บทถอดความฉบับเต็มของ Breaking the Pause: Joanna Strober on Menopause, Midlife, and Massively Better Women's Health

really following him, I think, is a, is a value. But, um, you know, my parents [00:02:50] also just were... There was not a lot of pressure on me. It was really what, do whatever you wanna do. I think I had a lot of encouragement to just do whatever I wanted to do, and honestly, I had so [00:03:00] much support from them, and that is one thing that I don't think can be valued enough. When I was like, "Oh, I don't wanna be a lawyer anymore. I hate being a lawyer. I wanna go do something else," they [00:03:10] never said, "Well, you have a nice safe job. You should continue that." They were like, "Go for it." Like- Wow ... "And if you fail, you can always just come live with us for a while." Um, [00:03:20] and I've always felt that from them. I've always just felt that, like, if something didn't, really didn't work, I could just go home, and, uh, I think that's actually a superpower th- they gave me. Leah: That's [00:03:30] amazing. Has that translated to your parenting style as web, as well with your kids? Joanna Strober: You know, I hope so. Um, I hope my kids feel that same level of [00:03:40] confidence that, that my parents gave me. Um, they were just always there in a very supportive way, that if something didn't work out, we would... [00:03:50] You know, they weren't gonna support me, but I could move home. Uh, and, uh, and I think that was actually very valuable. And then I was always a working mom. I've never not been a working mom, and my [00:04:00] mom saw that my dinners were not very good. Uh, she was a little judgmental perhaps about my, my food that was, in a while, that I was serving my kids, so she said, "Friday night dinner." She said, [00:04:10] "Every Friday night, you come to my house for dinner. I will make sure that you and your children have a really great dinner." And, um, to this day- So nice ... yeah, to this day, actually, my kids are gone, and now she [00:04:20] still cooks for me. Leah: Oh my Joanna Strober: gosh. That's amazing. So I'm very fortunate Leah: Wow. What does she cook? What's your favorite thing that she makes? Joanna Strober: Ah, she just New York Times, New York [00:04:30] Times recipes, but- Leah: Yes, Joanna Strober: I love that too ... so it's not fancy. It's really more about the love I guess that goes into it. Leah: It's so great. It's so great. Yeah. Well, it's, it's interesting. I mean, I was reading that you [00:04:40] were one of the very first investors in BabyCenter. This is 1998. Yeah. You were pregnant. Were you pregnant with your first baby at the time? I Joanna Strober: was, yeah. Leah: Exactly. My gosh. Wow. [00:04:50] You were also an early backer of Blue Nile. I remember- Yeah ... Blue Nile as well, and you joke that these are companies that got founded as you were a child. So what were [00:05:00] you seeing in these emerging brands, these emerging companies that you feel like were being overlooked by other investors, that they weren't seeing? Joanna Strober: So at the [00:05:10] time,

you know, w- certainly when we funded Blue Nile, no one thought someone would buy jewelry on the internet. That was, right, like that was not understood. And if you went to [00:05:20] the store, however, that we went to in Seattle, uh, the store was selling many more diamonds online than it was in person. Leah: Amazing. Yeah. Joanna Strober: And so you could see [00:05:30] this happening, and you could see that people were willing, particularly men, they just wanted to know the quality at the time of the diamond. They didn't, they didn't need to hold it. They just wanted to know it [00:05:40] was a good quality diamond. So you saw at the store what was happening, that they had s- few people coming in and many people online. And, you know, when I think about [00:05:50] BabyCenter, it's a little different, but I was pregnant. I didn't have any place to go to get information. I had a huge need for information, and BabyCenter was fulfilling that need. So I think in both those cases, you [00:06:00] had companies that were truly fulfilling a consumer need, and, um, and that's really my learning is that looking for things that people want.[00:06:10] Yeah. That you don't have to create demand, right? That people already have the demand, and then you're just solving for that. Leah: Yeah. Well, and what strikes me about that too is your lens and your [00:06:20] experience as an investor, right? Because you saw the demand. You understood it. You were pregnant with your first child. Yeah. It, like, it's just so interesting that you were [00:06:30] able to, to make that click, right, and, and do that investment. You spent 20-plus years in private- Yeah ... equity and venture. What did all those years [00:06:40] watching how the cap tables were formed teach you about who's getting funded and which problems end up getting skipped? Joanna Strober: So it's very interesting you ask that, Leah. [00:06:50] I actually feel really badly. When I was working in the fund to funds business, um, I had a woman come talk to me who wanted to run a fund about women and, um, and invest in women founders. [00:07:00] And I was... I just didn't think she could get the fund started. And