Pivot - The future of travel and a Friend of Pivot on telehealth

Episode Date: March 16, 2021

Kara and Scott talk about the biggest weekend for airlines since the pandemic started and what that means for the industry. They are joined by Hims/Hers CEO Andrew Dudum to talk about how telehealth surged in the past year and his decision to take the company public as a SPAC. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Bose is a registered trademark of the Bose Corporation. Hi, everyone. This is Pivot from New York Magazine and the Vox Media Podcast Network. I'm Kara Swisher. And I'm Scott Galloway. Yeah. Scott, what's new? Anything going on? You know, absolutely nothing in my life, Kara. I'm trying to think, what have I been up to?

What have I been up to? Rebecca, cue the music. Oh, that's right. Who's destroying the cable bundle single-handedly? Is it a bird? Is it a plane? No, it's not even a jungle cat who has been on Bill Maher twice before me. It's the dog, Kara. After 30 years of working my ass off, I'm an overnight success. An overnight success. Okay. All right. Stop the music, Rebecca. It's actually three times.

But nonetheless, that was an amazing thing. I have to say, I have to hand it to you. They had never gotten a dose of Scott Galloway, and you decided to go full on Scott Galloway. It was amazing. You went nuts. So rather than me going on about you, let's listen to you on Bill Maher.

Capitalism is hands down the best system of its kind. When young people are saying today it's not capitalism, we have rugged individualism on the way up. And then we have we're all in this together on the way down. And we have socialism. Capitalism on the way up where five CEOs of airline companies make 150 million bucks, use all their excess cash flow to buy back stocks so they can artificially inflate their own compensation. And then shit gets real and a pandemic comes and they don't have any money. And all of a sudden we're in this together. When you have capitalism on the way up and you have socialism on the way down, I'm not done yet. And then you have socialism on the way down.

That's not capitalism or socialism. It is cronyism. It is the worst of all worlds. Capitalism, socialism. It is cronyism. It is the worst of all worlds. Capitalism, capitalism is full body contact violence at a corporate level so we can create prosperity and progress that rests on a bed of empathy. We have flipped the script here. We need to be more loving and empathetic with people and more harsh on companies. Capitalism, we are protecting. We should be protecting people, not companies. Fucking Delta, burn yelled a little bit you were emotional the whole thing it was it was a perfect it was i thought i was gonna throw up i'm not kidding before the show i was so fucking nervous i thought i was well next you'll be on again you'll be on again i think unless you bill you pissed bill off i couldn't tell actually one of your one of your muckety muck friends who's

like big in the world of pr called me and go, two things. First off, you did great. Second, you'll never be invited back because- You upstaged him. Well, in so many words, but I didn't think that was true at all. I watched the whole thing. You did. He's got an ego on him. I was really nervous about it. Maybe he should have us both on. He wouldn't do that. He would be finished. We'd take over the show and we'd just be hired by HBO. No, Kara, I'll tell you what. We should have him on.

We have Bill Maher on. We have Bill Maher on. That's a good idea. We'll have him on. Okay. So one thing that's interesting, someone I'm going to have on the show soon, is Christie's Auction House named the buyer

of the $69 million digital artwork. That buyer was MetaKoven, a founder and funder of MetaPurse, the largest NFT fund in the world, another Bitcoin boy, essentially. So we're going to have someone next week on to explain, one of Scott's NYU colleagues, to explain NFTs and other cyber currencies. The Bitcoin's going up again.

It's all being, you know, it's a lot of Bitcoin bros buying this digital art too to keep it going. But I think it's fascinating. I think it's not a, I don't think it's a Ponzi scheme whatsoever. I think it's showing how you use these things. And in some cases, there'll be fraud and others not so much.

Yeah, it's just never underestimate the market's ability to find products when people have cash in their hands. And this notion of creating just fascinating kind of artificial, digital-inspired assets or scarcity. And then creating a currency where two people agree that something is worth something. It feels like a lot of speculation right now. It does. A lot of people are- But what isn't speculating? Like I was just thinking, I was trying to explain to my son.

And so he's like, oh, you can get, he has of course obsessed with the basketball ones, but he's like, I can get those clips anytime. And I said, but you don't own them. Like you don't own the clips. You, you, you, you can get them. And so what I was sort of interested in, I was like, you don't own the Mona Lisa, but you can have a picture of it on your wall and you can buy, you can take a picture and you can look at it, but someone owns it somewhere.

So I don't, you know, it depends on how they can monetize it and what it trades at. So I think of it that way. Like, what is a painting worth? Why is someone painting worth something and another not worth something? You know, I don't know. Well, art has outperformed every asset class because it's not only a store of value, but it's also consumption. Usually it's one or the other. A store of value is like a T-bill, a treasury, and you don't get to enjoy it a store of value or something you consume you know a car whatever it declines in value so art has been this fantastic a lot of people get a lot of reward from

it it's also been a fantastic store of value and so art art has outperformed almost every asset class and the idea of putting kind of some sort of bitcoin like secure ownership on top of a digital asset is an interesting idea. It's not Bitcoin. It's blockchain. Yeah, that's, yeah, absolutely. Yeah, it's interesting. I think it's fascinating.

I mean, I was just, for some reason, I rewatched Tenet the other day because I was still trying to understand it. And remember, there's a whole scene in an art place without taxes. They have the art stored securely. Anyway, like, what is, I just think of, what is anything worth? This is my new feeling of everything. What have the art store securely. Anyway, like what is, I just think of what is anything worse? This is my new feeling of everything. What is anything worse?

Value. Value. Like what is your value? Could I sell you in some way? Like, like a Bitcoin version of you, a digital version of Scott's many rants, for example. Cause like this, this guy who's a, who's a football players doing it. Well, I was thinking we should put an NFT on top of one of our most downloaded podcasts and see if we could raise money for charity. I think there's going to be a lot of interesting applications.

Let's think of something. Let's make an NFT. We'll do something like that. Maybe all your different rants of various kinds and stuff like that. Anyway, it's a fascinating time. Scott, really, congratulations. You did a beautiful job.

I'm going to be not going to make jokes at you. I'm not going really, congratulations. You did a beautiful job. I'm going to be not going to make jokes at you. I'm not going to do anything. You did a great job. Your sweater was nice. You were dressed well. You looked good. You looked smart. I have to say.

