On March 12, 2019, New York government officials declared a local state of emergency in response to the 95 confirmed COVID-19 cases. Within one month following New York’s actions, many cities across the United States have followed suit in order to contain the spread of the contagious disease.
On April 15, Columbia Venture Community hosted a webinar with healthcare industry professionals and entrepreneurs to understand their perspective on the virus and its impact.
The 60-minute conversation covered a myriad of topics, including business operation pivots, venture capital trends, and fundraising advice for founders.
Columbia Venture Community (CVC) — a global network of nearly 6,000 Columbia University alumni, students, and staff who are interested in all aspects of entrepreneurship and innovation.
Panelists:
Naj Austin, Founder & CEO, Ethel’s Club
Jared Friedman, Partner, YCombinator
Latoya Thomas, Policy & Government Affairs Director, Doctor On Demand
Moderated by: Andrew Satz, Founder & CEO, EVQLV
Startup Founders, Regulatory Directors, and Portfolio Managers assess the impact Crisis has had on their businesses
73% of surveyed attendees said their job or business had been negatively impacted by COVID-19.
Jared of YCombinator shared that the famous accelerator will be moving their next cohort entirely online this summer. While it’s going to present some challenges to replicate the true in-person experience, there will be opportunities to engage founders who aren’t in a position to move to Silicon Valley.
Naj, Founder & CEO of Ethel’s Club, shared their entire business model had pivoted and focused on having a digital component to the product. Although originally planned to be implemented in 2022, the plan came to fruition out of necessity.
Latoya, a regulatory leader in the industry, expressed shock at the regulation changes towards telehealth:
“I never thought that I would see the day when a federal official at the top level would be in a position to promote, endorse and validate telehealth at the level that we need on a daily basis.” — LaToya Thomas, Regulator & Government Affairs Director at Doctor on Demand.
Startups and Portfolio Managers see this time as a “good test in being lean and agile”
Startups have redirected their business focus and repurposed technology to fight the pandemic.
Company leaders have learned several tactics to keep motivated
Being CEO of a tech company is hard, even without a pandemic. What’s important is adapting to change and finding a way to be successful anyway.
This pandemic can truly “test the startup” and requires the Founder to be nimble.
Startups are widely redirecting their business focus and repurposing technology to fight the pandemic.
For some panelists, work during COVID-19 has been the highest it’s ever been, requiring people to be more intentional with relaxing.
Latoya finds moments during the day to unplug digitally and find time for fresh air, while Naj is intentional about not looking at her phone first thing out of bed.
Scheduling downtime is a must for some!
Venture capital and fundraising won’t be as severely impacted as other industries
Because venture capital firms already have committed capital from investors, VCs are still going to meet with founders.
VCs raise large sums of money that they are then committed to invest over a period of time, and those funds have largely already been raised.
“Venture capitalists already have the money [to invest] now. Because of that, venture capital is not as cyclical as one would assume.” — Jared Friedman, YCombinator Partner
However, fundraising is going to be slower and venture capitals will be less aggressive chasing deals: “ Your fundraise can take a lot longer and it means talking to a lot more investors.”
Entrepreneurs should also assume it will be harder to earn the same valuation as they would pre-COVID19: “ Try to think about raising less, at a lower valuation and plan to run your business more capital efficient.”
Founders should also prepare contingency plans: What they should do if COVID lasts for 18 months, or if there is a recession: “ Plan for the best, plan for the worst, and prepare for both.”
For more news and resources during COVID-19, please follow our publication.
If you are a healthcare professional, consider applying for the first cohort of CVC’s Healthcare Mentorship Network.
Full Transcript:
Andrew Sats (Moderator): I’m Andrew Satz. I am the CEO and Co-Founder of EVQLV. We’re an AI plus drug discovery company. We use AI to accelerate the speed at which drugs are discovered. We’re actually working on a coronavirus drug right now. And I feel very fortunate to introduce our panelists:
Naj Austin is the founder and CEO of Ethel’s Club, which is a private social wellness club, with people of color in mind.
Jared Friedman is a partner at YCombinator, which is an incubator for seed-stage companies.
Latoya Thomas is a digital health policy expert and Director of Policy and Government Affairs at Doctor on Demand, which is a telemedicine company.
Thanks so much for being here, we’re just going to jump right into it.
How has COVID-19 changed your business operations? Or in the case of Jared, how has it changed your startup or portfolio company’s business operations?
Jared: Sure, I can start and thanks very much to Andrew and the folks from Columbia for having us here. Well, COVID had a direct effect on YCombinator, actually, because YCombinator runs an in-person program where founders come to the Bay Area from all over the world and we host a lot of in-person events and of course, all of that has had to go virtual starting in March, which has been a really new experience for us. And something that honestly, we’re still trying to figure out. The way YCombinator works, we run two batches of startups per year. And ordinarily, they all come to Silicon Valley for the program. This summer, we’re going to run for the first time in our history, an all-virtual batch where the founders will take part in YCombinator from wherever they are in the world, which is definitely going to present some challenges in terms of how do we replicate, like the true in-person feel of the program. But I also think some opportunities because it, I think, is going to make it a lot easier for international founders and founders that aren’t in a position to move to Silicon Valley to participate in YCombinator. So I’m excited to see that.