I, I, I was, I was overly negative, although it was really hard for her to get it funding. When Leah: was this? How, like how long [00:07:10] Joanna Strober: ago? I'm trying to think about when that was. Um- Yeah ... that would've been, like, early 2000... No, mid-2000s. 2008. Wow. Leah: So this is, like, [00:07:20] 20 years ago. Joanna Strober: But when I was- Yeah ... doing venture direct investing, I actually went to go look. I don't think that we funded one [00:07:30] female investor in the seven years that... S- sorry, female entrepreneur. I do not think we funded one female entrepreneur in the seven years that I was there. [00:07:40] And, um, so I... And you know, honestly, I think about you and my vision of you. You were so freaking brave when you started your company. Oh, God. We didn't have

[00:07:50] models. Or insane. No, brave. Yeah. Brave. Uh, we didn't have models. We really didn't. And so who w- people who had the money- Leah: Mm-hmm ... Joanna Strober: [00:08:00] were investing in things they understood, right? And so that was very much the understanding. If you understood a certain thing, you would go fund that thing. Um, and, and the [00:08:10] people who had the money were men, and they were f- in funding things that were designed for men or designed for the, what they wanted to use, right? And, and so I do think what I've learned more than anything [00:08:20] is that the people who control the capital are really making the determination on who gets funded and what gets funded. And so that's just a reality of, of... [00:08:30] It's, it, that's just a reality. So- Leah: Yeah ... Joanna Strober: understanding that is actually very helpful, and it's understanding also the motivations of people to understand when you're talking to an investor. You know, [00:08:40] their job is to make investments. They need to understand what you're doing. They need to understand why it's gonna be a big company. And so I think if you understand them, it actually, it helps a lot. Leah: Well, [00:08:50] you said something there too that I think is very nuanced but so interesting, and it's, you know, something I'm living right now too as I raise my own fund, which is, you [00:09:00] know, it's not just the investors, the people that are deploying the capital into founders here that, you know, are, um, you know, are, are, [00:09:10] have the power, that are making the decisions, right? It's about who actually is running those funds, and are they getting funded- Right ... by limited partners? And I'm curious, when you were [00:09:20] in venture and you were deploying capital, direct investing, did you, did you feel any pressure or opportunity even from LPs? [00:09:30] Um, or like how was that relationship with your LP base maybe influential to what you ended up investing in as an investor? Joanna Strober: [00:09:40] You know, I was never senior enough to in, to interact with the LPs. Leah: Mm-hmm. Joanna Strober: So that wasn't part of my- Yep ... that wasn't part of my world, the interaction- Right, right ... with the LPs. That was very- Yeah ... [00:09:50] closely protected- Leah: Yeah ... Joanna Strober: property. Leah: Yeah. Right. Right. So it was kinda like this black box, and you were just kind of executing, right, the playbook that- Right you're given [00:10:00] and trying to build a career, right? And as you're trying to build a career, it's like, you know, you make the decisions that you think are best at the time. Right. So fascinating. Joanna Strober: Yeah. Leah: Well, you've had a lot of different [00:10:10] careers, so not just venture, not just as a founder. Um, you describe your path as five different careers. I mean, most people are told to pick one lane, right, and stick with it, [00:10:20] but when did you decide that rule didn't

apply to you, and what gave you sort of the confidence and courage to kinda move around? You talked a little bit about your, your parents [00:10:30] influencing you in that way, but was there something, you know, that, that clicked that made you able to explore and have that curiosity?[00:10:40] Joanna Strober: Maybe I'm just very impatient. I, I think that's part of it. Honestly, when I was, uh... When I started Curbo, which my last company, I, I really felt like [00:10:50] I uniquely had something to offer that very other few people did, which is I understood I was living in Silicon Valley. I understood that the mobile was [00:11:00] changing how people are gonna behave, was going to change how people dieted and how people had behavior change, and that no one was targeting children. And [00:11:10] I had a child who needed something like this, and I felt like I have a unique opportunity to start this company. Because I understand venture capital and I understand [00:11:20] technology, I felt like I just uniquely could start something that would, um, be able to get funded and that I could, I could scale. And, and so that was really why [00:11:30] I left my job to go do that. It was, uh... That was very much a jump of a leap of faith, but, uh, it just felt like that was the right thing to do. Leah: And you had a, [00:11:40] again, a unique perspective you felt like you could share. So you built Curbo, you sold it to Weight Watchers. Right. And while you were