Go on. Go on. Thank you. I was very impressed because it could have been a frigging disaster. I was expecting a possible disaster, I'll be honest. Oh, there was a non-zero probability this was all gonna come to an end on HBO. I was literally like, oh shoot. You were nervous, you were more nervous than me.

A little bit, I'll be honest. I'm like, what's he gonna say? Was he gonna cancel us? He's gonna cancel us a little bit. And I'm like attached to him, like at the hip. Oh God, I'm going down like the tight. Except, you know, it'll be like, you know when Leonard DiCaprio was hanging on that thing

on the door that Kate Winslet was on? Remember that scene at the end? Hanging on the door? You mean Titanic? Titanic at the end, when they're at the end. Yeah, when he's about to drown and she just lets him go. She lets him go. Oh, no, you're going down with me, by the way.

No, no, I'm staying on the door. I was like, how do I stay on the door? So just two words, Kara. Two words. My heart will go on. First word, suicide. Second word, pact. We are in this together.

Oh, no. You ride with the dog, you die with the dog. No, I am Kate Winslet on the door. That is who I am. I'm just saying. I love you, but goodbye. Freeze to death in the depths of the North Atlantic. But I love you, goodbye.

You know, they both could have gone on that. I'm women and children first. I'm on the first boat out of there. There's Rebecca. That's right. 100%. All right. We're going to go on to big stories.

Air travel is surging this week with vaccine. People taking the vaccine are starting to feel free to move out the country. Let's talk about the reopening of American travel. Over the weekend, TSA officers screened the highest number of passengers on a single day since March 15th of last year. The reduction in travel hit airlines hard last year. U.S. airlines lost more than $35 billion combined. On the other hand, a smattering of colleges like Yale University are canceling spring break this year in an effort to keep students from traveling to hotspots like Miami Beach. All right. What do you think? I'm students from traveling to hot spots like Miami Beach. All right. What do you think?

I'm thinking of traveling. I've gotten my vaccine. Not until, of course, it's all in. But what's going on, Scott? What do you think is going to happen now? It's both super exciting and also we don't want to acknowledge this. It's also frightening. Duke just canceled classes.

They have an outbreak there. Yep. This is what Fauci said was going to, Dr. Fauci is going to these little outbreaks. It's happened in other countries too. Well, and we don't want to acknowledge this, but, and this is why it's so important we get vaccinated. I see it as a race between vaccinations and variants. Viruses are incredibly impressive pathogens, organisms. I don't know what the correct term is. And you can bet that this virus is working overtime to try and figure out a way to get around these vaccines. Yeah. And when we have people traveling and we create more opportunities for asymptomatic carriers, you just you're kind of I don't want to say you're arming the variants.

But I think this is a very nervous time because if you want to see a crash. Yeah. That would affect everybody. If all of a sudden there's an outbreak right of a variant that appears to that that resists the vaccine that is when gets real for us i mean it's gotten really real it's a half a million but all of a sudden it looks like wow we could go from half a million deaths to five million and you'll see the econ you'll see the economy the economy wouldn't won't be able won't have any kevlar against that. So look, I'm a glass half empty kind of guy.

Right. I think it's exciting that people are traveling. It's a good sign that people want to get out. There's no doubt about it. This is going to be the roaring 20s if we continue to see progress. Agreed. Look at the stock market. Look at the stock market's roaring.

I think it's interesting to see what happens. What would be interesting to see if U.S. airlines actually change their practices, like in terms of how they behave and operate their businesses? The second thing is, I just talked to Airbnb's Brian Chesky for Sway coming up. And, you know, one of the things is he has pivoted his business, obviously, but his will, that business will go right up. You had talked about that because people were moving closer to home, but now they're seeing an upsurge in traveling, he said. Not

internationally yet, but in the country and stuff. It's going to be, you know, I think that I mean, I love Airbnb, but it's going to change. We're just going to change so many ways. We're going to return to travel, but I think we're going to travel differently. He said no business travel. He wasn't focused in on at all he said it's over business travel is going to get business travel is going to get crushed that's what he said it's yeah it's just it's just we've realized i have several friends who do nothing but kind of circle the planet raising money from sovereign wealth funds and they say say they'll still go to Canada to meet with

Ottawa teachers. They'll still go to the Gulf or wherever, but they'll go once a quarter instead of once. I mean, they're just off planes because everybody has learned new technologies and is comfortable. And I think the same thing, I wonder what's going to happen. I think travel is going to be reconfigured. I think people are going to spend as much money, but they're going to spend it. They're going to crowd it around leisure travel and consumption and travel with their families. That is precisely what Brian said. He said he doesn't think business travel is going to come back in ways that people think people have changed the way, you know, he had talked about their own headquarters, you know, that they had made these beautiful headquarters. And he's like, you know,

I rethink everything now. Like, not that he's not going to make it available and people want to go in, it's temperature, but it's going to be a much different strategy. He that he's not going to make it available and people want to go in, it's 10%, but it's going to be a much different strategy. He said he's not going to go full hog like a lot of tech companies. At the same time, he feels like most of the investments his company should make should be in consumer travel. And he thinks that's going to surge. He thinks people are really dying to get out and stuff.

But they're not going back into airlines. Remember, they had an airline plot going on. So it'll be interesting. What do you think was going to airlines? And I have one other question about spring break since you're down in Florida. A lot of airlines will go bankrupt and they'll be reconfigured. Airlines in the United States have gone bankrupt or they call restructuring, I think, 62 times since the turn of the millennium. Airlines are famous for going bankrupt. And guess what? That's fine because it'll give another set of investors a chance to come in and try and reconfigure

and make airlines more resilient to these types of shocks. What would you do in that way? What would you do? Because of course, at the same time, the fact that travel is down, climate, the emissions are down, obviously. And there hasn't been a real, when I talked to Bill Gates,

he talked about a green fuel, essentially fuel that's made with less emissions or it's much more expensive. It has a real premium on it. Would you, they're not really going to invest in that, right? I mean, would you, or is that something everyone's like, look, emissions are down, people are traveling less. This is good for the environment.

