You are Inés Cabrera-Folch, 44, founder and CEO of Vidalia Salud for seven years. The board chair Roser Esteve has said it cleanly: "We love what you've built and we think you should have someone help you run it." Three concrete proposals are on the table. None of them are obviously right.
The situation
Vidalia Salud is a Barcelona-based digital-health platform for chronic-disease management — telehealth visits, remote monitoring devices, AI-assisted titration, integration with five regional public-health systems and seven private insurers. 180 employees. €28M ARR (up from €8M two years ago). Series C of €40M closed in October, led by a Madrid-based health-focused fund; Roser, your earliest backer, remains chair.
You have been founder-CEO since 2019. You used to run product, sales, fundraising, partnerships, hiring, and crisis-of-the-week. At 60 people that was sustainable; at 90 it was barely sustainable; at 180 you are clearly the bottleneck on three things at once. Last month your VP Engineering and your Head of Partnerships both raised the same complaint in their 1:1s: "I can't get a decision from you fast enough."
Three concrete proposals sit on your desk. External "professional COO." A recruiter has lined up two candidates: a former Teladoc regional president and a McKinsey-then-Babylon-Health operator. The Sandberg model. Internal promotion. Marta Aguilera-Vinyals — your VP Operations, person number 15 at Vidalia, has run patient-ops and provider-ops for four years, is universally respected by the team, and is the only person who shadows your customer calls. Stay solo-CEO + Chief of Staff. Add a strong CoS to reclaim your time, restructure your calendar, and hire functional VPs deeper — keep the single operating point at you. Roser leans toward the external hire. Your husband, who has watched you for seven years, leans toward Marta. You don't know yet what you lean toward.