there, you designed a whole [00:11:50] national medical practice. And Weight Watchers, what did they say? They said, "No, it's too risky. We don't wanna move forward on this." Can you walk me through that story, and what that was, and, and [00:12:00] how that turned into Midi? Joanna Strober: So I was, um, very fortunate when I was working at Weight Watchers. They had an incredible medical advisory commission, and that medical [00:12:10] advisory group was among with obesity experts from around the world. And they would come together to have meetings, and I got to attend those. And what I heard was that they were all [00:12:20] consulting for weight loss medication companies. And so they were talking about the weight loss medication companies and what a big impact those medications were going to have [00:12:30] on weight. And so what... I got very excited about this, and I said, "We need to do something in this area," and I started working on it. I started meeting with the weight loss companies. I [00:12:40] started learning how we could ship medications to people's homes, started learning about all the different things that were gonna come. This was, um, in nine- in [00:12:50] 2019. And, um- There was a lot of hesitation and skepticism there, but rightfully so because this weight, Weight Watchers had built [00:13:00] 60 years of experience as a behavior change company. What do you do as a behavior change company when all of a sudden maybe behavior isn't important anymore, and the only thing that's important is [00:13:10] the medication? So I put together a program, and, uh, it got to the very senior levels, and someone at a meeting said, "But you're gonna turn us into pill pushers. We can't be [00:13:20] pill pushers." And, um, but what was exciting to me is it was very clear to me the world was changing. And so it w- I decided I wanted to go look at that [00:13:30] as a opportunity. Leah: Amazing. So let, let's talk about Midi because what did you see specifically in perimenopause and menopause care that the entire [00:13:40] system was walking right past? I mean, this is really the first company that has focused here directly, provided, you know, [00:13:50] direct-to-consumer care. So walk us through the Midi story. I got to hear a little bit about it last week at Inc., but I, I'd love to hear it again. Joanna Strober: So for me, perimenopause [00:14:00] was a rough journey. I experienced all the symptoms. I had, you know, the hot flashes and the night sweats, and, but also I wasn't sleeping very well, and I had anxiety, [00:14:10] and I gained weight, all the things. And I learned that the primary care system as we have it is not set up to deal with this. Mm-hmm. So I went to a primary care doctor, and the [00:14:20] primary care doctor said, "Well, we can give you sleeping pills. We can give you, um, to help you sleep. You can also get a sleep study. Maybe you have sleep apnea." They also said, "You [00:14:30] know, you're, you might be ex- experiencing depression. Let's put you on an SSRI, an antidepressant medication." Um, and they sent me to get therapy. Uh, it, I did not [00:14:40] like the antidepressant. It didn't do anything for me. I had no sleep apnea. I... So, so these symptoms went on. Eventually, someone introduced me to a [00:14:50] concierge doctor, and I drove to San Francisco. I paid a lot of money to see this doctor, and I got the right medications, and within two weeks, my life had [00:15:00] changed. And it was so incredible to have this experience that I was all of a sudden sleeping, and I was less anxious, and all these things got better so fast. And so for [00:15:10] me, it was very interesting to have that experience and realize that it was, it just took too long, number one, and also it should not be covered. It needed to be covered by insurance. It couldn't be a concierge thing [00:15:20] that people had to experience. So I started thinking about that, but it wasn't until COVID that I realized you could start a company around this because prior to [00:15:30] COVID, you couldn't start a company because it couldn't be done on telehealth, right? So he- healthcare is so fragmented, and everyone goes to in-person care, and that's the only way [00:15:40] historically you could get care. Leah: Mm-hmm. What Joanna Strober: COVID unlocked was the ability to basically take the best doctor's office in the world, right, the best providers, and [00:15:50] say, "Everyone can get access to this level of care virtually