Well, that's, it's two different issues there, how airlines reinvent themselves. But I think a big question for society and for all of us as individuals as it relates to our professional and all our personal lives, our relationships, our behaviors, this is a crisis, this is a terrible thing to waste. And what I say to my kids when I say my kids, my students, ask yourself, what are you going to leave behind? I mean, as a society, there were parts of the country where emissions were down 20, 30, 40 percent. And the question becomes, well, might that be something we want to hold on to even post-pandemic? And what would be required

to do that? It's an exciting moment to say, how do we leave emissions behind? I also think it's a really interesting exercise to say, what about my relationships with my children, my spouse, my parents, my friends, my coworkers was better and what was worse? And which relationships or behaviors do I leave behind? No, my baby, my young daughter, the first year, I would have been traveling quite a bit. I would have a hundred percent. Amanda and I talked about this and I have to say, I don to say, I want to travel more intentionally. I hate to use that word because I hate that word. That's right.

Just more intentionally. Do I have to do this? No. Can I do it via online? Yes. That kind of thing. I think it's turned out to be just fine. And it's kind of stupid trips where you travel somewhere.

I mean, Farhad Manjoo had a piece about this. He traveled one place to get in an argument with someone for an interview and it didn't even work and he came back and he was like, it was a waste of money, time and emissions. I mean, he could have done it a much different way. I track everything I do pretty meticulously. And my first business, Profit Brand Strategy, my biggest client was Audi.

And I used to commute every week from San Francisco to Munich and then get in a car and drive to Ingolstadt, Germany. strategy my biggest client was audi and i used to commute every week from san francisco to munich and then get in a car and drive to engelsstadt germany so i said i could spend one or two days with the cmo of audi trying to figure out what you know audi's purpose was or as a brand and i was commuting back and forth to germany and i last year in 2019. Like a 10 hour flight, 10, that's it, right? Oh, like 11. Yeah. And then, and then consulting is a young, a young woman's game.

It's, it's, it's a terrible lifestyle. Anyways, but in 2019, I did about, I did 41 speaking gigs and for 25 of them, I had to travel. And when I looked at the amount of money and the amount of miles I spent somewhere between 75 and 125,000 or my client spent that on just my travel. And in 2021, I will do somewhere between 70 and 80 speaking gigs and I'm not traveling. And I'm going to cut that entirely out of my life. If I can't go into my studio, turn on Zoom, then I just don't, I don't do it. I'm not going to the Radisson in Scottsdale. And when you think about what that means, not only is it a destruction in business travel, but I also think it's a real opportunity for mothers and fathers to spend more time with their kids, right? It's like, okay, I might give up a little bit of income, but I save a lot of

money, save a lot of emissions. And where do you reinvest that capital, right? Do you reinvest it in remote technology? Do you reinvest it in your family? Do you reinvest it in making more money? But it'll have, what's interesting about it is like all digitization, it'll have a really, it will have a negative impact. And that is the speaker circuit, which I'm technically on. There's sort of tier A. I'm familiar. There's tier A that gets, call it 60 to 200 grand for a speaking gig. And then there's tier B. And tier B is kind of 20 to 40. And there's a lot more of those folks.

Those folks are getting crushed because by going remotely, you take your prices way down. And so you can get tier A for what used to be tier B prices. And they're soaking up everything because they can do two or three gigs a week versus just one. And so it's like all digitization, there's big winners and the tier two or the tier B get crushed. Guess what? You just moved into tier A this week. You moved into tier A. Go on. Cable star, Cable, cable, HBO star. All right. That's right.

Tier A minus, I would say. Tier A minus. Tier A minus. Anyway. All right, Scott, let's go on a quick break. We'll be back with a friend of Pivot to talk about telehealth, which is just what we're talking about now. Fox Creative. This is advertiser content from Zelle.

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And when using digital payment platforms, remember to only send money to people you know and trust. their investment approach? What learnings have shifted their career trajectories? And how do they find their next great idea? Invest 30 minutes in an episode today. Subscribe wherever you get your podcasts. Published by Capital Client Group, Inc. We're back with our friend of Pivot, Andrew Dudum. He's the CEO and founder of HIMSS and HERS, a telehealth platform that connects people to healthcare professionals. Welcome, Andrew. Thanks for having me.

So tell me, I see your ads everywhere. Explain what you're doing, what the company does. You guys just went public via a SPAC in January, and I want to talk about that. And Scott will have a lot of SPAC questions. But talk about what you do, because you've made some big strides during the pandemic, for example. Yeah. You know, HIMS and HERS is actually relatively simple, which is to be the front door for people to come access healthcare. So from the comfort of your phone, you can go to

4hims or 4hers.com. You can pay between $ 20 and $30. You can access a specialist for things like dermatology, sexual health, anxiety, depression, a whole bunch of things you might be concerned with, and then get immediately connected to, you know, that doctor have a personalized treatment plan and have anything necessary to feel better and be well shipped to your door kind of an on monthly basis. So it's, it's really consumerizing and making accessible a really complex healthcare system, which is just brutal, really, in this country. Now, what do you do? Telehealth, do you have doctors on your platform? Are they doctors hired by you? Because there was an effort in San Francisco, and I'm totally blanking on the name,

you probably know it right away, that an ex-Google guy was doing, which is these sort of storefronts sort of for millennials, where people would have sort of, it was very digitally oriented. You'd go in, you'd see a doctor, it was beautiful looking, you know, sort of trying to consumerize the healthcare experience. What's the difference in what you guys do? So this is entirely digital. So we have a platform that connects doctors to you as a patient. So no matter where you are in this country, you could be, you know, in a rural, rural zip code of Nebraska, you can go onto the platform and get connected with literally a specialist in, you know, let's say post-pregnancy melasma, right? And actually have a real

consultation with best clinical care you could possibly get as if you were living in San Francisco or New York, but have it from the comfort of your home. So we're really this marketplace connecting world class physicians and specialists with patients that need us across the country. And how do you know they're world class? an entire medical organization, which is led by Dr. Patrick Carroll, who previously actually was the chief medical officer at Walgreens for five years, practicing physician for 30 or 40 years. And what we do is actually vet and train all of the physicians on the platform. So, they go through constant re-education, making sure that they're aware of kind of the best protocols for whatever they're specifically treating. They have to pass tests before they can even get onto the platform. And on average, you know, the doctors are experienced for 15 or 16 years in a hospital before they even get to him and her. So we pretty