Andrew: Cool. How about you Naj? How’s it affected your business operations and, and what guidance are you giving to other people around the changes that you’re experiencing and how they can, how they can think about it, especially since you’re part of really a community-based business.
Naj: Yeah, so very similarly to Jared, we — our entire business model was built around, you know, people of color, having a safe space together. And very quickly that had to come to an end. One of the things about being a venture-backed company is that we were always planning on having a digital component to the product. It was definitely pushed out for like 2022, Q4, and we had to sort of ramp it up for today. But we, we had such a strong sense of community here with our members and with our brand across the world that again, very similarly to YCombinator, once we launched a digital membership, we were able to bring in members who don’t necessarily live in Brooklyn to be a part of our community. So that’s been really interesting to kind of see the things that we’ve done here replicated online, and that people are still responding positively to it. In terms of guidance, I don’t know if I necessarily have any, I think sort of taking one day at a time and being really open to learning has gotten us where we are today. Every time we have an event inside the Digital Clock House, we have events three times a day at 9 am, 3 pm, and 6pm EST, we learn whether our members are, you know, more interested in learning how to finance their lives in this time, if they want a place of respite away from sort of the traditional news outlets and kind of away from COVID. Whether they’re looking for workshops, or whether they want to just hear a DJ set, so it’s constantly a learning battle. And I think my team and I have just learned to sort of lean into the unknown and sort of build with what we’re being given every day on sort of how to shake it out for us.
Andrew: Yeah, it’s great to hear that there’s some positive changes and accelerating the tech as well. So that’s a that’s it’s nice to see that it’s sort of like not that total shutdown that a lot. We’re seeing a lot of organizations.
Naj: Yeah, definitely. I mean, my investor updates, I think it was probably one of my most well-received ones, they were like, finally, like, we were waiting for you to kind of bring in the tech. So that’s been exciting. I mean, mainly just from the standpoint of building the technology that enables you to do so many things. So that’s been, it’s been fun. It’s been really fun amid all of the chaos that is happening. It’s been nice to have something to build.
Andrew: And for you Latoya, I mean, I’m assuming since you’re in the health space, your company is in the health space and telemedicine is really ramping up. You know, I’d love to we’d love to learn more about how it’s changed your business operations but maybe something that’s been unexpected that has changed and sort of how you’ve handled it.
Latoya: Yea, those are great questions. I can tell you I’ve been doing this work for over a decade and I never thought that I would see the day when a federal official is at the top level would be in a position to promote, endorse and validate telehealth at the level that we need on a daily basis. So it’s been nice. It’s been affirming. I’ve also been affirming to see state governors come out and check each other and say, you know, what, if you haven’t necessarily gone through all of your state policies to see if there are any existing barriers, at the state level for your health care providers, as it regards to telehealth, you should probably take stock of some of those policies and do everything that you can to remove them. So it’s been a really great regulatory space right now for virtual care. I will say that because Doctor On Demand because we’re a little unique from some of the other telemedicine companies in that we employ our healthcare providers, and we had already scaled efforts to all 50 states and DC, pre-Coronavirus. And so we already had a presence with licensed health care providers for primary care, urgent care, and behavioral health. We were, we were ready. We were probably more ready than others just because of the nature of our clinical operations, but also the strength of the telehealth platform, an integrated Electronic Health Record system that we created ourselves. I think what we were really welcome to see. And I mean, just talk a little bit about the policy space was just a removal of barriers for us to be able to service what roughly 38 million Medicare beneficiaries and we hadn’t necessarily been able to do that before, because of discriminatory policies that prohibited us from seeing folks who are non-rural areas and also from policies that prohibited us from seeing those same patients in their own home. Now that we have about 42 states that have stay at home orders, not only being able to support the mitigation requirements that are being promoted by the CDC, and being able to see some of those patients in their home, while also being able to provide routine primary care and behavioral health care. Obviously social isolation can lead to depression for some, maybe increased anxiety for others. And so it really has been really great for us to be kind of integrated into a larger healthcare system and provide much more robust care then I think folks previously thought that telehealth could provide.
Andrew: Yeah, it’s great to see that we’re starting to see those breakdowns in that regulatory resistance. I knew it was always such a good thing to see that telemedicine was available and then such a terrible thing that it was like the resistance was not so much the providers or the patients it was really the system that was getting in the way. So it’s really great to see that you’re seeing the breakdown of barriers, and also the breakdown of barriers of video chat, right, like look at these video meetings and how they’ve been really positively impacting and in some cases negatively impacting but that sort of transformation of business to having more video conferences and have those conversations where a lot of times it was before you need to come in person to see me so it was it’s really great to see that change and everyone sort of accepting that your kids or your pets might be in the background. So. So, you know, a lot of startups, regardless of the industry or the business model are really about unifying culture and community. But you know, work from home, and social distancing really, physically pushes us further apart. So these are really conflicting ideas. So how are you guys dealing with this? This process, either, you know, within your portfolio companies, within your businesses, or within the way that you operate your lives. Naj, do you want to take this one?