covered by insurance." That wasn't possible before. So that's what we decided to do with Midi, is [00:16:00] say, "Here is the best menopause women's health experts in the world. We're gonna work with cardiologists, endocrinologists, [00:16:10] OBGYNs, primary care physicians. We're gonna work with all of them, create fantastic care protocols, and then offer that nationally covered by insurance."[00:16:20] And before COVID, you couldn't have done that. So that's really our innovation is to be able to say, using technology, now you can really scale access to great [00:16:30] care in a way that you couldn't before. And what's exciting to me is that, you know, you shouldn't be limited where you live, whether you get great care. Leah: Right. [00:16:40] Right. I mean, yeah, you're really making it accessible. You're democratizing access. I mean, these are such important things, particularly for a population that makes up more than [00:16:50] half of this country, right? Yeah. And globally around the world. You, I know you didn't start with a deck. You started with a pilot. Can you talk a little bit about this pilot? You recruited 100 [00:17:00] women. You gave them six months of free care just to learn what they- Right ... wanted. How important was that? Joanna Strober: I think that was key. So- Mm-hmm ... we've recruited them just on Facebook, and we said, [00:17:10] "We'll take care of you and in ex- for free, and in exchange, we want you to give us feedback on how we're interacting with you. How are we treating you? How are you, how are we [00:17:20] making you feel? What are the things that are important to you in your care?" And we learned so much in this pilot. So for example, when we first designed it, we thought they [00:17:30] were either gonna be people who wanted hormones or people who wanted supplements. So we asked you to choose a path. We said, "You wanna have a supplement path, or do you wanna have a hormone path?" Turned out everyone wanted both. [00:17:40] So we had to change our system, right? We had to make sure that we were gonna talk to everyone about what supplements you were gonna take and what hormones you were gonna take. We learned that [00:17:50] everyone was hormone curious. Everyone wanted to learn about the hormones. They wanted a discussion about what worked, but also what their other options were. They wanted to understand their own personal [00:18:00] risks. So we've learned all of that. A- and then, uh, we also started learning that you needed to take care of people's weight, that honestly, women in midlife gain [00:18:10] weight. They didn't wanna have a separate weight visit and a separate hormone visit. Instead, it was all one thing. So the learning in this was, was incredibly valuable, and then we went back, and [00:18:20] we're like, "Okay, we're done. We're gonna go work on this." And all of the patients freaked out. They were like, "No, no, no." They were like, "You can't go away. We have no place else to go to

get this care." And [00:18:30] so that's really when we knew we had something special. Leah: That's amazing. And you insisted, you know, pretty much from day one, that there was insurance coverage. You've talked a little bit about this already. Why [00:18:40] was that so important for you to get right from the beginning? Joanna Strober: I mean, we have a real mission at this company to give all women access to great care. [00:18:50] That is our mission, and you can't do that if you only charge cash pay. It's just there is not a model that enables you to do that. One of the things I am most proud of about this company [00:19:00] is that we do have a lot of the most powerful women in the country as our patients. We have a lot of factory workers, a lot of factory workers. We have a [00:19:10] lot of people who are taking the call from a closet at work. They're taking it from the carpool lane. They're taking it, you know, from wherever they are working during the day, and we're able to [00:19:20] give them access to great care, and everyone gets the same care. So I'm, I'm very proud of the fact that we've been able to give such a diverse population access to high-quality care. Leah: [00:19:30] Yeah. Yeah. Well, I mean, I think so many women at this point in life, and like I'm one of them, right? We think we're going crazy- Yeah ... until we finally find someone [00:19:40] that can help, that understands, that, you know, is, is open to hearing and listening, right? Right. About the issues that we're experiencing. So I mean, [00:19:50] how does it feel to be running a company that says, "You're not crazy. I see you." Yeah. "I hear you." Joanna Strober: That's our value. It's amazing. That's exactly right. Yeah. That's the value. And the system isn't [00:20:00] set up for this, right? And it's actually interesting. Even the physical, the physical system, the act of going to an office, taking off your clothes, sitting on a [00:20:10] table, doesn't really prompt a good conversation with the provider. It is a very transactional approach when you get into that office [00:20:20] because you don't really wanna say, "Well, I've been crying a lot, and you know, I'm feeling angry, and I haven't had sex for six months." Like, those are not the [00:20:30] natural thing you want to discuss on sitting in that office. So actually, the technology that you and I are using right now is so much better for this, right? It's actually much easier to have a [00:20:40] conversation, and an open and honest conversation, like this, than it is in a doctor's office. Leah: Yeah. Yeah, absolutely. Well, in February, you crossed [00:20:50] a billion dollars, billion with a B. This is the first menopause company ever to do it, and you're caring for thousands of women a week. When you scale [00:21:00] that fast, though, how do you scale trust at the same time? And I, and I felt this pressure too with TaskRabbit in building trust, and particularly when you're dealing with [00:21:10] patients, patient care, medicines. Can you talk a little bit about that? Joanna Strober: Yeah. So I'll give you an example of a mistake that we made. So last Christmas came, [00:21:20] and, um, we wanted to give a lot of our providers a day off, or a whole week off, actually. They wanna be with their moms, right? I have fabulous providers. They just... Sorry, they wanna be with their children. We wanted to give them [00:21:30] all time off, and we thought, "Okay, a lot of the women, our patients, are gonna be with their families. They are gonna need... They're not gonna be coming to us." But we had [00:21:40] a whole storm of all these women who were relaxing themselves and then of course wanted to take care of themselves, and we weren't there for them [00:21:50] And, um, we got w- significantly backlogged in terms of responding to their emails and responding to their requests, and we really [00:22:00] got... We, we betrayed the trust of a lot of those people. It was a very good learning experience for me, at we need to actually staff up on vacation times, not staff [00:22:10] down on vacation times, because our patients are gonna need us more when they have time to think about themselves. So it is a constant [00:22:20] challenge for us. I need to make sure that every one of my patients receives excellent care, and that is a lot. It's a big responsibility. And so we spend a lot of time [00:22:30] using AI, actually, to track outcomes, to track the high-quality care, to make sure that we're doing the care that we are providing that is excellent, to make sure that we are maintaining that excellent [00:22:40] quality. Um, and we're using technology a lot for that, but it's, it's because it's so important to us. My brand, the thing that I stand for, is expert [00:22:50] care, and that we need all women to get access to this expert care and expertise, so we can't betray that brand. And, and that's really, as long as that's my North Star, I feel like [00:23:00] that's mostly, we mostly succeed. Leah: I love your take on AI. Um, we talked a little bit about it last week with Mike at Inc. [00:23:10] And, um, can you talk a little bit about your philosophy about utilizing AI as part of your tech stack and your system, um, and maybe, [00:23:20] you know, some of the, the philosophies and learnings you've had there? Joanna Strober: So fundamentally, we are a care company, and we don't believe that the need for p- people is [00:23:30] going away. So I'm gonna, like, put my stake in the ground there. I don't believe that your care is gonna be delivered by AI. That said, AI is [00:23:40] amazing in healthcare. It is making our platform significantly more effe- efficient. It's enabling us to automate a lot of tasks that are, um, better [00:23:50] done by AI than by humans. You know, things like pre-authorization forms or other, other forms. Um, it's also enabling us to m- have significantly [00:24:00] better clinicians. So I feel really good about the care

we're able to give because we are building our own AI to enable our clinicians to be [00:24:10] superhuman and to deliver better care. So what I actually really think is gonna happen over time is that specialty care and primary care is gonna collapse. Um, [00:24:20] most care can be done by one person supplemented by AI. And then when you need in-person care, you'll get a referral there. So absolutely, [00:24:30] if someone needs in-person care, we will always get them there. But I believe our clinicians will be able to do more and more over time using technology, and that is actually very exciting to me. [00:24:40] So We have an endocrinologist on staff, actually more than one. She will make right bone health protocols, right? We will send you to get a [00:24:50] DEXA scan. We'll send you to get some blood tests. We'll be able to give you the initial feedback on what, what we can do for your osteopenia or osteoporosis. If you need a specialist, we'll send you [00:25:00] there. But we can do that first lay- layer of care. And we're really seeing that with a lot of different areas. With thyroid care, with migraine care. There's a lot of basic care that we can do, and then we'll send you to [00:25:10] specialists when appropriate. Leah: Yep, yep. Yeah, I mean, it is really exciting. I, I, I think it was you who used the word, you were kind of like supercharging these roles with AI. [00:25:20] Yes. And I was like, "That, that's so true." Like, people are able to be supercharged with the expertise that they have. You keep the human in the loop. Right. Exactly. You keep the human there. That's right. Yeah. [00:25:30] Yes. It's awesome. Joanna Strober: Yeah. Leah: You're doing all of this in your 50s with sort of this culturally obsessed, right, like 22-year-old founder.[00:25:40] I mean, make the case to me. Do you feel like this has really given you an edge to start this company at this stage in your life? Joanna Strober: I [00:25:50] absolutely think it's an edge. Uh, you know, first of all, I am, I am our clau- I am our audience. I care deeply about this audience, and I am not doing this as a theoretical problem. [00:26:00] It's my friends. It's, it's the people that I'm engaging with every day. So I, I think it's actually very helpful to me, living and breathing this problem every day. And, um, honestly, I [00:26:10] think being in my 50s is a superpower. So my kids are gone, and I have so much time and energy to dedicate. So it's actually, it's a great time to start a [00:26:20] company because you have really int- intellectual freedom and you have, you know, time on your hands and, uh, and a lot of experience that I think has been helpful to me.