much take the cream of the crop, then make them accessible to the rest of the country, all through a really beautiful and simple experience. And this is a really unique part. That's all cash pay. It's $20 or $30. It's something anybody can afford. And that price point is really important because that's a price point that in most situations is cheaper than people's co-pays on their insurance, right? People have insurance and they're covered, but they could pay hundreds of dollars just

to see a doctor given what's happening in the high deductible insurance plans in this country. So making it affordable and accessible, I think, is a really important part of our vision. All right, Scott. So first off, Andrew, congrats on your success. I think a lot of people acknowledge there's a huge opportunity here and that you're seizing it. How does a company like HIMSS build moats? You have technology, you have a customer base, you have a brand, obviously a bunch of components and execution, but assuming companies ranging from, I don't know, the largest health insurers to Amazon decide to get into remote or telemedicine, what are the moats that you're building that are going to sustain what

right now looks like a very healthy valuation? Yeah, it's a great question. You know, I think it's across, you know, a lot of the areas you talked about. The clinical care, making sure that, you know, we can really deliver personalized, customized care for every patient that comes on the platform. So, for example, in our skincare world, we have partnerships with compounding pharmacies so that we can get you literally the perfect personalized formula for your skin. So I think that clinical personalization really matters. The technology platform, at the end of the day, that's what powers this whole thing. So if you think about our numbers, it's kind of crazy. We, in the last three years, because the business is just 36 months old, have powered close to 3 million medical visits. And then if you look at the

largest competitors in the space, you look at Teladoc, for example, 30 or $40 billion public company, it took Teladoc 13 years for them to power just their first 1 million medical visits. And we did that in our first 12 months of operation. And the only reason that was possible was because we spent, you know, four or five years and hundreds of millions of dollars building essentially this digital workflow for physicians on one side and patients on the other, and then our own custom EMR in the middle that made it way easier for them to interact, for them to diagnose accurately, for us to have programmatic check-in with our patients that gave our doctors, you our doctors leverage on their time, but resulted in better adherence to medication.

So all of this technology is just new in healthcare. And from a regulatory standpoint, in the last couple of years, it's really now the first time you can even invest in this technology to allow patients and doctors to use it. And so that's a huge moat that when you think of the biggest healthcare companies in the world, they really just haven't built that yet. And so I think that's something we focus a lot on. And the same thing, you also tend to, you focused early on things like erectile dysfunction or skin with women, birth control and sexual health. So a lot of the ads were, felt very condom-y. I think, I don't know how to say it. It just was like that you had hair growth kits, skin, sex, birth control. Talk about that, why you decided to start there.

So they were relatively healthy people, just wanted to either look better or have more sex, essentially. You know what? There's a lot of people that want to look better and have more sex. I would argue it's probably most of the country. Spring break. That's right. You know, but it was actually a really intentional decision, which is, you know, I truly believe in the next 10 years, probably 80% of what we know is healthcare. You know, going into the doctors, waiting in line, getting a prescription at a pharmacy.

That's going to move to a digital first experience. 100%. Right. And if you think about that, 80% of a $4 trillion market, that's massive. So if we believe in the next 10 years, this whole industry is going to be completely revolutionized, digitized, mobile first, et cetera, beautiful. Well, you then need to go think about who's going to be the biggest paying customer in healthcare in 10 years from now, right? And in 20 years from now, be the biggest paying customer in healthcare in 10 years from now, right? And in 20 years from now. And it's not going to be my parents, right? Because, you know, their affiliation and awareness of technology expectations are so different from those in their teens and 20s and 30s who expect

everything on demand, everything price transparent, everything beautiful. I mean, they were just spoiled, right? By the consumerization of everything, right? It's at their fingertips. And so we felt if we needed to build the future of healthcare, we had to go and build it for the young generation because they're going to be the ones that are going to be the biggest spenders in healthcare in 10 and 20 years from now. And then when you go talk to those people, turns out the things that they really care about when they're in their 20s and 30s, when you're trying to build that relationship with them, is things like dermatology, anxiety and depression, sexual health issues, STDs, pregnancy. And so that's really where you see our core focus

in the beginning is building that loyalty with what we think is going to be the future biggest spenders in the healthcare system. So how do you get when they become creakier? is going to be the future biggest spenders in the healthcare system. So how do you get when they become creakier? What's the plan? Because then it becomes people do have to see doctors physically more frequently. Or maybe they don't. Well, I think a lot of things that affect the country in mass, you're talking about hypertension, hyperlipidemia, diabetes, weight loss, right?

You're talking about hypertension, hyperlipidemia, diabetes, weight loss, right? Those types of categories probably are the leading cause of 70 or 80% of death in the country. When you talk to physicians, most of them tell you it's actually really quite safe and standardized to treat those in a digital experience, right? You can have cognitive behavioral therapy apps that help you readjust your expectations of food, for example. You can have really safe online nutrition therapy and coaching for anxiety and depression. There are safe SSRIs plus CBT plus individual psychotherapy. So, I actually think there's this world where it really will be almost everything except for in-person procedural

work that will be done in a digital setting. And even those procedural works will start in a digital setting, and then you'll get referred into a specific brick and mortar institution. So, for example, in the last year or two, we've gone and partnered with Ochsner Health Systems, Sinai, Privia. These are large brick and mortar institutions insner Health Systems, Sinai, Privia. These are large brick and mortar institutions in the country. So those are in-person visits. Exactly, in-person visits. So when patients come to us and they need something that we can't offer them in our virtual experience, we can then refer them in via this really seamless experience into something that's brick and mortar to help them out.

Can I ask you two questions? I'll have another one. The business model involves a subscription that's about $20 to $30 a month and aimed at millennials and Gen Z who don't have insurance. Your main revenue comes from the sale of prescriptions, correct? Is that correct, essentially? So it's actually not. The main revenue comes essentially from the sale of a comprehensive treatment package. So it's about 80 or 90% of our revenue

is recurring, as you said. But with that treatment package, you get personalized medical consultations, unlimited consultations, you essentially have a doctor in your pocket. Which you don't use that much, right? That's probably like a jam, like people use it a lot less than... You know, for a lot of our conditions, they actually use it quite frequent. You're talking about something like anxiety and depression, and you're doing check-ins, right? Of like, how are you feeling? Is the medication working?

