Grateful for an Incredible Chapter!
After an incredible four years at Teladoc (via Livongo) I’ve decided to seek my next adventure!
This has been a journey of a lifetime — I joined Livongo Health as the Chief Data Scientist while it was still a late-stage startup; got to be part of an IPO that showed digital health was coming of age; and a year later a merger that defined the entire industry. This was was followed by 2 years as the CDS across all products and services helping integrate multiple acquisitions. Teladoc serves over 80 million consumers in 30 countries, in telemedicine, primary care, chronic conditions, and mental health, and is the global leader in digital and virtual care.
The word that embodies the last 4 years is grateful. Thank you to Teladoc leaders Jason Gorevich, Mala Murthy, Claus Jensen and so many others for the opportunity to work on important healthcare problems. Also I would be remiss to not thank Glen Tullman, Jenny Schneider, and the incredible Livongo team for the exciting path that led me here.
I cherish my team — we grew from a handful to 180+ in this period — so many of whom are seasoned leaders helping Teladoc scale today. The impact we collectively had on our product, member experience, marketing, clinical operations, client experience, data fabric & platforms, AI research and important social issues like health equity, is to be celebrated.
Few Insights and Learnings
As I took December to unwind, it gave me a few moments to jot down a a few lessons.
1. Scale requires a different mindset
Growth on a $2B ARR denominator, at say 25%, is adding $500M in new revenue, increasing every year. Learning how healthcare companies approach multi-B$ revenue scale at this stage was an invaluable lesson for me. Given the discontinuities and payment model complexity of the US healthcare system works, scaling revenue at this rate is non-trivial, and isn’t as straightforward as product-led growth at many SaaS and consumer-tech companies.
2. You have to get good at rebuilding the plane, while it’s airborne.
Core problems are the bread-and-butter of the business. Teladoc hit over 50M visits in 2022, and has over 12000 clients and 10,000 providers. Core areas include consumer app and experience, client backend systems, clinical operations, and so on. All of these require collaboration between product managers, engineers, data scientists and AI experts. For these problems, there is no world where we hit pause to make improvements. Not only does this add an order of complexity on how you build systems and components, but it also radically changes how product and AI teams make strategic decisions and validate new ideas.
3. People leadership as an art-form and science, evolves when leading teams in the hundreds.
If you’ve done a good job attracting talent, your teams are now chock-full of driven, ambitious, technically capable people. The challenging part then, is getting people to work effectively and cross-functionally — as one team with a common set of goals, while responding to a constantly changing external and internal environment. This topic can go deep, and deserves it’s own future post.
4. 2023 has a new playbook for midsize/large companies
This is totally not news— but worth reinforcing. For later-stage or public companies, 2023 is an incredible opportunity to get ahead of their competitors, by focusing on core products and margin efficiencies. I’m excited for what the Teladoc team will deliver this year!
Looking into the Future
A lot has changed in four years— digital health is accepted as a part of healthcare; AI, ML deep learning, large language models have made incredible strides; and B2B2C business models have been proven out.
But some things remain the same. Access, quality and health equity remain important challenges across healthcare; physician and nurse burnout after a multi-year pandemic is at an all time high; and digital health is entering it’s teenage years, where clinical efficacy and value-based care are critical.
I’m eager to listen and learn from founders, VCs, and companies at the intersection of these trends.
(You can also reach me at firstname.lastname@gmail.com)