[00:26:30] Leah: It's incredible. I'm curious, as you were building out your board, raising money, building the team. I mean, you're building a company that no one had ever [00:26:40] built before, and we talked a little bit about, right, the funding dynamics, particularly for women. This is a women's health company, obviously. Was there [00:26:50] anything that was really hard for you as a founder, as you were building out that board, the investor group, the team, et cetera? Joanna Strober: I mean, everything is, is [00:27:00] hard. Leah: Yeah. Joanna Strober: So- I feel you. Right? Yeah. I think everything about this is hard. I mean- Yeah ... but, but that's what makes it worthwhile and interesting also. So I would say [00:27:10] that, you know, what we've had to do is convince people for a long time that this was a business, that it was a, could be a business, that it was a big opportunity to serve this population, and that we could [00:27:20] write it and create a big business. By, by doing that. And, um, you know, along the way, we had more proof points. So every time we, we [00:27:30] would create more and more proof points, and then would show to other people that, yes, this could be big. Yes, you know, they're, we're solving a problem that people really want. Yes, it can be a good business. [00:27:40] So it's really very much an iterative process, and what I really tried to do is never take it personally when people said no, because that's just a waste of time. I, I think the [00:27:50] most, uh, the p- the relationships that I built in the fundraising process, it's always just a not now - Yeah ... uh, instead of a no. Right, right. And, um, [00:28:00] that's actually very helpful to me, to think of it like that. And you know, if you don't wanna invest right now, that's great. I'll go find someone else who does, and we'll stay in touch. And that has been actually a very effective strategy for me, [00:28:10] because a lot of people who invested later did turn me down earlier times. Leah: Really? Yeah. That is interesting. That is interesting. So they came back around after es- they saw the data, the [00:28:20] traction, et cetera. Joanna Strober: That's right. Sometimes Leah: two or three times. Yeah. Wow, wow. You, well, you understand the game, because you've been there. I think that's such, um, that's such a [00:28:30] value add too, 'cause you have that perspective not to take it personally. Right. Makes a lot of sense. Yeah. You've already changed what midlife care looks like today, and I kinda [00:28:40] wanna spend, like, this last stretch looking at a bigger picture. Because, you know, I said to you last week when I saw you, the thing that I'm excited about [00:28:50] is how you're really breaking this massive precedent around medicine, which has really been built for men for decades- Yeah ... like since the beginning of [00:29:00] time, right? Like, most people don't realize most of modern medicine , the default patient is a man, right? Right. And, and, like, even when you go [00:29:10] into, you know, an OBGYN clinic, like, uh, men have been creating these protocols, right? And, and these trials. So women have been [00:29:20] left out of clinical trials- Yeah ... for decades, and so much of the standard of care has not been

based or personalized on our bodies. So [00:29:30] what you're doing with Midi is so incredibly game-changing. When did it really hit you that, that you were contributing in this, this massive, [00:29:40] you know, precedent-setting way? This is a massive shift for the entire industry. Joanna Strober: I hope so. You know, I think it is, hon. I, I, what [00:29:50] I'm seeing is I started walking around Los Altos, which is where I live, and women would come up to me and hug me and say, "You changed my life." And, [00:30:00] um, and then I would go to a party and, uh, a guy would come and say, you know, "You saved my marriage." Uh, and so it was really the feedback more from patients more than anything [00:30:10] else of people responding. And then it's really the getting back to seen and heard. I think women have been very used to being dismissed, and so they felt [00:30:20] like the medical system didn't take their concerns seriously, and it didn't. So what we really started hearing from patients more than anything else is, "Thank you for listening to me. Thank you for paying [00:30:30] attention to my symptoms. Thank you for helping me understand that this is normal and I can feel better." And so a lot of it is just listening to the women and really responding to what they are [00:30:40] telling us and, and, and their needs, and then making sure that we're respon- you know, that we're treating them appropriately Leah: And you have all this real world longitudinal [00:30:50] data, right? Right. On how women's bodies are actually responding to these protocols and to these medicines. You can offer more personalized in- [00:31:00] individual care as well. Is there anything, I'm