Naj: Sure. Yeah. I mean, our entire business model, again, is around sort of creating culture and community for people of color. I think that what we found is that people are seeking connection more so than ever and people are also seeking any sort of practice that they can turn into a habit. I think there is so much chaos and so much unknown that they want things that they can depend on. So when we launched our membership, it wasn’t so much about trying to just provide this place, it was about providing a place alongside some structure. So the structure of the events being a thing that you can depend on every day was really important to our model. And very similarly to the clubhouse where we had scheduled programming every day. So even if you worked here, or came here for meetings, you would be able to depend on us having mental health therapists come by at 12 and/or an event at 3 pm. So really trying to keep that spirit alive as much as possible. We’ve had a couple of different members reach out to us for support groups, which is not something that I thought people would want from us, you know, we’re sort of like a fun place where you can see DJ set and sort of be in a group therapy session, but it’s turned out that people are looking, turning to us for a lot more so it’s put us in an interesting position to make sure that we can constantly provide it and I think also kind of stay on our toes and be nimble for whatever community does mean, because, you know, again, I would not have thought that that was the outcome. But, you know, we want to always be a company that can do whatever our customers need.
Andrew: Yeah, I think it probably sticks very well to what you, probably your grandmother wants, you know, Ethel wanting that. So creating that community. It’s super cool, right.
Naj: Yeah. And I think it’s been great. Again, to see it kind of happen online, because the community here in Bushwick and Brooklyn was very, I wouldn’t say specific, but I mean, you had to live in Brooklyn, or there or in New York City so right there it’s kind of specific. And now it’s sort of this combination of people dealing with what’s happening, and coping with it all over the world and to see us all kind of going through the same thing. I think it’s very unifying, in a way.
Andrew: Yeah, absolutely. So Jared, so Credit Suisse very recently surveyed consumers in China I mean very recently, and asked them coming out of the event of the Coronavirus event. What are the things that they were most likely to spend money on going forward and what are they less likely to spend money on going forward? And so the top three answers for more spending are, we top two answers. Were health care and education and the less spending were dining and travel. So given the viral nature of pivoting, excuse the pun, how do you think healthtech needs to pivot to respond to the current and upcoming new normal.
Jared: Yeah, I saw that Credit Suisse poll. That’s, that’s interesting. One thing I wasn’t sure of is, I wasn’t sure if people were saying that because sort of, they were still worried about Coronavirus. And they were saying, well, in a world in which travel is dangerous, who want to travel less? Or if the way the question was worded was like, after all of this is over, and like returns to normal? What do you want your spending habits, do you expect your spending habits to be there? I don’t know, if you were able to figure out.
Andrew: You know, it was really hard because when they actually met, it was written in Chinese, so it was like I don’t speak Chinese so I don’t actually know I had to go based upon some person’s interpretation. So I played the telephone game on that. I just, I know that they asked these questions, but I mean, it was it seems to make sense that people are spending a lot more money now on health and education. Right. So You’re seeing all fintech startups blowing, you know, shooting out, like through the roof, and then the health, the health, and all the online yoga. And I’m sure, you know, Naj is sort of experiencing that with the sort of the health of people, whether it’s their mental health or their physical health in the community that she’s built. But I would, I’m curious to sort of thinking about how the companies that are doing healthcare right now and the healthcare companies, where you see, especially since you’re looking you look at so many different organizations, and you’ve seen so many companies pivot, especially since you’re starting at the seed stage, where, how do you think like, companies now need to pivot to respond to what is currently happening, which we obviously are seeing, but maybe the upcoming new normal? I mean, it’s very hard. I know, it’s very hard to look in the future. But as you know, as YC you’re looking at seed-stage companies with the assumption that they’re going to do something later. So you are to some extent peering in the future. So.
Jared: Yeah, so, I think one interesting trend that we’ve seen is the number of healthtech companies that have actually like redirected their business focus and repurpose the technology that they’ve been working on for years to fight the current epidemic. So we have companies that were working on tests for other diseases now they’re working on tests with COVID. We have companies like yours that that were working on drugs for other diseases, and they’re like, cool, we can use the same technology for discovery to discover a drug for COVID. And then we even have sort of like, like, more dramatic pivots, where we have companies that had a factory to build, you know, sweatshirts, and now they’re building face masks, or how they’re making face masks. And so I think it’s been really inspiring for me personally, to see the way that the startup community and the healthtech community has sort of rallied to the cause here. Um, and I don’t know what’s going to happen when hopefully the world gets back to normal. But I, I hope that we’re able to retain some of the sort of community spirit that we got and the spirit of working together to fight the cause.
Andrew: Yeah. So I think that’s very interesting to say because that common cause is going to go away at some point, right, that common challenge is going to go away, or it’s going to get to a point where we’re going to be re-entering to some sort of, I wouldn’t say new society, but new version of the lives that, you know, it’s not going to be what we had change is going to happen, right? Whether it’s, we see more people interacting online, or we see, you know, we can see these broad communities and not just community moves outside of just being in Brooklyn and becomes more of a world or a national world community. Where maybe people who are really interested in Brooklyn can actually become part of that community, but they don’t have to live there. And so you know from your perspective Naj, where do you see your own organization trending at like if you’re thinking ahead to when this is over what do you think the world will look like? Because we, I think we all have our sort of own perspectives on what it is I’m much more optimistic about the world, what the world will look like. Right, although I’m concerned about like people just even after everything goes on, of people giving me dirty looks in the grocery store when I get a little too close to them, right so I’m curious how you, how you see it and how you’re thinking about your, your organization post Coronavirus.
