.
Medvi’s growth also benefited from a regulatory window of opportunity in the United States, where rules for remote prescribing were relaxed during the pandemic, and in some cases, that flexibility stuck around. Gallagher knew how to capitalize on that moment, scaling patient acquisition with digital campaigns highly optimized by AI before the market got more congested and expensive.
What the Numbers Reveal About the Future of Startups
$401 million in sales in the first full year of operation with a two-person team and a net profit margin of 16.2%, equivalent to $65 million. That number is not just impressive — it is a signal of how the startup concept is being reinvented. Hims, with its more than 2,400 employees, had a net profit margin of 5.5% over the same period. The comparison speaks for itself.
For decades, the Silicon Valley playbook was to raise millions in funding, hire dozens of people, build out infrastructure, and then try to scale. Medvi flipped that logic entirely: scale came first, and the structure stayed intentionally lean. The startup raised no outside funding and has no official market valuation, but its revenue and profit numbers put it in a tier that many highly valued tech companies would dream of reaching.
This model has profound implications for the tech entrepreneurship ecosystem. If a single person with the right tools can run a company generating hundreds of millions in revenue, then the role of venture capital, mass hiring, and even traditional corporate structures needs to be rethought. When Gallagher asked investor Kobie Fuller whether he should pursue venture capital, Fuller told him that if he did not need the money, he should not raise it. Gallagher later thanked him for the advice.
And this wave is not only hitting the startup world. Major tech companies like Pinterest and Block have cut thousands of employees in recent months, citing efficiencies brought by AI. The barrier to creating something with major impact has never been lower for those who know how to use the tools available.
Expanding in Every Direction
Gallagher is reinvesting part of Medvi’s profits into expansion. He considered acquiring companies that offer other health products but decided it was just as easy to build them himself.
In February of this year, Medvi started selling men’s health products, including erectile dysfunction medications. That segment reached 50,000 customers in its first month and is on track to surpass the GLP-1 business within four months, according to Gallagher.
Last month, the platform added healthy meal delivery plans, managed by OpenLoop. Next steps include women’s health — including hormone therapy medications — as well as hair growth products, supplements, and skincare.
The company’s total revenue in terms of accumulated profit came in between $70 million and $80 million, numbers that left Gallagher emotional given his humble beginnings.
For the first time, I am not in survival mode, he said.
Last year, he set up a foundation with $1 million and made donations to a cat rescue organization in Los Angeles, with plans to also give to a group that helps homeless youth. His goal is to direct most of Medvi’s profits through the foundation. For fun, he invests in movies and buys historical items, including an 18th-century pocket watch.
The Human Touch That AI Still Has Not Replaced
Despite all the automation, Medvi discovered that some human touch is still necessary. In September, the company started assigning human account managers to a subset of customers. When those customers call, text, or email with a question, they connect with the same manager every time. The idea is for those managers to get to know the customers and remember details like birthdays or kids’ names, creating a more satisfying experience.
Medvi now has seven account managers, all hired as contractors, each serving several hundred customers. And how do they manage that many relationships at once? Using AI, naturally.
Gallagher does not plan to hire more people. He said he simply does not see how it would help Medvi at this point. But he admitted he misses the camaraderie of having coworkers.
At this point, I kind of want to hire people because I am lonely, he said.
When asked about the story he has built, Gallagher was blunt: I mean, it is crazy, right? And then he answered himself: It is crazy.
Radical Efficiency: The New Competitive Edge
The Medvi story reignites a debate the tech industry has been conveniently avoiding: maybe the problem with many companies is not a lack of talent or capital, but rather an excess of organizational complexity. When you have two people making decisions, communication is direct, alignment is almost automatic, and execution is fast. There is no office politics, no unnecessary meetings, no layers of approval slowing down what could be done in minutes.
The efficiency Gallagher achieved is not just technological — it is structural. The failed experience with Watch Gang, where 60 employees could not generate a profit, stands in stark contrast to Medvi, where two people and an arsenal of AI tools produce profit margins that outpace competitors with thousands of employees.
Of course, this model has its limitations. There are regulatory, medical compliance, and clinical liability aspects that demand specialized human attention and could become bottlenecks as the operation grows. The startup will likely need to expand its team in critical areas as legal and operational requirements increase with scale. But the central point Medvi demonstrates is that the threshold for hiring more people has shifted dramatically higher than it used to be. With artificial intelligence absorbing functions that previously required entire teams, the moment to grow the human headcount can be delayed considerably without compromising quality or speed of operations.
As CareValidate and OpenLoop confirmed to The New York Times, Medvi quickly became one of the largest clients of both platforms. Jiten Chhabra of CareValidate said he always asked Gallagher if he had an army of people hidden somewhere. The answer was always no. Jon Lensing, CEO of OpenLoop, said Gallagher’s native language seems to be AI, and that he started sharing tech tips with OpenLoop itself.
At the end of the day, what makes Medvi’s trajectory so relevant for anyone following the worlds of technology and artificial intelligence is that it is not a theoretical experiment or an isolated stroke of luck. It is a practical demonstration, with real numbers verified by The New York Times, that the promise of AI as a multiplier of human capability is being fulfilled right now, in this moment, in real companies. And that changes how entrepreneurs, investors, and even tech professionals need to view what is possible to build with limited resources and the right tools. 🎯
As Gallagher himself put it: Medvi is not an AI company, but he built it with AI. And that might be the most important detail in this entire story.