You change dosages. You might change a different medication. You might actually schedule a therapy appointment that week. So you actually have this kind of quarterback system in our experience where they're leading your treatment for this condition. And so that 20 or $30 includes that full-time doctor, the personalized treatment for whatever you need, both services and products.

And then on top of that, the delivery of the actual medications and products on a monthly basis. So it's really all encompassing, you know, to solve whatever issue you come into the door with. Scott? Yeah, look, this just feels like the biggest consumer business in the world, U.S. healthcare, that's undergoing the biggest disruption. It just seems like the opportunities here are just titanic, for lack of a better term. The question is, it feels to me like this is going

to be an arms race, that there are going to be a lot of deep-pocketed players come into this. And speaking of raising capital, you went public via SPAC. And I'm just curious why you decided to SPAC instead of a traditional IPO route. And if you could give us what you felt were the biggest surprises to the upside and to the downside about doing SPACing versus a traditional IPO route. Can I just put that in before you go on? Just so people know, you raised $280 million. About $75 million came from a private placement from investors.

And before, you had raised $158 million in venture capital, including from your own venture capital firm, Atomic, which I know pretty well. So talk about, so why SPAC? You know, we kind of approached it as a really just first principle debate, right, at the board level. And the board, including myself, you know, is very blue chip traditional Silicon Valley investors. You're talking founders fund, IVP, Thrive Capital. You know, these are not people who are taking huge, massive risks when it comes to structuring ideas like a SPAC. But at the beginning of last year, as we were planning for the traditional IPO process, working with the banks you'd expect us to be working with, prepping for that process, we started to learn about just the fundamentals of the SPAC structure, which, as you guys have talked about, has been around for a really long time, right? This isn't new. And tee them up against the traditional process. And when you look at it actually under the hood, despite, I think,

the fact that there are maybe an overabundance of companies going public right now, and there's too much capital, which is creating all types of perverse dynamics. If you actually look at the structuring of the SPAC, it's really advantageous for the team and for the company. You have a process that takes four to eight months instead of 12 to 18 months, right? Having raised hundreds of millions in capital over the last decade, I know the real distraction costs when my management team is raising capital instead of focused on my business. And an additional six months of them being distracted with a traditional IPO is a real cost that I took into the equation.

So I think that speed was really important. I think there's a degree of flexibility in structuring with SPACs that is really undervalued. So as an example for us, we raised that 75 million pipe, as you said, Karen, and we really explicitly wanted some funds that we'd gotten to know who were really big, long-term believers in our business to be in the business and to anchor that pipe. And with a SPAC, we could structure those dynamics appropriately. So, for example, Franklin Templeton, phenomenal public market fund, they really anchored the pipe for us. And for us, that was an important dynamic. And so with the traditional IPO, you have a little less control of your book, right? The banks are really managing this dynamic. And then lastly, you know, and this is hotly

debated, you know, it's the trade-off of the traditional roadshow and the excitement and the PR you get from that IPO. and in a lot of situations that pop with the real cost of that pop and whether or not you can get that roadshow and get that momentum in a less costly way. Because you had also been marketing, correct? Heavily. That's right. I'm so aware of you and I don't know why I ride in New York subways. Right. And so we're a business that people knew about in general. Our customers, we've been marketing to for a really long time. When you look at the actual historical costs of IPOs and working with the best banks that we would all expect to be working with,

there are real dynamics there on pricing where their clients are getting real upside. pricing and where their clients are getting real upside. And so what we decided to do with the SPAC because every other dynamic we really liked was have a real roadshow, you know, as if it was a traditional IPO, we met with, you know, 100 or 200 individual accounts and told the story and got people excited. But we could price the deal what we thought was a real practical price and an appropriate price. And so, you know, the stock has, you know, traded up and down and all over the place, just like the rest of the market, but it's up 50 or 60% on the IPO price. But we still felt like we priced it appropriately. And I think we would have left a material amount of money on the table if we had done a traditional

IPO. So I think, you know, first principles, speed, right? For entrepreneurs who are looking for efficiency on their team, a process that takes half the time is something that... It's also a complex story, right? Obviously, it's a more complex story. It's not as easy to tell. Let me, could you answer Scott's question about the mega tech companies like Amazon and traditional players like CVS coming in? And obviously, Walgreens, interestingly, CVS and Walgreens are both headed by women, which is interesting. But the new head of Walgreens ran Starbucks.

She knows something about this kind of thing. I mean, picking her was a really interesting choice from my perspective. Totally. I think that was really fascinating. She knows how to sell coffee. She knows how to sell health to the masses. So talk a little bit about that. I mean, Amazon's going to come in here

and have a doctor show up at your door or or or whatever or be in there you know the thing in the the um the various devices yeah right that's right you know i think the there's going to be a tremendous amount of investment in the space as there should be right from a first principle standpoint you're talking about an industry that is so fundamentally broken. 80% of rural counties in this country don't have a doctor within two hour drive. Half the people in this country can't afford the deductible on their insurance plan. I mean, it's entirely broken system. So everybody needs to invest a lot of money into it just to get it into a good place. With that said, I think the players that will really win are the ones that understand that

consumer expectations have dramatically changed, right? That they are technology forward, that they're digitally native forward, right? They expect everything on demand from the comfort of their phone. They expect it to be beautiful. And then they expect to have a lot of finance stuff. Exactly. A lot of the finance stuff. And so, you know, when I talk to, I talk to a lot of CEOs of big health care systems

and big pharmacy systems like you were talking about, and what I see overwhelmingly is still a pretty historical legacy type of approach to health care, which is we control your health and we give you a couple of options. Right. And it's behind the scenes, complex incentive webs of insurance and reimbursement of how we're making money. But the patient is really a recipient of our care. And in my opinion is, you know, customers in the next 10 years are going to be using

their dollars and going to the places and companies that they love, right? The companies and experiences that are beautiful, that make them feel good, that kind of feel empowered, so to speak, with their dollars. And in order to do that, you have to have a great orientation for the customer, a really, really heavy technology focus and experience focus. And I think in a lot of ways that will frankly filter out, so to speak, probably a large number of the players that are, I think, playing in this space.