Naj: We’re thinking about a lot of things. And I think a lot of that is born out of not knowing what’s next. So everything seems plausible and feasible and like it should be built. And so I think our biggest conviction is that sort of the same conviction we always had, which is that people of color are struggling to find space and that was the original thesis of what Ethel’s Club was, we always wanted it to be a place that provided every answer that a person of color would need, whether it was, where can I find, where can I buy a product that’s meant for me? Where can I, you know, shop that’s meant for me? The clubhouse was meant to be our laboratory to test a lot of that out, right, we have a marketplace here and we can bring in mentors to see what people responded to. And so we’re really just shifting all of that online. We’re really becoming a resource and a directory for anything that centers and celebrates people of color. But again, removing that focus of New York City where we were super like focused on and now saying, like, what about if we could provide a directory of every mental health practitioner that is a person of color in the world? You know, I mean, definitely not starting there, maybe the US, but trying to think enormously because now the problem is that big and now our audience is that big. And so trying to make sure we can be responsive to them. People have asked us all kinds of things. And I’m just sort of like, you know, we aren’t the best company to answer that question right now. But should we be, you know, can we do that? And so we had a lot of meetings the past two weeks, about positioning ourselves as like the end all be all for answers revolving around the celebration of people of color, and how can we do that? Because I do think, on the outside of people’s values, which I think have dictated consumer behavior for a long time, obviously, and definitely now will change and we want to be on the other side of that. And so I think just thinking bigger today versus like, again, in my deck where it was 2022 and trying to kind of reposition that, and so I’ve always had an appetite for crazy, insane, large ideas that I’m like, let’s reinvent the internet. But now I’m like, Well, we’ve got some time, maybe you should. So I think just thinking bigger has been the biggest change.
Andrew: That’s really interesting. I like hearing that. And I think it also talks a little bit to the idea that we’re seeing, like, besides the changes of the communities and how we’re interacting with one another, but having this big idea of how do you create positivity out of this experience, right. So I think there’s like a lot of people who are very worried and have a lot of anxiety but to create positive outcomes, right? How can we level up as human beings, I think it’s really beautiful that you’re actually pushing that and really trying to help beyond the local community, which is great. I mean, I think it’s amazing. So now that we have Latoya back, I’m going to hop back to the question that was on. Welcome back, by the way. So um, so we’re talking a little bit I was talking a little bit earlier about the idea that you know, we were you were saying that you’re seeing a huge ramp-up in telemedicine, but what that also goes that also corresponds to a huge amount of reimbursement, right, so you’re seeing the Centers for Medicare and Medicaid starting to reimburse telemedicine in ways that they hadn’t maybe as easily reimbursed them before. But at the same time, you’re seeing other, we’re seeing other types of regulatory changes. For example, I’m in the drug space and the FDA is performing unprecedented review times, like within 24 hours. So if there’s a drug for or, or diagnostic for the Coronavirus, they’ll review your application in 24 hours, which is insane considering the bureaucratic nature of these things, and, and some US government agencies that are issuing grants are getting grants out in under 30 days, which again, insane time acceleration. So now you’re seeing a lot of things are quickly happening when it comes to how healthcare companies interact with the government insurance companies and regulatory authorities. How do you think these, what do you think about these positive and negative regulatory changes and where do you see them? Where do you see maybe like right after the Coronavirus ends and how are you guys navigating these changes. So because it’s very rapid and regulatory changes are never, you know, they’re never this fast, ever.
Latoya: Yeah, yeah, they’re never this fast especially in healthcare, and healthcare is probably one of the more highly regulated spaces that you can think of. And those are all really great questions. I guess I could get into my technical issues. I’ll start with a $300 million investment from the FCC to support broadband and broadband connectivity. And the use of connected devices to healthcare, healthcare providers there were two programs that were approved and appropriated from the Cares Act. That was the $2 trillion package legislative package that came out and signed by the president just a few weeks ago. So I think there was this, this understanding that our current broadband and wireless infrastructure was inadequate to kind of support the kind of scale that was needed today but also to support the efforts of continuing virtual care post-COVID whenever that is going to be so supporting many of those health care facilities that are trying to adopt and integrate virtual care systems into their own practices and hospitals. But you’re absolutely right. It has been unprecedented. I can say from my lens of having done this for over a decade, and having worked with the 400 plus licensing boards at the state level, that has probably been the biggest challenge, one, getting those various licensing boards to recognize telehealth as an appropriate way of permitting care. You know, pre-COVID all 50 medical boards in all 50 states, including the District of Columbia, recognize video as an appropriate way of seeing diagnosing and treating one patient. There are some other modalities that were questionable in other states, whether it be purely audio or whether they be text-based or some kind of an online questionnaire whether or not that was permissible. We’re starting to see states now offer some temporary relief if you will, or waiver for healthcare providers to use some of those other modalities just give them the sense that not everybody may have a video-based platform but may need to connect with a provider they already have an existing relationship with to refill