curious, that you're seeing in the data yet that you feel like maybe just has never even been looked at before? [00:31:10] Joanna Strober: So one thing that I think a lot about is bone health. Um, you- very, the, the standard of care is that women don't get something called a DEXA scan until 65, and [00:31:20] that is significantly late. You do not want to wait until 65 to find out your bone health, because if you take hormone replacement therapy, it strengthens your bones and it keeps [00:31:30] them from deteriorating. So you wanna find out in your 40s what your bone health is, and then start tracking that to see how it's doing, and then be [00:31:40] proactive in taking care of your bones instead of waiting. Um, and so that's, that's just one area that is so important. If you think about older ladies and how they're crippled [00:31:50] down, we don't wanna be like that, so we need to take care of our bones early, and that has not been done. Like, the, the fact that the standard of care is 65, that's so late. You c- [00:32:00] there's not enough time to be proactive. Leah: Wow. And so- And, and there are things that we can do to intervene- Absolutely. Joanna Strober: Yeah ... Leah: is what you're saying. Okay. Joanna Strober: Absolutely. Yeah. Yes. That's Leah: right. Because you're right. You kind of look at, [00:32:10] you know, an older, older population, and you just assume like, "Oh, I guess that's where I'm going- Yeah, no, there are- the next 20 years." Joanna Strober: There are absolutely things that you can do when you're, um, [00:32:20] younger, in your 40s, that will make a huge impact on your bones later. Leah: Okay. I'm writing down, "Get a DEXA scan- Yeah. Yeah ... next week." Yeah. Joanna Strober: Yeah. [00:32:30] Leah: Great. Okay. Um, so if the last century of medicine was built on the male body as a default, what do you think the next century [00:32:40] could possibly look like if we finally incorporate all of this data around women and women's health? Joanna Strober: So in general, medicine [00:32:50] is gonna become significantly more personalized. I m- right? It's gonna be personalized by gender. It's gonna be personalized by your genetics. It's gonna be personalized in a way it was not before, and that is really [00:33:00] exciting. And so the opportunity to, to make sure that all women get access to great personalized care is going, it is going to happen. We're gonna be able to [00:33:10] look at data from wearables, and, and from your genetics, and from your f- just understanding your family history and understanding how you are, and personalize treatments for you. And, and I think [00:33:20] that's gonna be, it's gonna really change th- a lot of women's healthcare. Leah: It's so exciting. It really is exciting. Joanna Strober: It is exciting. Leah: If you were to wave a magic wand to [00:33:30] 2050, a girl born this year reaches midlife, if you've done your job, what's gone from her experience, do you think? [00:33:40] Joanna Strober: Such a fun question. So historically, women really have been told to suffer through. That really [00:33:50] has been the, the standard of care. I actually, I had breakfast this morning with someone who went to her postpartum visit, and it was a [00:34:00] six-week visit, and the woman, the OBGYN said, "When are you gonna have another baby?" She said, "Two years." Um, and she said, "Okay, I'll see you in two years." [00:34:10] It was a five-minute visit. Um, this woman is suffering from anxiety. Her hair is falling out. She has a lot of concerns about her life. I want her to immediately start [00:34:20] getting personalized care so that she doesn't start dreading thinking about her aging experience. I don't think you need to dread thinking about your aging experience. There are so many things [00:34:30] already that we can do to help you stay stronger, stay more alert, be able to perform extremely well, and I think that is, that is gonna continue, and I'm, [00:34:40] I'm very excited about that. Leah: I mean, that is really exciting. Do you see opportunities to expand? I mean, I'm just thinking, like, as women are [00:34:50] maybe waiting to have children. I mean, I've been through the IVF process as well. Yeah. Are there opportunities to kind of expand

and broaden where Midi is [00:35:00] working right now, or how do you think about that? Joanna Strober: So what's fun right now is we already have women who are coming to us and then sending their daughters to us and sending their mothers to us. So the, um, [00:35:10] the opportunity to be the platform for women's health is really where we're going, and, and I believe that we, women deserve specialized care, and we will be there for you. We'll be there for you [00:35:20] if you wanna talk about what birth control you're taking or your menstrual migraines in your 20s. We'll be there for you for your postpartum care in your 30s when you, again, when your hair starts falling [00:35:30] out and you wonder if you're ever gonna have sex again. Uh, the, uh, you know, we'll be there for you in your 40s with your s- skin care changing and your hair. There's a lot of issues that are [00:35:40] all related to your hormones, and so our job is to be that partner in healthcare for women, and I think