I think that's how I see it. A quick question. Do you have a branding issue? Just because I didn't know you were really in telemedicine. I think of HIMSS as the erectile dysfunction delivered anonymously to your door company. And now that you've gone broader into what is a much bigger market, and it sounds like you're doing really well, have you given any thought to just your brand positioning or even the name of the company?

Because there's guys like me who think, oh, that's the Viagra to your door company. Right. Yeah, I think there's two elements in there. The first on the kind of positioning of the company, my opinion is generally people don't get super excited when they hear about the word telemedicine, right? I'm a customer. I hear about this telemedicine company that doesn't, you know, when I'm feeling sick, I don't think the word telemedicine, I think, you know, flu, or I think the acne on my face, or I think depression, or I think anxiety. And if you think of this next generation

of consumer experiences, people want to feel an emotional resonance with your brand and with your company. And so, you know, Scott, your point, people don't know the word telemedicine. And we actually kind of intentionally don't want customers to think about the cold, sterile hospital when they come to our experience. We want them to come think about solving their depression or solving the fact that them and their partner are struggling in their relationship because of sexual issues, right? And that we're going to help you with that issue and empower you for that issue. So, I think that was actually a pretty intentional move for us, which is kind of put the doctors and the clinical and the white coats kind of behind the scenes and make it just

feel beautiful and seamless. And then the second is on the, you know, on the, on the naming of the company, you know, I actually think we will probably at some point, you know, change that name. You know, the hymns and hers name is such a binary name to be completely honest. And I don't think it's particularly reflective of, you know, the, the access. Yeah, it feels like you're bigger than that now. It feels limiting to what you're doing. When you call it up on Google, just so you know, it goes official site, ED and hair loss, meds from home. That's where it says when the Google. I can validate big market.

Big, big market. Huge market. Pfizer built a very large company on that market. But yeah, I think there's a lot from a consumer expectation standpoint that's changing really quickly. And especially we hear this a lot, right? Because our demographic are kids in their teens and their 20s. And they're the ones that are pushing the boundaries of identification, non-cisgendered, non-binary in a lot of different ways. And so our team is actually spending a tremendous amount of time on how you navigate that, how

you do it safely from a medical standpoint, right? Because there's actually a lot of dynamics. It's not just a branding exercise. It's also a clinical protocols exercise, right, from a healthcare standpoint. But it is something that I think is an important part of the future that you'll definitely see us take lead in. So just one last question here. So you said publicly you're a $3 billion market cap. You can see you being a $20 billion market capitalization company. What is the major

point of friction between $3 billion and $20 billion? Is it customers? Is it talented management? Is it regulation? Is it more capital? If you could solve one point of friction, predict it from three to 20, what is it? It's execution at this point, right? We have plenty of people bringing in the right people. You know, I actually think we have the right people. It's an entirely remote team. We have about 150 people across the country. But what we need to do over the next five years is systematically go from a business that is currently made up of, you know, five or 10 different verticals and categories and continue to grow that base

and also expand into five or 10 new verticals and categories, right? You need to broaden the set of customers that you can help on the platform and that's how you do it. I just noticed on your site, which immediately goes to hair and sex, essentially at the top, which is nice.

I'm enjoying your cactus standing straight up, which is kind of an interesting choice, but I like it. Are you mocking me? No. Oh, wait, I'm sorry, go ahead. This is, Scott, this one is simple. You need erections when you want them, not when it's convenient for your penis.

This is their text. I have absolutely nothing, no response for that. I have no response for that. I'm going to call HIMS and get counseling. I'm reading away from the HIMS site. Okay, so you have popular hair. You and I should call HIMS. Anyways, go ahead. Okay, please don't. I'm going to call HIMS and get counseling. I'm reading away from the HIMS site. Okay, so you have popular hair. You and I should call HIMS. Listen.

Anyways, go ahead. Okay. You and me? You added skin. You've added primary care is now there, and then COVID-19. That's right. So last question, what has happened during the pandemic for you? I'm clicking on the COVID-19.

You have home saliva tests, self-assessment tools is what you're working on there. In primary care, you have cold and flu, allergies, infections, UTI right up top, skin and bug bites, eczema, stuff like that. Talk about what's happened during the COVID time period. Yeah, you had this situation where these massive tailwinds of telemedicine have been happening for years. And we were kind of expecting five and 10 years from now, you'd see this mass market awareness of telemedicine. And what happened is you had all of it happened in 12 months, right? You had the president saying the word telemedicine over and over and over again on daily interviews. And so you went from this world where less than five or 10% of people have ever experienced digital health to now coming into this year, almost 80 plus percent of people having experienced it. And once you've experienced it, it's amazing, right? You're on your couch, you click a button, you connect to a doctor, you talk about the UTI, you don't have to come in and

wait in a line and get childcare lined up. You know, the medication comes to your door within a couple of hours or the next day. It's just beautiful and affordable and seamless. And so I think what we were able to do was look into the future of what's going to happen in a lot of industries in the last year, and in particular with healthcare. And now customers, more than ever, I think expect to be able to pick up their phone and get access to it. And so we launched, as you were saying, you know, primary care. So now if you have a bug bite, if you have a UTI, if you have a migraine or a stomach, you know, stomach bug, you can come talk to a primary care doctor and, you know, 10 minutes, get a medication if you need it, get some advice if you need it and start to feel better. Right. And it's just seamless. Tonal fungus, super,

super common thing. Yeah, how many times? Yeah, but isn't, just to be serious for a second, isn't a big value proposition not only remote medicine, but it's the delivery of anonymity? I mean, anonymity is a huge component, a huge value add of a lot of medical,

a lot of specific, and it seems to me that you went after what would people really value a certain level of anonymity or discretion around that remote provides, and you're attacking those. Privacy better than anonymity, excuse me. Maybe privacy or I don't know what the term is. I think it's normalization, right? And stigma.

It's stigma busting is how we think about it. That's a great term. If you think about the New York City subways, these beautifully photographed cactuses, right? That's not healthcare. You don't think of that as healthcare, but it starts a conversation between men or women sitting on that train talking about their sex life. I'm not sure that's a good idea. No, it is. Like friends sitting there and maybe they start by giggling and they laugh at it, but then they actually have a real conversation or you see a conversation about anxiety or depression and there's a little bit of a-

That one is the big area, I think, is interesting. Yeah, there's a little bit of irreverence maybe in the marketing and brand, but it gives people the access point. It opens the door just a little bit. Oh, you mean with friends you're on the subway with, not just on the screen? Yeah, exactly. No, with friends, yeah, friends you're on the subway with. Dr. Amanda's a stranger on the subway, Scott.