medications and have that kind of 90-day stockpile of medications that you may routinely use, or just to have access to health care providers. If you don’t have access to video-based platforms, there’s that one thing, I think the other thing that folks are now starting to recognize is that we have a country filled with 50 different countries. Our states have their own state laws and state licensure laws, which permit the ability to provide health care across state lines, and those who need it can be very, very challenging. You know, there are numerous entities who have created compact similar to that of your license, your license is actually compact agreed to by all 50 states that either agree to expedite the licensure process, agree to mutually recognize your license from other states pre-COVID. And so that kind of allowed our practice to kind of engage and leverage some of those compacts as we were employing nurse practitioners and physicians and psychologists. Now that we’re in this kind of heightened emergency disaster space, we’ve had over 50% of states waive some of those out of state licensure requirements. So either through an application process or by virtue of just kind of an order of a governor, essentially stating you are permitted to practice in this state temporarily, maybe it’s 10 days, it could be 30 days, it could be 60 days, but for the duration of that particular state, emergency duration period, so that certainly has allowed for us to be able to practice, practice across state lines a little bit more easily, temporarily, obviously. But as we’re identifying key hotspots and key states where folks are presenting with symptoms or signs for COVID and needing to quarantine at home, or again, folks just needing routine care, and that includes behavioral health, and there being a shortage, generally of primary care providers or of behavioral health providers and us being able to provide the level of service to them if and when they need it, at a 24/7 capacity so some of those state laws have been great. From a reimbursement perspective. Again, the investment from the federal government, whether it be the FCC in their $300 million package should support just overall broadband support and connectivity for healthcare. But the ability for now 38 million Medicare beneficiaries, and again, those are my parents, and people grandparents, that the fact that you can expect that you can now see either your own health care provider or another health care provider who can then send your records to a specialist, if necessary, with your permission, without delay, I think is pretty incredible. And the fact that you now have a significant number of them who aren’t going to have their claims denied because they’re at home receiving care or because they happen to live in a non-rural area. I think it’s pretty unprecedented. It just took 20 years for the acts of Congress and the acts of the administration to remove some of those geographic and patient barriers, just a few are the things I can just kind of battle off a little bit. It’s important that we not overlook the many millions of these, between 60 and 70 million individuals who are presently enrolled in Medicaid, and knowing that 50% of folks who presently get their health insurance from their employers, and knowing that that number is probably going to be dropping significantly over the next few months, I think that we can anticipate that Medicaid enrollment is going to receive by about 5 million, which means additional stress on states additional stress on health care providers who support those vulnerable and low-income populations at the state level, and ensuring that all Medicaid entities are covering telehealth, many of them did, if not all of them did before, but making sure that they’re also covering telehealth to those patients in the home with no issues. So that’s certainly something that we’re keeping our eyes out on as well, just the difference of variation in where folks were receiving health insurance if any, and who will kind of take up the mantle of covering important health care services delivered virtually, if they happen to transition from employer-based coverage to no coverage at all, or having Medicaid as a program cover, cover them as well. It’s been crazy, ya know that you mentioned a little bit, some of the interesting regulatory barriers that have been lifted in healthcare that maybe existed before. Two really notable ones come to mind. We were in the past year, we were just kind of starting to see the light of day with the opioid epidemic, the federal government responding to it, many state governments responding to that. And there were some pretty big enforcement decisions on the part of the Department of Justice, and DEA on how you could or could not prescribe controlled substances. Via telehealth, essentially you needed an in-person encounter in order for that healthcare provider to then use virtual services to prescribe. The DEA is now saying you know what we are temporarily going to look the other way, we recognize that there are many Americans who are going to need access to some kind of controlled substance, either to help them with their substance abuse treatment or Americans who have other mental health serious mental health issues for which they will need some kind of a controlled substance to switch system with a non-substance abuse treatment if you will. If you think of a kid who has been diagnosed with ADHD who might use a stimulant in order to go about their adhere to their care plan. The DEA is now saying temporarily, we’re going to look the other way. And you don’t need an in-person encounter. You also have states responding to that too and saying, you know what, not only do you not need an in-person encounter, but we’re going to permit the use of a phone in order to make sure that there’s continuity of care for many of those patients who have may have those patients. I think the one big thing that surprised all of us is when the Office of Civil Rights decided to look the other way and said, you know what, we’re going to temporarily waive any HIPAA violations or any penalties related to violating HIPAA security and privacy laws. Again, it’s I think, folks recognizing that not everyone has an adequate video-based system and many healthcare providers had to use FaceTime or Skype or some kind of more commercial platform in order to connect with their patients. And so I think that we’ve certainly seen federal governments in an unprecedented fashion look the other way when normally they would be typically hawkish in a sense.