that's, that's the exciting thing that we're gonna be building out. Leah: Yeah, I mean, you've [00:35:50] really focused in on this midlife, you know, patient care network, and, and it's a completely underestimated, overlooked data set in all of [00:36:00] healthcare. But I think it is really exciting to think like, wow, that's your wedge, and you're able then to offer and broaden- Right ... the scope of practice beyond that. [00:36:10] Yeah. What, as you think about kind of, um, you know, the precedent that you are setting at Midi Health, you know, for all of medicine, for this medical [00:36:20] industry, what do you think is something that you're doing that you feel like everyone else is gonna have to follow this? This is the new precedent we're setting, and everyone else will have to [00:36:30] just fall in line. Joanna Strober: So honestly, telehealth should continue to expand quite significantly. For most care, there is no reason to go to an [00:36:40] in-person visit. There really isn't. And I think that we have been very constrained in our thinking by the box of an in-person care. So I believe that [00:36:50] What telehealth is going to enable is access to great care wherever you are, and there's going to be specialists online, and there's going to be primary care [00:37:00] online, and you're gonna be able to get great care remotely from your house without having to go in person. It's much more efficient, and you're gonna get access to great care. I actually s- [00:37:10] it's so funny because someone was telling me the other day, like, the one doctor in their office is never gonna have access to the amount of resources that we can give our provider, right? Like, the [00:37:20] amount of data that we have on the 400,000 patients that we've taken care of on what works and what doesn't work, and all the protocol work that goes into developing this. You really are gonna [00:37:30] want a superhuman clinician taking care of you who has access to all of this information. That's gonna be done online. O- obviously, lots of care is still gonna be in person. You're [00:37:40] not gonna be, you know, operated on online. There are also, you know, there's lots of things that are gonna require in-person care. But I think that a lot of care will go r- virtual, telehealth, and then [00:37:50] they'll be in person when it's necessary. And I think that's actually a very exciting future 'cause many more people will get access to great care. Leah: Yeah. Yeah. It is incredibly exciting, [00:38:00] and you have done so much work already in this space, and it's just, I mean, it's so inspiring to hear how much more that you wanna build. I feel [00:38:10] like you're just at the beginning. Does it feel like you're at the beginning to you? Or give me a sense of, like, what's next? What's kind of the next big milestone that you're looking ahead to? Joanna Strober: You know, we wanna [00:38:20] take care of millions of women. There's a huge market, and there's, it's hugely underserved. By most reco- by most of our calculations, 50% of the patients [00:38:30] coming to us don't even have a primary care doctor. So there's not enough, uh, primary care. There's not enough specialists. There's a huge lack of care, and we wanna really f- be able to fill that, the, [00:38:40] the big care gaps that exist in our country, and that's very exciting to me. Leah: Cool. Joanna, thank you so much for joining me. This was such an amazing conversation, so inspiring, and [00:38:50] it's really, for me, particularly as a female founder, it's very inspiring to see what you have built, the success that you've had. You are, you're paving the way [00:39:00] in a way, um, that goes far beyond what you're doing at Midi. You're paving the way for, for other, other female founders across the space as well, so thank you for that. Joanna Strober: Okay, Leah, you [00:39:10] did that for me- ... many years ago, just to say it. I mean, I still think about reading about you and going- Oh, God ... "Wow, she's amazing." And at the time, I didn't actually have [00:39:20] that level of courage that you did. So I- Mm ... I think you inspired a lot of people with what you did. Leah: Well, that's very sweet. I am so excited we get to connect now- Yeah ... at this stage of [00:39:30] our lives and, and collaborate in this way. So thank you again. Joanna Strober: Yeah. Leah: That was Joanna Strober, a founder who didn't just build a company. She challenged the assumption [00:39:40] that half the population's health wasn't worth studying in the first place. From the venture side of the table to her own dismissed doctor's appointments, [00:39:50] Joanna's story is really about one thing: refusing to accept being overlooked as the natural order of things. She reminds us that some of the most [00:40:00] precedent-breaking ideas start as the questions nobody in power bothered to ask. Why has so much of medicine been built around the male body? Who [00:40:10] decided menopause wasn't worth treating? And what becomes possible when women's care is finally built on her own data? If you know someone who's rewriting the rules in [00:40:20] their own industry, I wanna hear their story. You can reach out to me on my website, breakingprecedent.com. Until next time, I'm Leah Solomon.