Yeah. You have to stop doing that. What do you think that cactus said? No, no. Friends you're with, right? Yeah. And especially when you talk to people. Okay, good, good.

You know, when you talk to people about healthcare, that access problem isn't just about cost and location. It's about stigma, right? People are scared to admit that they've got an issue. And so we've spent a lot of time trying to remove that stigma and normalize these things for people because we know that that's a big empowerment. Really, the money besides stigma is inconvenience and how difficult. I think for a vast majority of people who are used to a relatively well-functioning healthcare

system, but not really because they're wealthier, This COVID has shown everybody how badly it is done and how easily it could have been done in terms of ways. Anyway, Andrew, this has been fascinating. I find this area so interesting. And both Scott and I will be talking about it a lot in the future, I think, because it's really, as Scott said, it's the brass ring in terms of the one area that tech has not affected at all in a way that you would imagine it should have. Congratulations on your success, Andrew. We really appreciate it.

Thanks for having me. See, Scott, it's more than condoms and cactuses. Penile-looking cactuses. It is an interesting— It's Viagra. Yeah, it's interesting. As they started to branch out, they were certainly ED and hair. I didn't know. Did you know that? I didn't know they were telemos.

And I always thought they were the get your Roman. That's where they started. We should keep it on. All right, Scott, one more quick break. We'll be back for wins and fails. Support for this show is brought to you by Nissan Kicks. It's never too late to try new things. And it's never too late to reinvent yourself. The all-new reimagined Nissan Kicks is the city-sized crossover vehicle that's been completely revamped for urban adventure. From the design and styling to the performance, all the way to features like the Bose Personal Plus sound system,

styling to the performance, all the way to features like the Bose Personal Plus sound system. You can get closer to everything you love about city life in the all-new reimagined Nissan Kicks. Learn more at www.nissanusa.com slash 2025 dash kicks. Available feature. Bose is a registered trademark of the Bose Corporation. Do you feel like your leads never lead anywhere? you're making content that no one sees and it takes forever to build a campaign? Well, that's why we built HubSpot. It's an AI

powered customer platform that builds campaigns for you, tells you which leads are worth knowing and makes writing blogs, creating videos, and posting on social a breeze. So now it's easier than ever to be a marketer. Get started at HubSpot.com slash marketers. Okay, Scott, wins and fails. So my win is Sarah Silverman, the comedian, did this great video that's gone viral talking about righteousness porn and her saying that as a proud progressive, she's thinking she may not want to affiliate any longer with a party because she's kind of the sick of the all or nothing attitude. And she uses minimum wage as an attitude and that, you know know there's just so much righteous anger on both sides

and i got an email from this really thoughtful guy and he said that and he kind of said he was trying to be i think paternal which i always welcome and said look you run the risk because you are in kind of this influence of circle of entering a bubble where you're drawn to issues that create, that are emotionally charged. Yeah. As opposed to issues, boring issues that don't augur as much emotion, but are more important in people's everyday lives. And it's, I feel as if in politics, we're like Tyrannosaurus Rex, we're drawn towards movement and violence. We want to talk about things that catalyze emotion, whether it's, you know, whether they build a wall or not, or late-term abortions, which just aren't

what I'll call, you know, it's an important issue, but it doesn't, it's not, we're talking about, you know, a fraction basis points of percent of actually what happens out there. And I thought that was an interesting comment. And what Sarah was saying is that, and I'd like to think, that there's a movement towards what I'll call the pragmatic middle, or let's be less focused on being right and more focused on being effective. And let's create more warriors and fewer wokesters and fewer bigots, so to speak. Let's put, on the far right, we have, they've weaponized bigotry and it's gotten out of control for them. And I think on the far left, we've made the mistake of believing we're a self-appointed police force for cultural issues. And it's like, OK, when are the operators showing up?

When are the people who are going to get shit done? It's interesting. You know, you're saying that Rebecca Traster's story in New York Magazine this week from New York Media is really quite good, actually. She talks about that, and it actually opens with that. You'd think it was about Cuomo, and it was like, it's not that they were,

this guy had come in from the Obama administration and other places, and he's like, it's not that they were just mean with each other. It was a mean culture, you know,

a mean and unpleasant culture. It's that they were ineffective, too. Like, they were mean. Who are they talking about? They were talking about the Cuomo administration. They're like, they weren't just mean at each other and grasping, but they were ineffective at their jobs. And every single person interviewed talked about that

is that they never got to policy. It was always about optics and fighting and winning and dominating. And it was really, it's a really, I did not expect this story from Rebecca Traister. I thought I was expecting a very different story. And it was about competence. Like, you know, and she wasn't saying you should be mean or anything like that, but he was like, it wasn't just this guy, these quotes were fascinating. There was one woman of color who was working in the PR department. She's like,

it was never about the policy. It was always about the projection. And, and you just wish you could just do something like you could actually do something that helped people. And you just wish you could just do something, like you could actually do something to help people. And that was really interesting to me. But you brought up Cuomo. I believe that it's unlikely that he's going to survive this and that it will be a function of what did actually take place or what didn't take place. But even more so than that, I think he's not going to be our governor because he's an asshole.