Andrew: That’s interesting. So while we’re seeing some increased level of enforcement on some rules, like people being dragged off of a bus. On the other side, you’re seeing a relaxation of other sets of rules. And I mean, it makes me think a lot about the people who are not part of the system, you know, the homeless or the indigent or people. So like, I don’t think there’s a lot of consideration being taken for individuals like that. But I mean, but it’s heartening to see all, to hear all these things that you’re saying as a result, really, those are some really big changes and thinking about how those changes how that what will happen afterward and how we’ll transition back. You know, I saw I think for you know, I’m a scientist and so, I get a lot of questions, epidemiological questions about what’s going to happen to the Coronavirus. And I don’t have any answers. I’m not an epidemiologist. I’m a data scientist and I’m a sort of a computational biologist. But you know, I think that there’s a, there was a when people do ask me, I send him to go watch an interview that Trevor Noah did with, with Bill Gates, which I think is probably right now, the best, provide the best amount of information that you can get, right? My English was terrible, my Columbia. I think I just have to throw my Columbia degree in the garbage for the way that I just spoke. But I do recommend it to anybody who sees it. But what Gates did, was really showed a sense of leadership, right? And it was really evident of his, the leadership that he’s taking, especially in infectious disease. So with that in mind, you know, I think a lot of times, in times of confusion, we look to leaders and experts to help guide our decisions. And so, so, what kind of leadership or operational lessons Naj are you learning right now during this time that maybe you weren’t you hadn’t learned in the past this, that this situation has caused for you to sort of think about?
Naj: Things I’ve learned about leadership. Um, I mean, I think that every day I’m learning still, I’ve been a founder for 16 months, so I wouldn’t consider myself a leader in that forefront. But I do think that I’ve led with a sense of heightened transparency. I think that every decision that I’ve made for the company, I brought my team along with and I’ve also brought our customers along with. We were incredibly transparent when we decided to shut down the clubhouse. It was before the New York City pause started. So we were kind of ahead of the curve in that regard. And we basically, you know, put out a message to our members and our community at large just saying, you know, we think it’s more important that we keep you all safe, and sort of take a step back from this and kind of lose a little bit on the business side, right? Like, I’m going through our models freaking out because I planned for a recession, not a pandemic. Definitely not a pandemic, where people can’t gather around a business, in which case you need people to gather. And so I was doing a lot of great work and had a lot of fears about what this meant for the future of the company. And I think I just leaned into being transparent about that and kind of, you know, making decisions alongside my community versus in a silo. I think as a founder, you can also find yourself sometimes there. Um, that’s probably the biggest one. I think again, the other thing is just taking every day as a new day and trying to be nimble and grab at everything and every small idea I’m like, let’s blow it out and make it a big idea, you know, everything sort of on the table now and I think most founders have that kind of heart and energy. It’s just happening amid so much loss and, and sadness and anxiety and, and all these other things. And so I think being you know, understanding that that’s happening at the same time is important. And so trying to do lots of things, but I think we all are, you know, I don’t think anyone was totally prepared for this. So one day at a time.
Andrew: Yeah, I mean, as a fellow CEO, I mean, I really think that our like, as part of our role is really to manage the values of the organization. So like, how do you balance this new value system. How about you, Jared? What are you seeing from your portfolio companies in terms of like, shifts in the way that people are leading? Or how are you helping your, your portfolio companies think about their leadership during these times of change? You know, which is, I think, a very important time for a leader to sort of step up.
Jared: So I think being CEO of a tech company is really hard. Even when times are good as they have been for the last five years. It’s still an incredibly hard job. And of course in a time like this it just only gets harder. We have CEOs grappling with all kinds of things that they never thought that they would ever have to grapple with CEOs having to do huge layoffs and figure out how to handle that figure out how to keep their remaining employees motivated and happy, having to deal with employees whose lives have been totally disrupted. From this. And, like, there’s been a lot of great advice sort of on the internet and our community on the public internet as well about how to do those things. But like, all the advice in the world doesn’t make it easy to do. It’s still really hard to have to lay off employees that you’d like work to recruit and retain for years.But the thing that I’m really proud of is the extent to which Founders have stepped up and have taken on challenges that they never thought that they’d have to face once, like what Naj had to do where they had a whole plan that was based on how the world worked before. And sort of at a moment’s notice, they have to like rip up the plan that they’ve been working on for years and write a whole new plan, like from scratch. We’ve had tons of companies that have done that in the last month, and a lot of them have like, reinvented their business completely. And I think it’s, it’s really sort of a true test of a leader, particularly at a startup to be able to be nimble and flexible like that and to not get de-motivated in the face of this kind of adversity, but instead to like rise to the challenge, and just like, figure out a way to succeed anyway.
Andrew: Yeah. Yeah, there’s a really great quote that I read in a book recently was like good things will happen, bad things will happen, prepare for both. Right, but I don’t think there was any way that we could have prepared for what we’re going through right now. You know, with that in mind, like we have we obviously, you know, we have to balance our lives and our business and our business lives and our personal lives. The work and leisure lives in novel and interesting ways that we’ve never had to before the whole work from home. Sometimes kids are home and, you know, adjusting to the idea of what it means to be working remotely with. Thankfully, I’ve been doing that since 2006. I’ve been able to share some of that. Interesting, interesting, like failures that I’ve had and what’s worked for me, but I’m wondering from you guys, from either a personal or business perspective, what’s one lesson or coping mechanism or method or tool that you’re using now, that you didn’t use before the Coronavirus. Something that you’re like some way that you’re adjusting to life in the new in the sort of current currently new normal, right? That you haven’t really experienced before. Latoya is there anything that you’re doing for yourself that’s like helping you cope, or helping you survive or helping you adjust to the, you know, I’m assuming this huge ramp up on your on the business side?
Latoya: Yeah, yeah, no, that’s a that’s a great question. You know, we are similar to that of a hospital we’re 24 seven virtual practice, which means that we provide care 24 hours a day, seven days a week, there’s no lag time. This is probably the busiest that I’ve ever been, as a public policy, in government affairs professional in my entire career, and with information, with very interesting information coming out on a daily basis and having to sift through that as we determine what we can rely on and what we can’t. I’ve had to find moments in my days where I just say no and just unplug And even though I know that there’s still information in there coming through my inbox, or there’s text messages or people trying to reach me or voicemail, there’s got to be a time where I’m just not responding to that and getting trying to just get myself up a time during the workday, and then on the weekends, where I reclaim my time and do things that make me happy. Also finding times for some fresh air, realizing that working from home and meeting connectivity, I’m inside a lot, but I respond better to some sunlight and fresh air, it makes me do my job a lot better. I’m super grateful. I know that there are a lot of folks who just don’t have the same kind of certain things that I do, but super grateful that I have an employer that allows me to work from home. I think this is the first time that as a company, we’ve been purely virtual, not just on our clinical side, but our insight as well. All of the employees working from home too, and so to have their support, but also to, allow to have them support us by permitting us free virtual visits through our employer has been great. It certainly does offset some of the other benefits that we get. But having them as a trusted telehealth provider has helped as well. So those are some of the things that I’ve been able to do to cope over the past few months.
Andrew: And how about yourself Naj what like, are you doing any, you have any personal tips that you’re using to help you cope that you might be interested in? Or maybe things that you’ve heard from members of your community that you’re like, oh, wow, that’s a really good tip. I’m gonna either, you know, like maybe haven’t rolled it out yet, but you saw it and you’re like, this is the best thing that I’ve heard so far.
Naj: The running joke on my team is that I’m really good at building wellness within communities, but I’m so good at it that I am terrible at it. I’m always like preaching that like, you know, your mental health is incredibly important. And in the clubhouse, there’s dedicated space for it because it should be a routine part of your day and you know, yada yada yada mental health is great, and I don’t listen to my own words. I’ve gotten better about it. The one thing I haven’t done a great job of unplugging and I’m really jealous of you Latoya. I’m working on it like literally every day. But the one thing I started doing is, I don’t look at my phone when I wake up, I’ve learned that it makes me tackle things in a different position of fear and anxiety versus growth and strength. And so because I read the news, and I’m like, everything’s on fire, you know, we got to do something and then I go into our stand-up meetings with that kind of energy and I don’t think that it helps anyone and so I cut that out of my day, so I usually show up at stand-up happy and in a good mood. And I think that’s the biggest thing that I’ve started doing, but I am trying to bring in more wellness practices of all kinds. I’m really going to, I just ordered a paint set, I don’t know someone suggested it and figured I try it. That might be my thing, but I’m trying to be more open and into enforcing it into my day.
Andrew: Yeah, if you and are the same like my calendar looks like I lost a game of Tetris. So what I’ve actually tried to do is actually schedule on my calendar, specifically like an hour or two half-hour sessions where it’s just like, you can’t book any I can’t book anything on my calendar, no one’s book anything on my calendar because I dedicated that time too, you know, re-energizing, doing whatever it is that I want to do, whether it’s exercising for a few minutes or cooking something or whatever. I found that like, for me, it’s making sure that I put something on my calendar because I’m like, I’m like Latoya, where I’ve gotten insanely busy. I mean, I’ve been an entrepreneur for a really long time. This is not my first company and, and I’ve worked a lot, but this is probably the most the hardest I’ve ever worked ever because of just sort of all the inbound and outbound work and at the same time our team is growing so I feel you on like, just trying to find that time. We did have a question from the community I wanted to ask and this may be a Jared, I’m sorry, I didn’t ask you for your personal tips if you can add it in, add them in. So how should founders who are preparing to fundraise? What are some of the ways that they can sort of think about that? Because I’ve been hearing like, you know, obviously, there’s going to be there’s, for everyone, there’s a sense of uncertainty. And that sense of uncertainty is not just for founders, not just for employees, but also for investors. So what kind of advice do you give to those individuals?
Jared: Or Founders who are looking to fundraise now?
Andrew: Or were preparing to or like, you know, they may have started in saying, okay, we’re going to start ramping up in December and then boom, right, like they were maybe they were in the middle of the fundraising. And you know, everything went haywire. Or starting right. Starting next month or in two months.
Jared: So here’s the advice that we’ve been giving to founders about fundraising. I think fundraising is definitely going to be harder than it would have been a few months ago. But I also don’t think it’s going to be impossible. The way venture capital works is VCs raise large sums of money that they are then committed to invest over a period of time. And those funds have, by and large, already been raised now. So like, the VCs already have the money, and they’re going to invest it in some startups. And because of that, venture capital tends to be not quite as cyclical as you would expect. If we go back to 2008 to 2010, the last recession, a lot of people thought that VC was just going to fall to zero. And it didn’t, it fell a little bit, but it actually didn’t fall that much, because of this sort of, like, committed capital issue. And so I don’t think we’re going to see venture capital like fall through the floor and like no Founders will be able to raise money. I think because the world is so uncertain now like VCs are moving slower, they’re not being as aggressive chasing fields, they know that they can take their time and it’s, so you should expect that your fundraising is going to take a lot longer than you probably planned that it would and that you’re probably gonna have to talk to a lot more investors. I think entrepreneurs should also assume that if they were planning to raise, you know, x million dollars before, it may be hard to get to x. So they should think about if they can raise a little bit less at a lower valuation and run their business more capital efficiently, and try to hit some more milestones before raising will open up in the future. And I also think that like because the world is so uncertain that founders should be thinking of contingency plans, they should be making scenario plans for what happens if COVID does last for 18 months. For what happens if there is a huge recession? As a result? How can they get to cash flow breakeven? How can they not be dependent on investors to fund the next round of their company? Obviously, we hope that that won’t happen. But I think it’s prudent to have this contingency plan.