And that is if you treat people poorly, if you treat people poorly, if you're all about leverage in your optics versus partnering with the mayor of New York and saying, all right, occasionally you get the spotlight. If you're about, if you occasionally hold back and don't threaten or intimidate people, you know, the moment, I mean, look at the way people are coming for him right now. He has no base of support. He has no pillar of loyalty. And so he may deserve or not deserve

to be drummed out of office, but he's going to be because he's an asshole. And here's the thing about being an asshole and not letting other people occasionally have some credit or some limelight or using intimidation. It makes you ineffective. It just makes you ineffective. And anyways. I think competence is going to really matter. I think, I forget, it was like Biden's gotten up to 3 million a day. It's just, it's getting done. Like, you know what I mean? Like getting things done is going to be a very attractive trait i think politically is what you're saying is getting things done and he's a he's the perfect example i think for the first time in several decades

we have an individual who's a better president than candidate and who is i don't need to hog the mic i want to obviously get credit but I'm more about behind the scenes getting shit done and trying to, you know, I'm not an ideological warrior. I'm just trying to get things done. Anyways, I think there's, I thought her rant was my win. My fail is, you know, the very disturbing news out of, I believe it was out of Britain, a woman named sarah

everard yeah disappeared on her walk home in london and was found dead a week later and she did everything you're supposed to do she called her boyfriend to let her know she was on her way home she took a safer route she wore bright clothing like she just did everything and they responded the police responded by going door to door and telling women they should stay inside. And I thought to myself, I thought, okay, here we are in America, and we're afraid to tell people to wear a mask, much less stay inside,

but when 51% of our population is under threat, we tell them to stay home. Yeah. And it's just, it's like, no. And then there was- Any modern society that has tax revenue has the wherewithal to say, I mean, if there was someone roaming the neighborhood with a gun or if there was a Jack the Ripper-like

psychopath out there, I can understand that. Well, they also didn't want them to protest is what they didn't want. They didn't want those protests. And then the protests got violent. And then they were heavy handed with the protesters. And the reality is it just struck me like this different standard.

The reaction shouldn't be you need to stay home. The reaction is we're doubling the police force. And this is why you can feel safe leaving your home. I also think that men have a responsibility here. And that is. Yes, they do. Well, at UCLA, we used to have something called community service officers. And it was this infrastructure where men and women with walkie-talkies could be called within three minutes.

We did that. Someone could help you walk on. I think men in these areas have a responsibility to ensure that their communities are safe. Because I don't think we can just always blame, the police have a responsibility, but there's something about, there's something very uncomfortable when you immediately move to, okay, there's violence against women, so women need to stay indoors.

And it's just not the right response. Exactly. But we might want to also get at the heart of why that is, why women are so unsafe walking in the streets everywhere across the world. That is to me, it can't be men are just that way. It can't... That answer is so old and ridiculous that you get...

But it still exists. And I think it's... One of the things is making men understand that. I think I've told you this story when I was walking down the street with my oldest son, who's a big guy. And I started looking around. It was dark.

And as usual, I was checking my surroundings because that's what a woman does every minute of the day no matter where you are no matter who you are you do that and um and he's like what are you doing and i'm like oh i i wanted to make sure we're safe and he's like why would you be unsafe and i said oh my god i can't like i can't even he's raised by two lesbians in san francisco and he still he still felt safe and i didn't. And it was a really interesting moment and we are well-to-do people and everything else, I mean, in a city neighborhood still,

it's an urban setting, but it's, you know, cities are, well, anywhere can be anything. So it just was interesting that the dichotomy between how I looked at things and how he did. And I was like, how do I get through to him? Lack of safety. And I think I extend it onto the internet people all the time. I'm like, the reason why bullying lasted so long on all these platforms is because these men had never been unsafe. They didn't understand lack of safety. And that's a big,

if everybody could understand that and be empathetic to it in a bed of empathy, as Scott Galloway said on Bill Maher's show, it would be much better. Thank you. I think there's two things at play with your son. And the first is instinctually, the male gender is about seeing an animal from 200 meters away and quickly reacting and moving to violence. And women are much more thoughtful about their immediate surroundings and noticing things. So it's hardwired into us,

but also the sad truth is women are less safe. That's the sad truth is that that's the reality. Women, women are less safe. So they're smart to be more thoughtful around them. And that gets to your point. It's like, well,

why is that? Yeah, we need to do it. But I do think the, the loud, the loud left and the loud right, especially the right, is not stopping. Peter Thiel just put $10 million into super packing potential Ohio Senate candidate J.D. Vance, who wrote Hillbilly Elegy. I think the loud parts

aren't going away for any time soon. I got to tell you, Scott. Except I like you loud on the Bill Maher show. That I liked. Well, you know what? There's the loud parts, and then there's the hard parts. We need to call hymns. We need to call hymns. Oh, that was good erectile dysfunction humor. You have already signed up during the entire interview. I could hear you typing, signing up. Anyway.

You kidding? It could help you on so many levels. I mean, like, really, at least. Can I buy it twice? The skin care. Can I be? Erectile dysfunction. Can I buy two memberships?

Hair, which I think is going to be a heavy lift for you. And then what else was there? Some COVID-y stuff. So anyway, it was kind of built for Scott. I think HIMSS could make me, I literally think HIMSS could make me feel 55 and 7-8s again. You need to wander over to hers and see what you can get available over there for you. Anyway, Scott, that's the show. We'll be back on Friday for more.

Congratulations on your show. It's serious. Everyone should watch it. There's clips all over the internets and Twitter. Thank you for saying that. That means a lot to me. You should watch him because he did a great dog episode. It was fantastic.

Anyway, go to newyorknymag.com slash pivot to submit your questions for the Pivot podcast. The link is also in our show notes. And we will be back with another episode at the end of the week. Scott, read us out. Today's show was produced by Rebecca Sinanis, Ernie Andretat, engineered this episode. Thanks also to Hannah Rosen and Drew Burrows. Thank you, Drew, for always figuring out my shit when I'm on the road.

I appreciate it. Make sure you subscribe to the show on Apple Podcasts. If you're an Android user, check us out on Spotify or, frankly, wherever you listen to podcasts. If you liked our show, please recommend it to a friend. Thanks for listening to Pivot from New York Magazine and Vox Media. We'll be back later this week for another breakdown of all things tech and business. Karen, Rebecca, have a fantastic week. Support for this show is brought to you by Nissan Kicks. We'll see you next time. urban adventure. From the design and styling to the performance, all the way to features like the Bose Personal Plus sound system, you can get closer to everything you love about city life

in the all-new reimagined Nissan Kicks. Learn more at www.nissanusa.com slash 2025 dash kicks. Available feature, Bose is a registered trademark of the Bose Corporation. Bose is a registered trademark of the Bose Corporation. Do you feel like your leads never lead anywhere? And you're making content that no one sees, and it takes forever to build a campaign? Well, that's why we built HubSpot. It's an AI-powered customer platform that builds campaigns for you, tells you which leads are worth knowing,

and makes writing blogs, creating videos, and posting on social a breeze. So now, it's easier than ever to be a marketer. Get started at HubSpot.com slash marketers.