Andrew: Yeah it’s interesting when you look back at the companies that were actually born out of the recession, the last recession, I mean, they’re some of the biggest names today. Uber, Airbnb. I think you guys were early investors in one of those companies. So, um, the last couple minutes, there’s a you know, if anyone has a question, you’re welcome to post it. But I have one last question. So there’s a lot of optimism and pessimism around the ideas about what the new normal of healthcare or technology is going to look like. Post COVID-19, right. The new world. What are we going to have TSA or Homeland Security response? I would assume that we’re going to have that sort that’s equivalent of September 11. But can you share your thoughts on what you would like to see? You know, not what you think it’ll be, but what you would hope it will be? Or what you, you know. And Latoya let’s start with you. What is, how would you like to see the world look afterward?
Latoya: That’s a great question. I guess I could start off by saying, I would really love the world as we’re rebuilding because I think that we’re going to have to rebuild healthcare is recession-proof, but we’re going to have to rebuild our healthcare system because I don’t think that there are going to be a number of practices or hospitals, rural health clinics SDHD that survive COVID so we’ll have to rebuild for sure. But I would really love to see that rebuild being done in the eyes of the patient. We have been, it has been reassuring for us as a virtual practice to see the fact that our post telehealth visits, surveys and all patients get a five star essentially kind of survey, we have not dipped below 4.9. Since the start of COVID, our ability to do telehealth related assessments for patients who present with COVID, which I think is reassuring that they like it, they want to keep it and they expect it. But that said, I think that we’re going to have to figure out how to rebuild our health care system, not just with telehealth and virtual care in mind, but with a patient-centered Primary Care Health Care System, if you will, if we’ve got to figure out how we remove specialties from the center of our healthcare system and really make routine care and that includes behavioral health, at the center of healthcare, if you will, but doing so that enables virtual care as well. I will add one other thing that’s not really healthcare-related, but it is an adjunct. We have got to figure out as we rebuild things, how we ensure that those with benefits get the types of benefits that they deserve and don’t fall through the cracks. And those who are working, get the kinds of labor protections that they also deserve so that we’re not having to repeat some of the same mistakes that I think that we are, we’re learning from this particular COVID period. There’s a lot to learn about how to do appropriate outreach and education to patients, especially those who are disproportionately affected by COVID right now. We ourselves have a practice for which we employ 20% of our physicians are African American, that’s four times the national average, that 60% of our physicians are females, but only 30% that are in practice are females. We are employing our health care providers intentionally because we know what the world looks like. And so we’re prepared for COVID but we’re also prepared to service after COVID.
Andrew: That’s awesome that you’re trying to make. You’re working to ensure that your workforce is representative of the population and I don’t think there are enough companies that really put that as a primary goal of their organization. So I really applaud you guys, what you guys are doing. How about you, Jared? What can you share on your thoughts on the world you’d like to see after COVID?
Jared: Well, I’ll give you one Andrew, that’s related to what you were saying earlier, which is that we’ve seen that when it has to, the FDA can move at unprecedented speed and can roll back rules and regulations that ordinarily make drug and diagnostic development incredibly slow, particularly, and expensive, particularly for startups. And we’ve also seen sort of, on the healthcare side that there’s lots of complicated rules around state licensing and reimbursement that when we have to we can just get rid of. And so I hope that when this crisis is over, we don’t just like, put them all back. But we take advantage of these, of this sort of great experiment that we’ve had to run to see what the healthcare industry is like without all these rules and be more strategic about which ones we decide.
Andrew: Yeah, I think that’s a really interesting point. And I think it like sort of mirrors what Latoya was saying, where we have all these stakeholders in the healthcare system, but really when we need to like we need to be thinking about the customer, who is the receiver of the care who needs the healing, or the people who love them, right, who also need that support. And I think it’s really great to see these barriers coming down. as well. I mean, we’re obviously seeing barriers coming up. But I think it’s a really great point. How about, you Naj?
Naj: I think mine is very similar to what Jared mentioned earlier, which is, seeing people sort of be — resourceful and work together. I’ve always obviously been towards community and, and to see it happen under these circumstances. It’s not ideal but you can kind of see like when everyone puts their mind together and efforts and their heart that really great things come out of that. In our community, people have shared job postings or, I mean really all kinds of things. The number to their therapists — it’s been very humbling and inspiring to see if you give people those kinds of tools that they can build something great.
Andrew: That’s awesome. Thank you so much. And thank you, guys. Thank you, Jared, Naj, Latoya for joining, and CVC for putting this on. So with that, we’ll it’s two o’clock we hit it right on the button. So thanks, everybody. Have a good one and stay healthy and stay positive. Thank you. Thanks, everybody.